If you or one of your family has developed a rash after using your hot tub, while that could just be a high pH level, it could also be folliculitis, and if that is the case, you will want to know how to get folliculitis out of your hot tub.
Here’s what I know from owning 4 hot tubs for almost 2 decades:
Get rid of hot tub folliculitis by performing a biofilm cleaning of the water, draining the hot tub completely, wiping it down with a mixture of water and white vinegar, and then refilling with fresh water, and balancing the alkalinity, pH, and sanitizer levels before entering.
But that’s just a quick answer.
Folliculitis is an infection of the hair follicles, which can be brought on by bathing in a hot tub that hasn’t been properly maintained, but before you treat it as such, you need to be certain that this is the cause of the rash.
There are a number of things that can cause itchiness and a rash.
So in this article, we’ll fully explore folliculitis, but we’ll also look at other possible causes of hot tub rash too. That way you’re covered no matter what the cause.
Let’s get into it!
— Nakatsui DermaSurgery (@NakatsuiDerm) October 26, 2016
How do you test for folliculitis in a hot tub?
There is no simple test for folliculitis, but it usually presents as red skin, tenderness, and puss-filled sores. The blister-like sores are normally what distinguishes folliculitis from other types of hot tub rashes.
The symptoms can be quite severe and usually appear within 72 hours of exposure.
Hot tub folliculitis – or pseudomonas folliculitis to give it its scientific name – is a type of bacteria that thrives in the warm water of a hot tub that isn’t properly sanitized.
Several forms of folliculitis fall into these four categories:
- Acute – where the condition lasts just a few days
- Chronic – where the symptoms persist for several weeks
- Superficial – hot tub folliculitis falls into this category
- Deep – usually associated with people who have underlying health issues
Although it is not life-threatening, complications can arise, such as boils, permanent hair loss, and in more serious cases, cellulitis.
It is crucial, therefore, to seek medical advice if the symptoms persist for more than a day or two where folliculitis is thought to be the cause.
There are things you can do yourself to ease the itching. Try soaking a clean cloth in warm water, wringing out the excess water, and applying it to the affected skin for 20 minutes. Some say adding salt to the water helps too.
You can also wash the affected area with your hands – not a cloth – using a mild soap and dry off by dabbing with a clean towel. Hygiene is paramount as you don’t want to risk spreading the infection.
Using antibacterial cream is also known to help ease the itchiness, most beneficial after washing. If you want to read more on this, check out this article in the Medical News Today newsletter.
— Queen Bee Salon Spa (@QueenBeeSalon) July 18, 2017
What else can cause a hot tub rash aside from folliculitis?
Other causes for a rash after exiting a hot tub can include too much chlorine or bromine in the water. But itchy skin and burning eyes can also result from high pH levels.
You should make sure the amount of chlorine or bromine you put in your hot tub doesn’t exceed the correct levels on your test strip. And if you have to keep topping it up, it could indicate that you have a biofilm problem.
Biofilm is a thin layer of bacteria and other organic material such as dead cells.
When this builds up in the pipework surfaces, it reduces the sanitizer’s efficiency, causing it to disappear quickly. You keep adding more, but it doesn’t seem to make any difference.
The best way to clear this is to flush out the jets using a cleaner such as Oh Yuk! on Amazon. Add this to the water and run the jets for 1 hour, then drain the hot tub and refill as normal.
But aside from chlorine or biofilm, the biggest culprit for hot tub rash is simply pH levels that are too high.
When your pH is high – above 7.8 ppm – it may be that your total alkalinity is off. This should be between 80 and 120 ppm, and if it falls outside of this range, it means that the pH is harder to control, so start off by correcting this.
High pH signifies low acidity, so to lower alkalinity and pH, you should add an acid such as sodium bisulfate or even vinegar (acetic acid). If alkalinity is fine, you just need to focus on the pH, and the best product for that is SpaChoice pH Decreaser (click to check the current price on Amazon).
You can read more on pH in a recent article. I go a lot deeper into the pH issues, and especially what to do if pH needs to go one direction and alkalinity needs to go the other way.
Just click on the link to read it on my site.
Jacuzzi time is greatest without Pseudomonas bacteria – drain frequently and use chlorine in the water instead of having to resort to antibiotics against Hot Tub Folliculitis later! Let’s learn #dermatology pic.twitter.com/COxreh9XLP
— Prof Alex Navarini (@AlexNavarini) January 10, 2018
Why do I keep getting hot tub folliculitis?
