What It Means If Hot Tubs Give You A Rash

Photographed by Rockie Nolan.
When you emerge from a hot tub after a soak, the only thing you want to feel is relaxed and maybe a little bit pruny from the warm water. But sometimes, you might notice a bunch of bumpy spots underneath your bathing suit, that become itchy and pus-filled over time — and that sight can undo any relaxing that you did in the tub.
There's a good chance that this type of irritation is "hot tub folliculitis," aka hot tub rash. Folliculitis is a skin condition that occurs when bacteria or fungus get into damaged hair follicles, causing the whole follicle to become inflamed, according to the Mayo Clinic. And if you're sitting submerged in a hot tub that hasn't been properly cleaned, you may contract folliculitis.
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While this might gross you out a little bit, hot tub folliculitis probably won't ruin your vacation. (That said, if you get hot tub folliculitis, you should talk to the pool operator to check the pH and disinfectant levels to make sure they're keeping the area safe and clean.) Ahead of peak pool season, here's what you need to know about this icky but preventable summer skin condition:

What is hot tub folliculitis?

When you're in a hot tub that hasn't been properly maintained, a germ called "Pseudomonas aeruginosa" can creep into hair follicles and lead to a rash, explains Meghan Feely, MD, FAAD a board-certified dermatologist and clinical instructor at Mount Sinai’s Department of Dermatology. Technically you can contract this from any body of water that you're in for a long period of time, such as pools, water parks, or lakes, she adds. But since hot tubs have warmer water, chlorine breaks down faster, meaning bacteria can really thrive, according to the Centers for Disease Control (CDC). Hence why it's often associated with hot tub use.

What does hot tub folliculitis look like?

The telltale sign of hot tub folliculitis is red bumps that resemble acne around your bathing suit area, Dr. Feely says. These spots usually appear a 12-48 hours after you've been in a hot tub, and they may itch or become pus-y over time, according to the American Academy of Dermatology (AAD).

How do you get rid of hot tub folliculitis?

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It's a good idea to see a board-certified dermatologist who can diagnose the condition or rule out anything more serious, Dr. Feely says. They might prescribe a topical treatment, such as silver sulfadiazine cream, she says. (In some cases, you might also need to take an oral antibiotic to systemically treat the infection, she says.) "Your dermatologist will also advise taking a break from shaving in active areas of folliculitis, as this will cause irritation," she says. Using a warm compresses on the rash can help to ease some of the discomfort or itch, she adds.

How long does it take for hot tub folliculitis to go away?

Most of the time, the rash will go away on its own after a few days, according to the CDC. But if it lingers any longer than that, you should definitely get to a doctor.

Can I go in a hot tub with folliculitis?

It's a good idea to wait until the infection has healed to get back into the hot tub, because while folliculitis itself is not contagious, there's a chance that you could be re-infected. The AAD suggests washing your bathing suit after you use the pool or hot tub, in order to prevent bacteria exposure. Opting for looser-fitting clothes over tight ones that could irritate your skin further is also a good idea. So, permission to go shop for new vacation clothes? We think so.
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