Hot Tub Folliculitis

• Also known as, "hot tub rash," the Pseudomonas aeruginosa bacteria that causes folliculitis thrives in improperly maintained hot tubs. Symptoms typically manifest within 24 hours and up to two days after exposure. Folliculitis first manifests as an itchy, bumpy rash that may transform into dark red nodules or pus-filled bumps. Swimsuits can increase infection by holding water against skin for longer periods of time. In extreme cases, folliculitis can lead to abscesses that may require surgical treatment.
  
  

Hot Tub Lung and Legionnaire's Disease

• The Legionella bacteria causes a type of pneumonia called Legionnaire's Disease and a milder form of the illness called Pontiac Fever. A lung infection, symptoms are usually seen within two to 14 days after exposure. Symptoms resemble pneumonia and untreated Legionnaire's can be serious, resulting in death in 5 percent to 30 percent of cases. The Mycobacterium avium bacteria causes Hot Tub Lung. Non-contagious, M. Avium belongs to the same class of bacteria as tuberculosis. While Hot Tub Lung can be serious, most cases resolve away from the hot tub.
  
  

Other Concerns

• Genital herpes can survive up to 4 1/2 hours on underwater hot tub seats. While not a risk in private tubs, this is something to think about when using communal spas. The American Medical Association advises women to avoid hot tubs during the first trimester of pregnancy, due to a risk of infant neural tube defects. The American Society for Reproductive Medicine notes that high heat of any kind lowers sperm production in men.
  
  

Preventative Measures

• Outdoor hot tubs are safer overall, as bacterial vapors disperse faster than they do indoors. This is of particular concern when dealing with respiratory bacteria such as M. avium and Legionella. Regular cleaning, treating water with chlorine and monitoring acidity levels can reduce or eliminate bacterium in hot tubs.