When hot tub or spa water is always pH balanced and sanitized, it can be relied on to provide a pleasant, healthy bathing experience. However, if it is not properly maintained, it can become contaminated with microbes, such as the pseudomonas aeruginosa bacterium, commonly referred to as hot tub rash. It causes inflammation of hair follicles, resulting in a rash that looks something like chicken pox; then it develops into tiny pimples (Pseudomonas folliculitis).
Since hot tubs have warmer water than swimming pools, they are more likely to attract bacteria. In addition, chlorine or other disinfectants commonly used to kill bacteria will break down faster in the warmer water.
Bacteria in hot tub water can enter the body through the pores of the skin, especially when they have been opened up by the hot water; and by inhaling airborne droplets emitted by the spa jets.
Symptoms of Hot Tub Rash
Symptoms include itchy spots on the skin that turn into a bumpy red rash. The rash is usually worse in areas of the body covered by swimwear worn in the water. The rash appears within a few days of using a poorly maintained hot tub.
Hot tub rash can be painful and/or itchy, and left alone without scratching will go away more quickly. If the rash is aggravated, it can stay, worsen, and spread, lasting for months, making it more difficult to treat. The spots usually go away within 7 to 10 days, but the condition can leave lesions that remain on the skin for several months.
Hot Tub Rash Treatment
The rash often clears up on its own within a week. However, if it lasts longer than that, you should see a health care professional If the rash from the skin infection does not go away on its own, a physician should be consulted. In some cases, antibiotics may be prescribed.
You Can Reduce Your Risk of Hot Tub Rash
To prevent skin infections like hot tub rash, be vigilant about following the CDC’s recommendations for hot tub and spa water – a pH level of 7.2 to 7.8 ppm, and a free chlorine level of 2-4 ppm, or 4-6 ppm level of bromine.
Other things you can do to reduce your risk: 1) after using a hot tub, remove your swimwear and wash your body with soap; 2) wash your swimwear with soap after wearing it in a hot tub;
3) before getting into a hot tub, use a pool test strip to make sure it is properly disinfected with chlorine or bromine. If it happens not to be your hot tub, ask the owner if the tub’s disinfectant and pH levels are checked at least twice a day, and if they comply with the CDC’s recommendations.
For more detailed information please visit the CDC’s website at https://www.cdc.gov/healthywater/pdf/swimming/resources/pseudomonas-factsheet_hot_tub_rash.pdf