What is Hot Tub Rash?

Hot tub rash, also known as Pseudomonas folliculitis, is a common skin infection caused by the bacteria Pseudomonas aeruginosa. While it can occur year-round, it's more common during the summer, especially here in Minnesota, when more people are enjoying hot tubs, spas and heated pools.

This rash develops when water isn't properly disinfected or maintained. The bacteria thrive in warm, moist environments and can enter the skin through hair follicles or small abrasions.

What does it look like?

Hot tub rash will present itself with red, itchy bumps or pus-filled blisters, looking a lot like acne, heat rash, or even appear as an allergic skin reaction.

Symptoms generally appear within hours and up to a few days after exposure. You will notice the rash show up in areas where your swimsuit holds water against your skin, like your chest, back, thighs, and buttocks.

While it isn't fun to have, it usually clears up on its own within 5 to 10 days. In some cases, the bacteria can infect the nails or ears, causing swimmer's ear. It can also sometimes cause red, swollen patches on both feet, known as Hot Foot Syndrome.

This rash is difficult to prevent if you're not the person who is responsible for maintaining the facility, and you're not sure if it's clean. The good news is that there are some steps you can take to minimize the risk of exposure.

Preventing hot tub rash

• Smell the water. If the water smells musty or foul, that's a red flag.
• Shower before and after. Make sure you're using soap afterward to help rinse off lingering bacteria.
• Avoid hot tubs, spas or pools if you have open cuts or freshly shaved skin. Open wounds are an easy entry for bacteria.
• Don't soak for too long. The longer you soak, the more time bacteria have to settle in your skin.
• Don't sit in your damp swimsuit. Dry off as soon as possible.
• Avoid crowded hot tubs or pools.
• Trust your gut. If it doesn't seem clean, avoid it.

How to treat it

If you do develop hot tub rash, you can use over-the-counter anti-itch creams like hydrocortisone cream or anti-itch lotion and warm compresses to ease any discomfort. The rash can be treated at home.

If your rash worsens, spreads, or isn't improving, that's when it's time to seek medical care. Your provider might prescribe an oral or topical antibiotic in severe cases.

Learn more about preventing Hot Tub Rash on the Centers for Disease Control & Prevention (CDC) website.