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Hot Tub Rash: Here’s What You Need to Know

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Your hot tub is a place of warmth, comfort, and relaxation and a tranquil respite after a long, hard day at work. Your nightly dip may have even have become an integral part of your self-care regimen, soothing away muscle aches and stress as you soak.

This zen haven is no place for an itchy rash or bacterial infestation. That’s why preventing the causes of Hot Tub Rash is such an important part of your spa care regimen. If the worst has happened and you’ve found yourself already coping with this problem, we’re here to help.

What is Hot Tub Rash?

Hot Tub Rash, also known as Hot Tub Folliculitis, is a skin infection caused by soaking in infected water, usually in poorly maintained hot tubs. It’s a kind of dermatitis, or inflammation of the skin, brought on by a nasty bugger known as Pseudomonas aeruginosa.

This bacteria is fairly common and lives in soil and water all over the place. Hot tubs are an especially cozy home for P. aeruginosa because of the warm temperature and the bubbles. Wait, the bubbles? Unfortunately, yes. The aeration of the water combined with the nice warm temperatures makes for perfect living conditions, allowing the bacteria to thrive and multiply.

Symptoms of Hot Tub Rash

If you happen to come into contact with water contaminated by P. aeruginosa, the most common symptoms you’ll notice are itchy red blisters forming on the skin, usually worse on the areas of the body previously covered by a swimsuit. 

The bumps may look and feel like chickenpox but are pus-filled blisters that form around infected hair follicles (hence the name) in the same way that pimples do. 

Other symptoms may include fatigue, fever, difficulty breathing, and just a general feeling of ickiness. All of these symptoms usually develop within 12-48 hours after exposure. You may not notice the secondary symptoms at first, because wow—that rash is itchy.

Hot Tub Rash can affect people of all ages indiscriminately. But the good news is that it’s not contagious. Although touching of any kind might be pretty painful until it’s healed. Time is your best friend here, as symptoms usually subside within a few days to a week.

How to Avoid Getting Hot Tub Rash

This bacteria is invisible to the naked eye so unfortunately, you can’t just bypass an infected hot tub when you see it. The best way to prevent this itchy and painful situation is to make sure to keep your hot tub clean and the water chemistry properly balanced at all times.

This bacteria can’t live in a hot tub that’s properly sanitized and pH balanced, so your first step to prevention is just doing what you normally do: test, adjust, rinse, repeat.

If you’ve had a hot tub party recently or have been soaking more frequently than usual, it’s a good idea to test more often than you normally would too. The best prevention in this situation is vigilance and consistent upkeep.

Good hygiene will also help to keep you safe from the dreaded rash as well. Always rinse off in the shower (with soap) directly after soaking in a hot tub. Make sure to never leave a wet bathing suit on for too long after taking a dip to avoid prolonged exposure to possible bacteria. Last but not least, wash or rinse your swimsuit with fresh water after a soak rather than just letting it dry.

With proper hot tub maintenance and common-sense hygiene practices, you should never have to worry about bacteria invading your spa. 

The Unlikely Alliance of Extreme pH and Hot Tub Rash

So, how do you even get P. aeruginosa in the first place? 

Good question. You might think that a properly chlorinated hot tub would kill off bacteria, right? It’s a sanitizer’s job after all. Disappointingly, P. aeruginosa is a stout and formidable enemy that can actually survive in chlorinated water. Put very simply, your sanitizer lost the battle.

Maintaining proper hot tub water chemistry can be a tricky dance to master, particularly because of the increased water temperatures that you need to make a hot tub worthwhile in the first place. 

Unlike the water in a swimming pool, warm or hot water makes for an inviting situation for bacteria growth. Not only that, but hot water actually burns through your sanitizer more quickly than sanitizer in air temperature water. 

Additionally, high or low pH levels essentially can cause the same problem. With a high pH, your sanitizer will hardly function at all. The chemical interactions are such that much of the chlorine you added simply won’t be available to use.

On the flip side, chlorine actually functions better at a low pH (around 6.0). But keeping your hot tub pH that low can cause your water to become corrosive and irritating to swimmers’ skin and eyes. So if your hot tub water pH has veered off in either direction, your sanitizer is not going to be able to do its job properly.

