Hot Tub Folliculitis

Key Points
Skin condition which affects areas of skin covered by swimming attire
Caused by bacterial infection contracted from water which is inadequately disinfected
Consists of a scattering of small red bumps and pustules, which may be tender or itchy
Causative organism pseudomonas aeruginosa

Hot tub folliculitis is a skin condition which appears after swimming, typically on areas of skin covered by swimming attire. The condition consists of a scattering of small, red bumps and pustules, which may be accompanied by tenderness and itching. In rare cases, this may be accompanied by a feeling of general unwellness, including earache, nausea, vomiting, fever, headache and sore throat.

Hot tub folliculitis is caused by a bacterial infection contracted from water which has been inadequately disinfected. It may affect any individual which comes in contact with infected water. In most cases the condition resolves spontaneously, but cases caused by the bacteria aeromonas hydrophila may result in severe folliculitis, cellulitis, or a rash resembling Impetigo.

Differential Diagnosis (Other conditions with similar appearance)
Acne
Bromide sensitivity
Staphylococcal Folliculitis
Gram-negative Folliculitis

Diagnosis
Key Points
Diagnosis based on the bacterial culture of the affected area
Other laboratory tests may be performed to confirm diagnosis and rule out other conditions

Hot tub folliculitis is typically diagnosed based on a bacterial culture of the affected area. Other laboratory tests may be performed to confirm the diagnosis and to rule out similar appearing conditions.

Treatment
Treatment not required in moderate cases, as they are self-limiting
Severe cases may require treatment with antibiotics
*The causal body of water should be properly treated to prevent recurrence

Mild cases of hot tub folliculitis are typically self-limiting, resolving in a few days, and do not require treatment. Severe cases may require treatment with gram negative specific topical or systemic antibiotics, including gentamicin cream, polymyxin B spray, and oral ciprofloxacin. Additionally, the causal body of water should be properly treated to prevent recurrence of the condition.