How do you cure hot tub folliculitis

Whirlpool Dermatitis - Causes & Online Treatment From Dermatologists

Whirlpool dermatitis forms pustules, itches and develops relatively quickly.

↓ causes
↓ symptoms
↓ diagnosis
↓ therapy
↓ prevention

Whirlpool dermatitis - causes

Whirlpool dermatitis is an infectious disease of the skin. This infection, also known as "hot tub dermatitis", is usually completely harmless. The cause is a bath in water that is contaminated with the bacterium Pseudomonas aeruginosa. As the name suggests, the typical infection site is a public or private hot tub.

As wellness offers and affordable hot tubs for private households have spread, the number of cases of skin redness, pustules and rashes caused by hot tub dermatitis has increased significantly. The triggering bacterium Pseudomonas aeruginosa feels particularly comfortable in warm whirlpools and other bathing areas with a water temperature of over 30 degrees and the air mixed in by the bubbling.

This provides ideal conditions for the bacterium to penetrate through the skin barrier, which is weakened as a result of heat and moisture. To make matters worse, the disinfecting chlorine is broken down at water temperatures above 30 degrees Celsius. An inadequately chlorinated whirlpool therefore presents a particularly high risk.

The rash after a hot tub is usually more common in children than in adults. In addition, there is a connection between bath time and the likelihood of infection. The longer the bath time, the higher the likelihood of redness after bathing in the hot tub. Since the pathogen can also occur in hot water boilers, the infection is in rare cases also possible via the bathtub at home.

About Pseudomonas aeruginosa

The bacterium Pseudomonas aeruginosa belongs to the soil and water bacteria. These occur everywhere in nature where it is sufficiently humid and there is a water reservoir with a standing water supply. The bacterium tends to feel more comfortable at higher water temperatures and when there is a high level of oxygen in the water. Pseudomonas aeruginosa can multiply in both dirty and otherwise clean water.

Symptoms of hot tub dermatitis

The incubation time for the first symptoms of whirlpool dermatitis is usually 8 to 72 hours. In individual cases, however, longer incubation times of 5 to 8 days are possible. The main symptom of the infection is an inflammatory rash (exanthema) in the form of red spots, pustules and papules. These usually appear as a symmetrical distribution on both sides of the body and occur preferentially in the area of ​​the swimwear or on the side of the chest wall. There is also a characteristic itchiness.

In many cases, the skin irritation after a bath in the whirlpool is accompanied by a sore feeling in the chest muscles and painful redness and swelling of the mammary gland. The latter is usually sensitive to touch and shows symptoms similar to those of a classic bacterial inflammation of the mammary gland (mastitis). The directly visible symptoms are supplemented by general disease symptoms, which only occur in some of the patients. On a statistical basis, the following figures result for other associated symptoms:

Other symptoms of hot tub dermatitis

  • Sore eyes (approx. 75% of all cases)
  • Earache (approx. 70% of all cases)
  • Sore throat (approx. 43% of all cases)
  • Headache (approx. 41% of all cases)
  • Fever over 38 ° C (approx. 33% of all cases)

Complications such as furuncle-like inflammation (recurrent folliculitis) or chronic abscesses are significantly less common with whirlpool dermatitis. The appearance of the characteristic papules and sometimes pustules on the soles of the feet or palms is also quite rare. This sometimes painful phenomenon is also known as whirlpool dermatitis with hot feet / hands. If the external ear canal is affected, the bacterium Pseudomonas aerinusa can cause inflammation of the external ear canal (otitis externa).

This is how the diagnosis of whirlpool dermatitis is made

Your assistance will be particularly helpful in diagnosing the skin infection. As a rule, a visual diagnosis is sufficient for clear identification. So be sure to mention the circumstances of the infection. Since the first symptoms sometimes only appear days after a bath in a whirlpool, many patients do not bring the two events together.

If you have enjoyed a bath in a whirlpool either at home or out, please mention this during the anamnesis interview. This note is usually indicative for the diagnosis. In order to rule out other infections with viruses or bacteria, a differential diagnosis is often carried out.

Not sure if your skin infection is hot tub dermatitis? With a few clicks of the mouse, you can send our dermatologists photos and more detailed information on your skin problems via our homepage. Regardless of whether it is an initial assessment or a second opinion with a suggested therapy - our dermatologists from Heidelberg can save you a lot of going to the doctor.

Whirlpool Dermatitis Therapy

In principle, there is no standardized therapy for the treatment of whirlpool dermatitis. Typically, however, the infection heals completely on its own after 10 to 14 days. Only in individual cases does the inflammatory rash become very persistent, lasting from 4 weeks to several months. In more severe cases that have a generalized spread apart from the infection of the skin, an immune deficiency should be ruled out by the attending physician.

For the therapy, preparations such as 0.2% gentamicin in lotio alba aquosa or alternatively 0.1% gentamicin cream for the external treatment of the skin are used. If the infection does not heal spontaneously, medication can also be used for internal therapy. These include the antibiotic agents ciprofloxacin and ceftazidime (in severe cases). Alternatively, if you are allergic to penicillin, short infusions with the active ingredient tobramycin are also possible.

This is how you can prevent whirlpool dermatitis yourself

If you have acute hot tub dermatitis or a past infection, avoid hot tubs for a few weeks. You can protect yourself preventively against infection by avoiding wellness and hotel facilities that only have low hygiene standards. A warning sign can be slightly cloudy water or dirt in the pool area. A thorough shower with soap before and after a bath in the whirlpool promises additional protection.

Once you've caught the infection in your own hot tub, this is your starting point. The first measure is to completely change the water. Furthermore, experts recommend temporary overchlorination for at least 72 hours. The guideline here is a chlorine concentration of more than 5 milligrams per liter of water. As a preventive measure, you should also regularly check the pH value and the ratio between bound and free chlorine.