Hot Tub Folliculitis: Symptoms, Treatment, and Prevention Guide
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Hot tub folliculitis is a skin infection caused by Pseudomonas aeruginosa bacteria in warm, contaminated water, producing widespread itchy, red bumps around hair follicles. It is not contagious from person to person and usually clears on its own within one to two weeks. See a doctor if the rash persists or worsens, or if you develop fever, nausea or vomiting. [1]
What the research says
Outbreaks can affect most people who share contaminated water. In a hotel whirlpool outbreak, 26 of 36 users (72%) developed folliculitis within 1 to 5 days; the attack rate was 90% in children and 50% in adults. (Ratnam et al., J Clin Microbiol, 1986)
The rash appears within hours to days and usually resolves in a week or so. In a report of a family outbreak linked to a home hot tub, the eruption typically developed 8 to 48 hours after exposure, and it usually resolved on its own within 7 to 10 days. (Silverman & Nieland, J Am Acad Dermatol, 1983)
Poor disinfection is the usual problem. In a 2023 hotel pool outbreak in Maine, 23 of 35 responding guests (66%) developed ear pain, rash, or pain or swelling in the hands or feet after using the pool. Inspectors found multiple violations, including no disinfectant feeder system, and the chlorine-susceptible bacterium *P. aeruginosa* was cultured from skin lesions. (Lamere et al., MMWR, 2024)
What Is Hot Tub Folliculitis?
Hot tub folliculitis, also called pseudomonas folliculitis or "hot tub rash," is an infection of the hair follicles. It is caused by *Pseudomonas aeruginosa*, a bacterium that thrives in warm, moist environments. It is most often linked to hot tubs, but it can also occur after exposure in swimming pools, water parks, flotation tanks and other warm, moist settings, including public and private pools. [1]
Researchers estimate that *P. aeruginosa* is present in about two-thirds of hot tubs and swimming pools at any given time. Anyone who sits in contaminated water can develop the infection, but girls and women are more likely to be affected. [1]
What are the symptoms of hot tub folliculitis?
The most recognizable sign is a widespread rash of small, itchy, red bumps around hair follicles, which typically develops a few days after exposure. [1]
Physical appearance
The rash can develop on any part of the body exposed to the contaminated water, even under a bathing suit. Common areas include the face, chest, arms, buttocks, genitals and legs. The bumps (pustules) may fill with yellow or greenish fluid (pus), and bumps can also appear on the palms of the hands or soles of the feet. [1]
Other symptoms
Some people also have symptoms beyond the skin. These can include: [1]
Digestive symptoms: Nausea, vomiting or diarrhea.
General discomfort: Headache, fever or sore throat.
Eye pain.
How is hot tub folliculitis treated, and how long does recovery take?
Hot tub folliculitis has no specific treatment and usually clears on its own within a week or two, though home care can ease itching. For most people it clears on its own, usually within a week or two. [1]
Home management
If your skin is itchy or inflamed, these measures may help: [1]
Topical steroids: An over-the-counter hydrocortisone cream can ease itching and inflammation.
Antibacterial ointments: These can help prevent infection of the bumps.
Potential complications
Complications are rare. Scratching or picking at the bumps can cause an infection, and occasionally an abscess (a collection of pus) forms in a pustule and needs medical treatment. Some people notice temporary darkening of the skin after the rash heals. If you develop an infection, you will likely need antibiotics. [1]
Situation | Recommended action |
Mild itching or redness | Use over-the-counter hydrocortisone and avoid scratching |
Pus-filled bumps | Apply an antibacterial ointment and avoid picking |
Fever, nausea or vomiting | Contact a healthcare provider, since an infection may need antibiotics |
Rash that persists beyond two weeks or worsens | See a healthcare provider |
How can you prevent hot tub folliculitis?
You cannot tell whether a hot tub is contaminated just by looking at it, but you can take steps to lower your risk. [1]
Personal safety tips
Pool and hot tub maintenance
If you own a hot tub or pool, regular maintenance, including keeping disinfectant (chlorine) at the right level, is essential. A hot tub that is monitored daily should be a safe choice. If you or someone else develops hot tub folliculitis after using your tub or pool, contact a professional to clean it thoroughly and advise on a maintenance routine. [1][4]
Conclusion
Hot tub folliculitis is a common and usually minor condition that clears up within a week or two. Understanding the risks of warm water and practicing good hygiene lets you enjoy soaking more safely. If a rash persists or comes with a fever, nausea or vomiting, see a healthcare provider. [1]
Stay informed about skin health and water safety. Explore more expert guides at Rinnit.com.
