Hot Tub Rash – How to Avoid and Treat that Little (okay, BIG) Itch

by Matt Giovanisci of Swim University

If you or someone you know has tiny red bumps on the skin around hair follicles shortly after using a hot tub, you or they might have a bacterial infection called: folliculitis. It’s caused by the bacterial strain, pseudomonas aeruginosa – good luck trying to pronounce it. It’s most commonly found in untreated water.

I asked Dr. Christine Cassel – Chief Dermatologist at Brownstone Dermatology Associates – why this bacteria infects hot tub users more often than people swimming in pools, lakes or oceans. “This bacteria is in many forms of water, even hospitals are concerned about Pseudomonas infection – which is why the ICU and Oncology wards won’t let flowers into them.” Cassel also said, “You could get it elsewhere but the heat opens the pores/follicles and hot tubs are the big culprit. “

This infection is sometimes referred to as, hot tub folliculitis, or more commonly, hot tub rash.

You’ll notice it start to develop when you see uniform papules and pustules, with a hair follicle in the center – usually located on the buttocks. The rash will start to appear 24-72 hours post hot tub exposure, and is itchy. The rash may be worse in the areas where your bathing suit was in contact with your skin.

The good news about hot tub rash is it’s not serious or life-threatening.

What to do if You See Signs of Hot Tub Rash

Hot tub rash can usually resolve without therapy. It’s best to wash with antibacterial soap (lever 2000) to relieve the itching.

I also interviewed board-certified dermatologist and media spokesperson for the American Academy of Dermatology Dr. Debra Jaliman M.D. who suggested using white vinegar mixed half with cool water and make compresses to use on the infected area(s).

“Apply these compresses for 15 minutes twice a day. If this doesn’t work you can use a topical hydrocortisone preparation for the itching. If the itching doesn’t respond to these measures you may need to see a dermatologist and antibiotics by mouth will be prescribed. The most common antibiotic used is ciprofloxacin. “ says Dr. Jailman.

How do you Avoid Hot Tub Rash?

Taking care of your hot tub is extremely important in the fight again hot tub rash. The only way to avoid this rash is to soak in a hot tub that has the proper chlorine or bromine levels and water balance, including a pH level of 7.4 to 7.6 and an alkalinity level of 100 to 150 ppm (parts per million) to keep your chlorine or bromine levels in check.

The bottom line is, make sure you hot tub is properly treated before you or anyone else decides to soak in it. You should always have a safe level of sanitizer in your water.

Also, make certain that you take off your bathing suit and shower right after going into a hot tub.

If you have any further medical questions, I would suggest you consult your dermatologist.

You can find out more information about hot tub rash and taking care of your hot tub water by visiting Swim University’s hot tub care page.

Happy Swimming!

is the creator of Swim University and Pool Business Marketing with over 15 years of experience in the swimming pool and hot tub industry. He is also an award winning web designer and has been featured on Martha Stewart Radio as a pool & spa expert.


About Shelly

Shelly Johnson is the Marketing Manager for FILBUR Manufacturing – producer of pool and spa cartridges and D.E. grids and top supplier to spa manufacturers. Shelly has been in the water filtration business for over 20 years and has been a contributor to AQUA Magazine.