Pseudomonas Folliculitis Symptoms, Causes, and Diagnosis


The development of red bumps from a hot tub is typically the result of a bacterial infection known as pseudomonas folliculitis. The condition is more commonly known as hot tub folliculitis or hot tub rash.

Pseudomonas Folliculitis


Pseudomonas aeruginosa bacteria is the primary cause of hot tub rash, which infects the hair follicles.  The medical term is pseudomonas folliculitis.

Pseudomonas aeruginosa bacteria thrive in warm, wet conditions. That’s why hot tubs and whirlpools are among the most common hot tub rash causes.

Several factors related to hot tub care increase the risk of water becoming contaminated, including inadequate or improper care of water. But the bacteria can thrive in sufficiently chlorinated water as well.

Also, when too many people are in a spa, the risk of developing hot tub folliculitis symptoms increases.

Hot tub jets are another one of the hot tub rash causes. Bacteria thrive in the jets. So contact with the streams increases the risk because the pressure can force the bacteria into your pores.

Jets are one of hot tub rash causes

Can lakes and swimming pools cause pseudomonas folliculitis hot tub rash?

Hot tubs are one of the leading hot tub rash causes because pseudomonas aeruginosa bacteria thrive in warm conditions. Still, the bacteria can survive in warm pools and lakes, as well, particularly if they’re overcrowded. So it’s possible to contract pseudomonas folliculitis hot tub rash from these sources.


Does showering prevent red bumps from the hot tub?

Showering after exposure to pseudomonas folliculitis doesn’t reduce the likelihood of infection. So try to avoid a hot tub that may be contaminated.

Is hot tub rash contagious?

When someone with pseudomonas folliculitis hot tub rash gets in a hot tub, the bacteria enter the water. Then it infects others. So hot tab rash is contagious.

What people often wonder is whether hot tub rash is contagious when coming in contact with a person that’s infected. The answer appears to be inconclusive. According to Gary W. Cole, M.D., at Medicine.Net, one of the hot tub rash causes is physical contact with an infected person or their clothing, towels, or bedding.

Some other experts, including Azam Anwar, M.D., say hot tub folliculitis does not spread from person-to-person.


Other hot tub rash causes

Hot tub rash can also be caused by chlorine, hot water, and alkalinity, which are not associated with the pseudomonas aeruginosa bacteria.



Red bumps from the hot tub are one of the most common hot tub folliculitis symptoms. They usually begin to appear within several hours after coming in contact with the bacteria, although it can take up to 5 days for symptoms to develop.

These red bumps from a hot tub may present as:

  • clusters of tender, small pink to dark red bumps
  • pus-filled nodules
  • scabbed over bumps
  • white-headed acne looking bumps
  • bumps that are thicker in areas covered by a swimsuit
  • a large swollen mass or bump
Pseudomonas Folliculitis

Other hot tub folliculitis symptoms include:

  • itchiness or burning sensation
  • headache
  • earache
  • nausea
  • mild fever
  • sore throat
  • fatigue
  • enlarged and tender lymph nodes
  • breast tenderness in men or women

Red bumps from a hot tub can appear nearly anywhere on the skin. But depending on the hot tub rash causes, the most common areas are the:

  • face
  • scalp
  • lower back or abdomen
  • armpits
  • buttocks and groin
  • chest or upper back
  • upper legs
  • upper arms

Hot tub folliculitis symptoms generally resolve within 7 to 14 days. However, dark pigmentations may remain on the skin for months. This hyperpigmentation is particularly common in people with darker skin.

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What do red bumps from hot tub look like?

Hot tub folliculitis symptoms can be confused with other conditions. Often people don’t realize they contracted the red bumps from a hot tub or that what they’re experiencing is hot tub folliculitis symptoms. Many people are uncertain whether it is hot tub rash or chickenpox. The bumps can also resemble psoriasis, chemical rashes, other types of folliculitis, and staph or other bacterial infections. Understanding hot tub causes and symptoms can help you in diagnosing your condition.


Are some people more susceptible to pseudomonas folliculitis?

Anyone can get pseudomonas folliculitis. But several factors make some people more susceptible or make hot tub folliculitis symptoms more problematic or severe.

The following factors increase the risk for infection or complications associated with the symptoms of hot tub rash.

Children are at increased risk for several reasons. Babies and younger children have weaker immune systems. Kids also stay in water longer and often remain in wet bathing suits for too long. They’re also more likely to put on a bathing suit that hasn’t been properly washed and dried.

Older adults also have weaker immune systems, so they’re more susceptible and more prone to complications.

Skin conditions, such as acne or dermatitis, make penetration of bacteria more likely.

Health conditions like HIV, leukemia, diabetes, or other conditions that compromise the immune system increase the risk of developing hot tub folliculitis symptoms.

Recent hair removal, including waxing, shaving, or epilation, is another risk factor in developing red bumps from the hot tub.

One-piece women’s bathing suits also increases risk because of the larger area that can trap bacteria.



If you’re unsure whether your symptoms are hot tub rash or chickenpox, or another condition, it’s best to see a physician. Doctors can diagnose hot tub rash based on skin examination, recent hot tub use, and medical history. If the doctor is uncertain, a skin swab might be taken to determine the diagnosis.

To prevent getting these nasty red bumps from the hot tub, find out how to clean a contaminated tub and how to care for it.

If you’re experiencing hot tub folliculitis symptoms, learn how to treat pseudomonas folliculitis.

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