Frequently Asked Questions
Is hot tub folliculitis contagious?
No. You cannot catch the rash from another person. However, several people who share the same contaminated water can develop it at the same time. [1]
How long does the rash take to appear?
The rash usually appears within a few days of exposure. In reports, it has developed from about 8 hours to 5 days afterward. [2][3]
Can I get this from a swimming pool?
Yes. Hot tubs are a common source, but public and private pools, water parks, flotation tanks and other warm, moist environments can also harbor the bacteria. [1]
What bacteria cause it?
The infection is caused by *Pseudomonas aeruginosa*. [1]
Will the bumps leave scars?
Generally, no. Rarely, the skin may darken (pigment changes) after the rash heals, and an infected or abscessed bump may need medical care. [1]
Should I use a hot tub if I have a cut?
It is wise to avoid soaking while you have open wounds or irritated skin. Do not shave or use hair removal methods right before getting into a hot tub. [1]
Does chlorine kill the bacteria?
*Pseudomonas aeruginosa* is susceptible to chlorine, which is why regular chlorine monitoring and proper maintenance of hot tubs and pools matter. [1][4]
Can the rash appear under my swimsuit?
Yes. It can develop on any part of the body exposed to the contaminated water, including areas covered by a swimsuit. [1]
What should I do if the rash is on my face?
Treat it the same way as a rash elsewhere, and talk to a provider if you have eye pain. Eye pain can occur with this condition. [1]
Is fever common with hot tub rash?
Fever is not the typical symptom, but it can occur. See your healthcare provider if you develop a fever, nausea or vomiting with a rash that is worsening. [1]
Can children get hot tub folliculitis?
Yes. Anyone exposed to the bacteria can develop it. In one hotel whirlpool outbreak, 90% of children who used the whirlpool developed folliculitis, compared with 50% of adults. [3]
How do I know if a public hot tub is safe?
You cannot tell by looking at it. If possible, ask the person who maintains the hot tub how often they clean and check it. A hot tub that is monitored daily should be a safe choice. [1]
What is a pustule?
A pustule is a small, inflamed, blister-like bump on the skin that contains pus. [1]
Can I use hot water to treat the itch?
Hot water may further irritate itchy skin. Cool or lukewarm water and a cold compress are gentler options.
Why are women more likely to get it?
Cleveland Clinic notes that girls and women are more likely to develop hot tub folliculitis, but the reason is not clearly established. [1]
Related Reading
Boils and Carbuncles: Symptoms, Causes, and Treatment explains deeper hair follicle infections and when they need draining.
Fungal Acne (Malassezia Folliculitis): Symptoms, Causes, Diagnosis, Treatment and Outlook — What You Need to Know covers a yeast-related folliculitis that looks similar.
Swimmer's Ear: Symptoms, Causes, and Treatment explains another water-related infection often caused by Pseudomonas.
Swimmer's Itch: Symptoms, Causes, Diagnosis & Treatment — Complete Guide covers an itchy rash from swimming in lakes and ponds.
References
Cleveland Clinic. Hot Tub Folliculitis. Cleveland Clinic. Last updated June 28, 2022. https://my.clevelandclinic.org/health/diseases/23358-hot-tub-folliculitis
Silverman AR, Nieland ML. Hot tub dermatitis: a familial outbreak of Pseudomonas folliculitis. J Am Acad Dermatol. 1983;8(2):153-6. PMID 6402527. https://doi.org/10.1016/s0190-9622(83)70017-4
Ratnam S, Hogan K, March SB, et al. Whirlpool-associated folliculitis caused by Pseudomonas aeruginosa: report of an outbreak and review. J Clin Microbiol. 1986;23(3):655-9. PMID 3082930. https://doi.org/10.1128/jcm.23.3.655-659.1986
Lamere L, Smith E, Grieser H, et al. Pseudomonas Infection Outbreak Associated with a Hotel Swimming Pool - Maine, March 2023. MMWR Morb Mortal Wkly Rep. 2024;73(2):32-36. PMID 38236783. https://doi.org/10.15585/mmwr.mm7302a2
Jacob JS, Tschen J. Hot Tub-Associated Pseudomonas Folliculitis: A Case Report and Review of Host Risk Factors. Cureus. 2020;12(9):e10623. PMID 33123436. https://doi.org/10.7759/cureus.10623
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have about a medical condition. Never disregard professional medical advice or delay seeking care because of something you have read here. If you think you may have a medical emergency, call your doctor or emergency services immediately.
Medical disclaimer
The information provided in this article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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