From the Research
Hot tub dermatitis is typically treated by first discontinuing exposure to the contaminated water source and using self-care measures such as thorough cleansing of the affected skin with antibacterial soap and applying cool compresses to reduce inflammation. For mild cases, self-care measures include using over-the-counter anti-itch creams containing hydrocortisone (0.5-1%) two to three times daily for up to a week. For more severe cases, a healthcare provider may prescribe stronger topical corticosteroids like triamcinolone 0.1% cream applied twice daily for 7-10 days. If the rash appears infected (showing increased redness, warmth, swelling, or pus), oral antibiotics such as cefiderocol, a new cephalosporin, may be necessary to target Pseudomonas aeruginosa, the most common causative bacteria, as suggested by the most recent study 1. Antihistamines like diphenhydramine 25-50mg every 6 hours or loratadine 10mg daily can help manage itching. Prevention is crucial - properly maintained hot tubs with adequate chlorination (2-4 ppm free chlorine), regular pH testing (7.2-7.8), and routine cleaning help prevent recurrence. Some studies have reported allergic contact dermatitis to potassium peroxymonosulfate, used as a chemical shock treatment for hot tubs and swimming pools, which should be in the differential diagnosis for patients presenting with dermatitis triggered by swimming pool or hot tub exposure 2. The condition typically resolves within 7-10 days with appropriate treatment and elimination of exposure to the contaminated water. Key considerations in the treatment of hot tub dermatitis include:
- Discontinuing exposure to the contaminated water source
- Using self-care measures such as thorough cleansing of the affected skin with antibacterial soap and applying cool compresses to reduce inflammation
- Using over-the-counter anti-itch creams containing hydrocortisone (0.5-1%) two to three times daily for up to a week
- Prescribing stronger topical corticosteroids like triamcinolone 0.1% cream applied twice daily for 7-10 days for more severe cases
- Using oral antibiotics such as cefiderocol to target Pseudomonas aeruginosa if the rash appears infected
- Managing itching with antihistamines like diphenhydramine 25-50mg every 6 hours or loratadine 10mg daily.