Hot Tub Folliculitis (Pseudomonas Folliculitis)- Causes, Symptoms and Treatment


Hot tub Folliculitis is also known as Spa pool Folliculitis or pseudomonas folliculitis. It is a skin illness. Hot tub folliculitis is an infection that develops after exposure to certain forms of bacteria that reside in warm, wet environments.

It is mainly arises hours to a few days after bathing in inadequately disinfected warm water, such as a spa pool, jacuzzi or swimming pool.

It first appears as itchy bumps, some of which may be filled with pus.


Most folliculitis is caused by the common organism Staphylococcus aureus. However, hot tub folliculitis is caused by Pseudomonas aeruginosa. Pseudomonas survives in hot tubs, especially hot tubs made of wood, unless the pH and chlorine content are strictly controlled.


The signs of hot tub folliculitis usually occur within 3 days of using of a poorly chlorinated hot tub.

The most common symptom of hot tube foliculitis is an itchy rash. It is often confused with bug bites (often complaints are received that a hotel has “bed bugs”), chicken pox, and other types of rashes. It may be much more serious including severe rashes requiring hospitalization, ear infections, urinary and vaginal infections, and probably most serious is pneumonia.

Common symptoms are-

  • small fluid filled blisters called pustules. Untreated, pustules may progress into dark, red, tender, hard nodules, also known as furuncles or boils.
  • body-wide discomfort
  • low-grade fever as symptoms progress
  • History of using hot tub within previous 3 days
  • Bumps developing into dark red tender nodules
  • Bumps developing small pustules (pus-filled blisters)
  • Multiple members of family or party with same rash and same hot tub exposure


Physical examination combined with a history of recent hot tub use is sufficient for your health care provider to make this diagnosis. Testing is usually unnecessary.

Treatment may not be needed, as the mild form of the disease usually clears on its own. Usually mild folliculitis heals on its own in about 2 weeks. Warm compresses made with white vinegar or Burow’s solution may help relieve itching and aid healing. If the infection does not go away then try to use an antibiotic or antifungal cream will usually clear up the condition. Medicated shampoos are available to treat folliculitis on the scalp or beard.

Your doctor may advise not shaving the affected area until the infection heals. If you must shave, use an electric razor or clean razor blade every time. If the problem persists, you may need topical or oral antibiotics.

In severe cases, your physician may prescribe an oral antibiotic such as ciprofloxacin.

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