What You Need to Know About Hot Tub Folliculitis

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hot tub

While relaxing in your hot tub is normally an enjoyable and safe experience, if your spa water is not properly maintained, chemicals and bacteria can lead to unwanted skin irritation. And let’s be straight here, rashes can be uncomfortable and frustrating! Recently there’s been a rise in questions about the symptoms of hot tub Folliculitis, Hot Hand-Foot Syndrome, and how these compare to a less severe chemical sensitivity. I’ll explain the differences in the three, and more importantly, let you know how to prevent them from happening!

Chemical Sensitivity

dry skin

Skin irritation caused by chemical sensitivity and Folliculitis are often confused with one another because the symptoms can appear very similar. Hot water can deplete your skin of its natural moisture. Chemicals such as Chlorine or Bromine can also amplify skin dryness. If you’ve been spending a lot of time in the tub lately and noticed that your skin is getting dry, don’t scratch! Scratching dry skin can lead to irritation, including embarrassing redness and bumps. Instead, soothe skin with a natural moisturizing lotion after each hot tub use.


Hot Tub Folliculitis

Folliculitis can be much more severe than typical chemical irritation. Hot tub Folliculitis is a bacterial condition caused by Pseudomonas aeruginosa. These bacteria can spread in under-sanitized spas or pools and infect hair follicles or breaks in the skin. This rash can cause fevers, bumps leading to painful nodules or blisters, and extreme discomfort. These symptoms can surface anywhere from a few hours to a couple of days after hot tub use. The rashes commonly appear on arms, legs, back, and stomach, but can spread to other areas of the body as well.

hot foot

Hot Hand-Foot Syndrome

Caused by the same bacteria (Pseudomonas aeruginosa), Hot Hand-Foot Syndrome can cause fevers, nodules on palms and soles of the feet, as well as extreme discomfort when walking.

Easy Prevention

Don’t sweat it! Preventing the development of skin rashes from use of your spa is simple and easy. The answer: maintain your spa water. If your spa water is imbalanced, it can become a place of cultivation for bacteria such as Pseudomonas aeruginosa. Factors such as water hardness can cause skin irritation, if not closely monitored. Similarly if the pH in your spa is low it causes acidic water that can be irritating to the skin and cause a burning sensation in your eyes. By keeping up on your water maintenance routine, you can easily prevent skin irritation as well as the growth of harmful bacteria.

Some Helpful Tips:


  • Test your water frequently using the proper test strips for your sanitizer.
  • Change your hot tub water after high bather loads and no less than once every 3-4 months.
  • Make sure to shower after spa use.
  • Using all natural shea butter moisturizers can also be useful in preventing dry skin after hot tub soaking.

Remember, only a doctor can determine if you have Folliculitis or a different skin condition. Seek professional advice if you notice any rashes or irritation after hot tub soaking.

Have a question about water maintenance or hot tub care? Post a comment below!


  1. we recently purchased a hot tub and we love it. After the 3rd use however my wife has developed a rash on the back of her legs. I check the water by using test strips and have been treating the water when needed. I am fine and have used it more than her. Any help would be appreciated.


  2. Hi Dennis, There are a few possibilities that could lead to your wife getting a rash. Your sanitizer could have been too low, your water could have been a bit out of balance (pH and alkalinity too low), or she may be allergic to the sanitizer you”re using. If you had the proper amount of sanitizer in the water and the pH and alkalinity were in balance, you may want to consider trying a different sanitizer. We have some excellent choices available here: http://www.spadepot.com/shop/Alternative-Sanitizers-W17.aspx I Hope this helps! Thank you, Mark The Spa Depot


  3. Thanks, I was also reading about converting my spa to salt water using a chlorine generator you sell. My water seems to be in balance. I”m not sure if the sanitizer is the issue or not. I am using “Natural Chemistry” Oxidizing Shock after every use of the Spa. Are you familiar with this product? Thanks


  4. Hi Dennis, The Saltron Salt System is really an outstanding sanitizing system. We have received lots of positive feedback from customers, and many people do switch to salt systems to prevent skin irritation. The Nature Chemistry oxidizing shock is one component of a sanitizing system. Are you also using Bromine tablets, or a mineral sanitizer as well? Thanks, Mark The Spa Depot


  5. Yes I am also using bromine tablets to treat my 300 gallon tub. My wife has a lot of allergies so from what I”m reading sometimes rashes like she has gotten are common and a salt system might be a better choice all around.


  6. Hi Dennis, I”m sure the salt system will make your hot tubbing much more enjoyable! Thanks again, Mark The Spa Depot


  7. Part of my question got dropped somehow. We have a bromide system so we are concerned about safety for our system as well as efficacy…


  8. Hi Norlaine, Following the directions of our decontamination process should flush your spa completely. The Dichlor Granular Chlorine and the Spa System Flush are perfectly compatible with your bromide system. You can order both products directly from The Spa Depot, as we do ship to Canada. Here is the link for the Spa System Flush: http://www.spadepot.com/shop/Spa-System-Flush-16-oz-P436C57.aspx Here is the link to the Dichlor Granular Chlorine: http://www.spadepot.com/shop/Dichlor-Sanitizing-Granules-1-lb-P618C43.aspx Thank you for checking with us, and please let me know if you have any additional questions! Thanks again, Mark The Spa Depot


  9. Earlier this year my girlfriend began to experience rashes that diminished when she avoided the hot tub. I contacted Spa Depot and they sent me their check list for decontaminating/sterilizing a tub. I followed the directions and in the months since there has been no recurrance of the rash. It cost some money for new filters, cleansers, and several purge/flush cycles of water but it was WELL worth it for us. I”m sure I could have avoided this whole episode if I”d stayed on top of the maintenance better but after a decade or so I had gotten careless.


  10. Thank you, I”ve been looking for info about this for a long time and yours is the best I have found so far.


  11. One of the more impressive blogs I”ve seen. Thanks so much for keeping the internet classy for a change.


  12. I only develop a rash on the parts of the skin that are exposed to air….not the hot tub water. So the tops of my shoulders and above my collarbones and neck. Any ideas what might be causing it and how to prevent it?


  13. Hi Connie,

    The rash could be developed by the steam being exposed to your skin above the water. Our suggestion would be to first test your spa water. If everything appears to be in balance, you could be experiencing a mild allergic reaction to one of the chemicals. What do you use as your sanitizer? Do you shock the spa regularly after each use?

    Thank you,


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