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Spa pool folliculitis, also known as hot tub or pseudomonas folliculitis, is a skin condition that is caused by bacterial (pseudomonal) infection of the hair follicle. 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 a specific rash caused by infection of the hair follicles of the skin with Pseudomonas aeruginosa, a particularly nasty bacterium. Pseudomonas survives in hot tubs, especially hot tubs made of wood, unless the pH and chlorine content are strictly controlled.


Fortunately the most common symptom 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 can 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


A healthcare professional may suspect hot tub folliculitis after taking a person's health history and doing a physical exam. The presence of skin lesions and a history of exposure to a hot tub or spa usually confirm the diagnosis.

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.

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.

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