Spa pool folliculitis

What is spa pool folliculitis?

Spa pool folliculitis, also known as ‘hot tub folliculitis’ or ‘pseudomonas folliculitis’, is a skin condition that arises hours to a few days after bathing in inadequately disinfected warm water, such as a spa pool, jacuzzi or swimming pool. It may affect several exposed individuals.

The result is an eruption of scattered small red itchy or tender bumps, some of which are pustular. They mainly occur in areas that were covered by the swimming costume.

Rarely, some people with spa pool folliculitis feel unwell. They may have earache, sore throat, nausea and vomiting, headache and/or mild fever.

A similar rash may occur from wearing a wet suit that has not been thoroughly washed and dried after previous use.

What is the cause of the folliculitis?

Spa pool infection is due to a bacterial infection of the skin.

The bacteria most often responsible for spa pool folliculitis, Pseudomonas aeruginosa, do not survive long on healthy normal skin so spa pool folliculitis usually settles by itself within a few days.

The bacteria Aeromonas hydrophila, common in brackish or unchlorinated water, may rarely infect broken skin and cause a severe folliculitis, cellulitis or an impetigo-like rash.

Spa pool folliculitis

		Wetsuit folliculitis

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Treatment

Mild cases do not require treatment. Extensive or severe spa pool folliculitis can be treated with topical or systemic antibiotics active against gram negative bacteria, such as:

• Gentamicin cream
• Polymyxin B spray
• Oral ciprofloxacin

The responsible pool should be properly cleaned and disinfected with adequate chlorination or other method.