Q: What type of skin infections can you get from sitting in a hot tub? For example, can jock itch (tinea cruris) be spread to others in a hot tub?

A: The warm, moist environment of a hot tub is relaxing but can also be inviting to certain bacteria, viruses, and fungi. Bacteria such as mycobacteria, E. coli, and pseudomonas aeruginosa can live in the slime found on wet surfaces and in pipes. They can all cause infection.

"Hot tub folliculitis" is caused by bacteria, such as pseudomonas, that can live in hot tubs. Infection of the hair follicles results in red, itchy bumps or pustules. These may go away on their own without treatment, or a doctor may need to write a prescription for medicine.

In addition to skin problems, hot tubs can be the source of a lung infection. The bubbling water creates aerosols that could contain bacteria or other germs, which can then be inhaled. Fortunately, lung infections related to hot tube use are rare.

Direct contact with infected people in the hot tub can lead to bacterial infections, fungal infections—including tinea cruris—and herpes virus infections.

Genital herpes, most often caused by HSV-2, is transmitted by sexual contact. HSV-1, which causes the common fever-blisters is usually transmitted by direct skin-to-skin contact. The herpes virus by itself may not survive long in hot tub water. Direct contact with infected skin or genitals in the hot tub, however, can result in infection, just as it can outside the hot tub.

It's important to drain and clean the tub after use and to maintain proper chlorine and pH levels. Pipes and filters should be disinfected. Everyone should shower before entering a hot tub.

If you have a rash or respiratory problems, or suspect you have infection, make an appointment with your doctor.

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