Hot tub folliculitis is a skin rash caused by bacteria that can grow in poorly treated hot tub water. It is usually mild and clears up on its own. Even so, it is uncomfortable and almost always preventable. This guide covers the causes, the symptoms and the simple steps that keep your hot tub water safe. It is general information, so see your GP or pharmacist if you are worried.
What causes hot tub folliculitis?
The rash is usually caused by a germ called Pseudomonas aeruginosa. It thrives in warm water, especially when sanitiser levels drop too low. The bacteria get into hair follicles, which is why the rash often appears where swimwear holds wet water against the skin. As a result, it is common on the bum, hips, thighs and tummy.
Symptoms to look out for
- Red, itchy bumps or small pus filled spots.
- A rash that is worse under where your swimwear sat.
- Tender or sore skin around the spots.
- Symptoms that usually appear from a few hours to a couple of days after using a hot tub.
Some people also get sore eyes or ears, or feel generally unwell. If you have a fever, a spreading rash or symptoms that do not improve, contact your GP. The HSE has more advice on skin infections.
How long does it last?
Mild hot tub folliculitis often clears up on its own within one to two weeks. Keep the area clean and dry, and avoid scratching. A pharmacist can suggest something to ease the itch. However, if it gets worse, spreads or keeps coming back, see a doctor, because some cases need treatment.
How to prevent hot tub folliculitis
The good news is that prevention is simple. It all comes down to clean, balanced water.
- Keep free chlorine at around 3 to 5 ppm, or bromine at around 4 to 6 ppm.
- Keep pH between 7.2 and 7.6, so your sanitiser works properly.
- Test the water before every use, or at least every few days.
- Shock the water after heavy use or a party.
- Clean or replace hot tub filters regularly.
- Shower before and after, and wash your swimwear after each soak.
- Change the water every three to four months, or sooner with heavy use.
Our guides on chlorine vs bromine and how often to change hot tub water explain each step.
Is it the hot tub or the user?
In nearly every case, the cause is water care rather than the hot tub itself. A well maintained hot tub is very low risk. So if you keep the chemistry right, you can enjoy your tub with peace of mind.
Frequently asked questions
What does hot tub folliculitis look like?
It usually looks like red, itchy bumps or small pus filled spots, often under where your swimwear sat.
Is hot tub folliculitis contagious?
It is not usually passed from person to person. It comes from bacteria in poorly treated water, so anyone using the same tub can be affected.
How long does hot tub folliculitis last?
Mild cases often clear on their own within one to two weeks. See your GP if it spreads, gets worse or you feel unwell.
How do you prevent hot tub folliculitis?
Keep sanitiser and pH levels correct, test the water often, clean the filters, shower after use and wash your swimwear.
Keep your hot tub water safe
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