Infections - Bacterial & Viral
Hot Tub Folliculitis
Pseudomonas folliculitis
Common after hot tub or pool exposure
No — it comes from contaminated water
Yes — usually clears on its own
What Is It?
Hot tub folliculitis is an itchy, bumpy rash that appears 1–3 days after using a hot tub or pool that wasn't properly cleaned. It's caused by bacteria in the water infecting the hair follicles. The rash is often worse under areas covered by a swimsuit and usually clears on its own within a week or two.
Signs & Symptoms
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Itchy red bumps or pus-filled spots
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Appears 1–3 days after hot tub or pool use
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Often worse under swimsuit-covered skin
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May have tender lumps in some areas
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Sometimes mild fever or malaise early on
Why Does It Happen?
It's caused by a bacterium called Pseudomonas aeruginosa that can grow in warm, inadequately disinfected water. The bacteria get into hair follicles, especially where a swimsuit traps water against the skin. It is NOT spread person-to-person and is NOT a sign of poor personal hygiene.
Treatment Options
Most cases clear on their own as the skin recovers. Treatment focuses on comfort, with antibiotics reserved for more severe or persistent cases.
WATCHFUL WAITING
Most cases resolve on their own within 1–2 weeks.
SOOTHING CARE
Warm compresses and anti-itch measures for comfort.
TOPICAL ANTIBACTERIALS
May be used for milder localized cases.
ORAL ANTIBIOTICS
Reserved for severe, widespread, or persistent infection.
Tips for Managing It at Home
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Shower and remove your swimsuit soon after using a hot tub
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Avoid the suspected hot tub until it's properly cleaned and balanced
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Don't scratch or squeeze the bumps
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Ensure hot tubs are well maintained (chlorine/bromine and pH)
When to Call Your Provider
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The rash worsens, spreads, or lasts beyond 2 weeks
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You develop fever, painful lumps, or an abscess
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You have a weakened immune system
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Symptoms keep recurring after water exposure
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
Centers for Disease Control and Prevention (CDC). About Hot Tub Rash (Pseudomonas). https://www.cdc.gov/healthy-swimming/about/about-hot-tub-rash.html
Canadian Dermatology Association (CDA). Folliculitis. https://dermatology.ca/public-patients/diseases-conditions/hair-conditions/folliculitis/
DermNet. Pseudomonas Folliculitis (Hot Tub Folliculitis). https://dermnetnz.org/topics/pseudomonas-folliculitis
DermNet. Folliculitis. https://dermnetnz.org/topics/folliculitis
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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