Folliculitis is a superficial infection of the hair follicle. Hot tub folliculitis is a folliculitis that develops after exposure in a hot tub.
Causes, incidence, and risk factors
Most folliculitis is caused by the common organism Staphylococcus aureus . Hot tub folliculitis is different in that it is caused by Pseudomonas aeruginosa . Pseudomonas survives in hot tubs, especially the wood type, unless the pH and chlorine content are strictly controlled. Hot tub folliculitis becomes noticeable within half a day to two days after exposure. It first appears as itchy (pruritic) bumps -- some pus filled -- and may develop into dark red tender nodules . The rash may be denser under swimsuit areas where the material has held the contaminated water in contact with the skin for a longer period of time.
Signs and tests
Physical examination combined with a history of recent hot tub use are sufficient for your health care provider to make this diagnosis. Testing is usually unnecessary.
Treatment
Treatment may not be needed, as the mild form of the disease usually clears on its own. Oral or topical anti-pruritics ("anti-itch" medications) may be used. In severe cases, your physician may prescribe an oral antibiotic such as ciprofloxacin.
Expectations (prognosis)
This condition usually clears without scarring, but may recur if the infected hot tub is not cleaned.
Calling your health care provider
Call your health care provider if you suspect a diagnosis of hot tub folliculitis.
Prevention
Careful attention to controlling the pH and chlorine content of the hot tub may help to prevent hot tub folliculitis.