If folliculitis recurs frequently in your hot tub, that is a sign that something continuing to allow bacteria to grow in the water. The best practice would be to perform a biofilm cleanout, drain the tub, wipe down with a mixture of water and white vinegar, refill, and treat with chemicals.
There are things you can do yourself to prevent rashes from appearing, like showering before AND after using the hot tub.
Showering before getting in gets rid of the oils, deodorants, make-up, and other things that can clog up your filter and lead to biofilm development. It also helps prevent the skin from absorbing chlorine.
Showering afterward will wash off the chlorine from your skin and help rehydrate it. The use of a moisturizer will also help in this respect.
Remove your bathing costume as soon as you can, certainly before showering, and set this aside for washing along with your towel after drying off to eliminate any bacteria.
If you keep getting a build-up of foam on the surface of the water, this is a sure sign of chemical imbalance that leads to folliculitis.
You can read about the causes of hot tub foam in this recent article, but the likely cause is your pH level may be too high. However, there is 1 other possibility that no one thinks of.
Just click that link to read it on my site.
— mads🌻 (@MaddySparkes) September 24, 2012
Can hot tub folliculitis go away on its own?
Hot tub folliculitis symptoms in a person will go away on their own. But it is always a good idea to seek medical attention. The bacteria in the water of your hot tub, however, will require treatment to remove it and will not go away on its own.
Hot tub folliculitis can refer to the infection in a person as well as the bacteria that causes it, so in this case, yes, it can clear up on its own, but that depends on how bad the infection is.
Folliculitis is an infection of the hair follicles, so it can easily spread across the body as we have hair everywhere.
There is no actual cure for folliculitis; all you can do is treat the symptoms, and eventually, it will clear up. Mild symptoms should disappear within five days and in more serious cases ten to fourteen days.
If symptoms persist, it is important that you get medical advice.
This is because some of the complications can be dangerous. If you start to feel feverish and achy, or the discoloration seems to be spreading, this could be a sign of cellulitis, and that will need a good dose of antibiotics and probably hospitalization for a short spell.
Biofilm build-up in the plumbing and jets could result in depleted chlorine levels.
I discussed why this happens in a recent article. Preventing biofilm from building up in your hot tub can help you avoid dangerous complications because of folliculitis. After all, biofilm is, at least in part, a buildup of bacteria in your hot tub’s plumbing and equipment.
Just click that link to read it on my site.
— Zara Watson (@zarawatson010) July 26, 2019
How do you prevent hot tub folliculitis in a hot tub?
Prevent hot tub folliculitis by ensuring the sanitizer and pH levels are balanced perfectly before every use. Then ensure the water is changed completely every 3 months and that the filters are cleaned regularly too. It is very unlikely to get folliculitis in a well-maintained, clean, and chemically-balanced hot tub.
Hot tub folliculitis is a form of bacteria (pseudomonas), and like all bacteria, it reacts badly to clean, sanitized conditions.
So, if you have had an outbreak of folliculitis, you need to empty the tub and give it a thorough cleaning.
Purge the pipes and jets before completely emptying the tub. I recommend Oh Yuk Healthy Hot Tub Cleaner for this purpose (click to see the current price on Amazon).
You should clean your filter at least every 3-4 weeks, with a kitchen sprayer or garden hose. A great product to help thoroughly clean your filter is the Filter Flosser (click to see it on Amazon), which connects to your garden hose and gets jets of water right where you need them – inside the pleats.
Then, every 3 to 4 months, you should give your filter a deep clean by removing it and soaking it in a 5-gallon bucket with a good quality cleaning agent.
There are lots of products on Amazon, but one I use and recommend is Power Soak by Spa Depot.
And the best part about Power Soak is that by using hot water, you only have to soak your filters for 1 hour. Other brands require overnight soaking!
But ultimately changing the water in your hot tub regularly is the best prevention for hot tub folliculitis. But how often can vary a little bit by use, and HOW to do it can be a little tricky.
Luckily, I have a recent article that covers you completely on both of those, including a cool tip on how I drain my hot tub in just 15 minutes.
Just click that link to read it on my site.
Did I cover everything you wanted to know about how to get folliculitis out of your hot tub?
Hot tub folliculitis is not a common ailment for hot tub users and the bacteria that causes it is easily destroyed if you keep your hot tub water clean and healthy.
More often than not, a rash following a hot tub session is caused by a chemical imbalance in the water, which is easy to resolve, and apart from a little discomfort, isn’t serious.
However, it is important to know that more serious conditions can result from dirty or badly maintained water. I hope this article has helped you to distinguish the difference, but if there is anything more you would like to know, just drop me a line.
Don’t forget to click on the links to read associated articles on my website.