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    Hot tub folliculitis

    Hot tub folliculitis is an infection of the skin around the lower part of the hair shaft(hairfollicles). It occurs when you come into contact with certain bacteria that live in warm, wet areas.

    Causes

    Hot tub folliculitis is caused by the bacteria Pseudomonas aeruginosa. This form of bacteria survives in hot tubs, especially tubs made of wood. Controlling the acid and chlorine level in the water can limit the growth of the bacteria.

    Symptoms

    The first symptom of hot tub folliculitis is an itchy, bumpy, red rash. Symptoms can appear from several hours to 2 days after contact with the bacteria.

    The rash may:

    • Turn into dark red, tender nodules
    • Have bumps that fill with pus
    • Look like acne
    • Be thicker under swimsuit areas where the water has been in contact with the skin longer

    People who shared the hot tub may have the same rash.

    Exams and Tests

    Your health care provider canoften make this diagnosis based on looking at the rash and knowing that you've been in a hot tub. Testing is usually not needed.

    Treatment

    Treatment may not be needed. Themild form of the disease often clears on its own. Anti-itch medicines may be used to ease discomfort.

    In severe cases, your health care provider may prescribe an antibiotic such as ciprofloxacin.

    Outlook (Prognosis)

    This condition usually clears without scarring. The problem may come back if you use the hot tub again before it has been cleaned.

    Possible Complications

    • Abscess formation (rare)
    • Discomfort

    When to Contact a Medical Professional

    Call your health care provider if you develop symptoms of hot tub folliculitis.

    Prevention

    Controlling the acid levels and chlorine content of the hot tub may help prevent the problem.

    References

    James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 14.

    Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 90.

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    • Hair follicle anatomy

      illustration

      • Hair follicle anatomy

        illustration

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            Review Date: 11/20/2012

            Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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            St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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