A Perfect Balance

You probably already know this but just to refresh your memory, the ideal levels for your hot tub chemicals are:

  • Free chlorine levels should be between 1-3 ppm (parts per million)
  • Bromine levels should be between 2-6 ppm
  • The pH of the water should always be between 7.4-7.6

With regular testing (1-2 times per week) and a monthly professional test, keeping your levels in-check should be no problem at all. As long as you keep your hot tub water sanitized and pH balanced at these levels, P. aeruginosa won’t have a fighting chance.

What to Do If The Worst Happens

The best medicine is always prevention but if you or someone in your hot tub has come away with symptoms of Hot Tub Folliculitis, the first thing to do is to stop using your hot tub immediately.

For You

Do not scratch (or even touch) any of the blisters! Soothe the itch as best you can and give yourself the gift of time. With a bit of patience and a liberal application of anti-itch balm, you’ll be back to new in no time. 

For Your Hot Tub

Regular pool maintenance and balancing your water chemistry is, unfortunately, not going to cut it after the bacteria has invaded your space. The bacteria responsible for Hot Rub Rash are strong, crafty and immune to your usual tricks. 

Even if you cleaned, shocked, and doused your spa with a truckload of sanitizer, the bacteria may still be hiding out in your filters and pipes. That’s why for this situation we need to bring in the big guns.

How to Drain and Clean Your Hot Tub

We’re not going to lie, this is a process, but it’s an important and completely necessary one if you find yourself with a P. aeruginosa hot tub contamination. Don’t worry—we’re going to walk you through it step by step.

  1. Flush: Add a line flush to your hot tub water and follow the manufacturer’s instructions. It will usually mean circulating the water for a few hours.
  1. Cut the Power: Important! Turn off all power to your hot tub and even trip the breaker, just to be on the safe side.
  1. Remove Filters: Next, it’s time to remove and throw away your filter(s). Contamination of this degree means that cleaning/disinfecting is not an option. Say your goodbyes and toss them out before getting some squeaky clean new ones. 
  1. Drain Water: Time to get rid of the tainted water. Drain your hot tub completely by unstopping the drain or using a sump pump.
  1. Clean: When all of the water is drained out, it’s cleaning time! Mix a diluted bleach solution of ½ cup bleach in a gallon of water and get scrubbing. Antibacterial is the keyword here. A simple hot tub cleaner is not going to do the trick unless it specifically says it’s an antibacterial solution. Make sure to use gloves so as not to get bleach on your hands. Wipe down the whole inner shell of the hot tub with the bleach solution to thoroughly disinfect.
  1. Rinse: Using fresh water (no bleach), spray and wipe down the hot tub shell with a hose and a fresh towel. Leaving any bleach or cleaning product residue will wreak havoc with your water chemistry later on.
  1. Refill: Grab your hose and preferably a hose filter to refill your hot tub. A filter is always a good idea to keep out those pesky minerals that will throw off your water chemistry.
  1. Turn It On: Now it’s time to flip those switches and get the power going again. Turn on your hot tub to get the water flowing and bubbles bubbling.
  1. Test & Adjust pH: Test your hot tub water looking specifically at the pH levels. Once you have your starting point you can adjust them accordingly.
  1. Add Sanitizer: Toss in your sanitizer of choice. Follow the manufacturer’s instructions regarding quantities starting from a newly-refilled hot tub. Once the sanitizer is added, run your hot tub for a bit to get everything mixed and circulated.
  1. Shock: Keep the water circulating and add shock, following product instructions for the proper amount.
  1. Set the Temp: Set the temperature to 104 degrees Fahrenheit and let it run for 24 hours.
  1. Retest & Adjust: Once you’ve given the water a day to move around, it’s time to retest the water. Adjust and balance your water chemicals as needed.
  1. Relax!

Now you can sit back, relax, and enjoy your hot tub again without a care in the world. 

The Good News

We like happy endings so the good news is that now that you’ve cleaned, drained, and disinfected your hot tub, the worst is officially over. You’re armed and ready with the solutions you need to fix the problem and the knowledge of how to avoid a contaminated hot tub in the future.

Now it’s time to turn on the bubbles and soak.

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