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Hot tub rash (folliculitis)

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 2 minutes read

Although most bathers enjoy and use hot tubs without encountering any problems, many people experience an itchy and painful skin condition called hot tub rash or folliculitis.

Folliculitis is when the hair follicles that cover areas of our skin surface become inflamed or infected. In day-to-day life, the most common occurrence of this is in relation to shaving, affecting men most often on the face and women in areas they wish to have hair removed from, especially around the bikini line.

Another cause is prolonged submersion in jacuzzis or hot tubs. The warmth, coupled with the high oxygen content of the water, creates optimum conditions for bacteria and funguses to grow. Furthermore, the frequent change of visitors into the tubs and relatively infrequent changing of the water leads to a hot tub that is teaming with bacteria.

Doctor’s advice

What are the symptoms?

The symptoms of folliculitis are red spots often covering areas of either high hair follicle density or areas that have had prolonged contact with bathing suits. Areas of friction are also affected, such as shaving sites. These are not usually due to infection. These are usually itchy and can become sore. Sometimes people can develop a mild fever or feel unwell. If not treated, folliculitis can result in more isolated infections resulting in boils or abscesses or cause cellulitis, which is a deeper, more widespread infection of the skin layers.

Usually, folliculitis will occur due to the person's individual circumstances, but if it is caused by bacteria, then this can be passed on to others through prolonged direct contact or through shared water in hot tubs.

Healthwords pharmacists' top tips

Avoid hot tubs if you do not know if they are regularly cleaned or if they do not have any visible method of chemical antibacterial measures such as chlorine or an antibacterial emitting device.

If you do enter these hot tubs, then limit your time to 30 minutes and shower and remove your bathing suit directly afterward. Wash with an antibacterial body wash if possible.

If you develop symptoms of folliculitis, try an antibacterial body wash called Chlorohexidine 5%. Apply to the body twice daily and leave on the skin for 5 minutes before washing off. Continue this for 7 days.

Pharmacist recommended products

Am I fit for work?

You are fit for work if you have a hot tub rash or folliculitis.

When should I see my doctor?

If the red spots are worsening and continuing to spread despite the above measures or you are developing a fever, consider discussing with your doctor whether you would benefit from oral antibiotic tablets. The lesions themselves can take up to 3 weeks to fully heal and can scar for up to 4 weeks afterward.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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