Can You Get Diseases from Hot Tubs?

Hot tubs feel relaxing, but they can hide more than just bubbles. Spending time in warm, shared water can sometimes expose you to bacteria and germs that cause skin rashes, ear infections, or even serious illnesses. 

Knowing the risks and learning simple safety steps helps you enjoy your soak without worrying about getting sick.

• Be Aware of Bacteria: Hot tubs can harbor Legionella, Pseudomonas, and Staphylococcus, which cause various infections.
  
  

• Maintain Clean Water: Regularly check chemicals, clean filters, and avoid stagnant water to reduce disease risk.
  
  

• Practice Personal Hygiene: Shower before entering and avoid hot tubs with open cuts or wounds.
  
  

• Protect Sensitive Areas: Use earplugs, goggles, and limit head submersion to prevent ear and eye infections.
  
  

• Limit Soak Time: Avoid prolonged or frequent sessions to reduce exposure to harmful bacteria.

Hot tubs can harbor bacteria like Legionella, Pseudomonas, and Staphylococcus, causing Legionnaires’ disease, hot tub rash, skin infections, ear infections, eye infections, and gastrointestinal illnesses. 

Risks increase with warm, poorly disinfected, or stagnant water. Proper maintenance, regular cleaning, chemical monitoring, limiting soak time, and personal hygiene significantly reduce disease risk, making hot tubs safe and enjoyable when used responsibly.

Legionnaires’ disease (LD) is a serious respiratory illness caused mainly by Legionella bacteria, which thrive in warm, stagnant water. 

As highlighted in Frontiers in Microbiology, outbreaks are often linked to cooling towers, hot water systems, and spa-type pools, including hot tubs. 

The Mayo Clinic explains that Legionella pneumophila is the primary culprit, and people typically get infected by inhaling tiny water droplets from hot tubs, showers, or fountains. 

Hot tubs, in particular, create ideal conditions for bacterial growth due to their warm temperatures (77–113°F), circulation patterns, and aerosol formation. 

The Centers for Disease Control and Prevention report documented outbreaks linked to private cruise ship balcony hot tubs, where inadequate maintenance allowed bacteria to flourish. 

To reduce risk, health authorities emphasize strict water disinfection, pH control, filtration, and regular cleaning, alongside maintaining safe temperatures and minimizing stagnation. 

Proper maintenance not only protects users but ensures hot tubs remain a safe, relaxing escape rather than a hidden health hazard.

Pseudomonas dermatitis, commonly called “hot tub rash,” affects a notable portion of hot tub users. A study highlighted in the International Journal of Environmental Research and Public Health found that 21% of hot tub and swimming pool samples tested positive for Pseudomonas aeruginosa, with most strains showing multidrug resistance. 

The bacteria thrive in hot tubs with high temperatures, elevated pH, and low or fluctuating chlorine levels, conditions that weaken disinfectants and encourage biofilm formation. 

Heavy bather use further fuels bacterial growth by introducing oils and skin cells. After exposure, symptoms like itchy red bumps or pustules usually appear within 8 to 48 hours, though they can sometimes take up to five days, typically resolving in 7–10 days. 

Documented outbreaks, such as a 2023 incident at a Maine hotel pool, show a direct link between poorly maintained water and infections, underscoring the importance of strict chlorine monitoring and regular maintenance. 

These findings remind us that vigilance in hot tub hygiene is crucial to prevent both discomfort and potential health risks.

Hot tubs can cause swimmer’s ear, an infection from bacteria entering the ear canal in warm water. Early signs include itching, redness, discomfort, or discharge. 

Prevent it by drying ears, using earplugs, and keeping hot tubs clean. Antibiotic ear drops usually treat infections, but repeated infections can cause long-term damage.

Hot tubs can be a hidden source of skin infections, most commonly caused by Pseudomonas aeruginosa, which leads to hot tub folliculitis. 

As noted in the Cureus Journal, about 67% of hot tubs are contaminated with this bacteria, and outbreaks often affect multiple people using the same facility. 

While true skin abscesses are rarer and usually linked to Staphylococcus bacteria, folliculitis can sometimes progress to more serious lesions. 

Epidemiological reports show that in some outbreaks, over 70% of hot tub users developed the rash, and in children, attack rates can reach 90%. 

Factors increasing susceptibility include prolonged water exposure, tight swimwear, recent shaving, or a weakened immune system. 

The Cleveland Clinic also points out that women are more prone to developing this condition. 

Documented outbreaks, such as those in hotel pools and hot tubs, underline the importance of proper maintenance and chlorine management. 

Staying aware and practicing safe hygiene can help prevent these uncomfortable, often itchy infections.

Spending time in a hot tub can cause gastrointestinal illnesses like diarrhea, vomiting, and stomach cramps. 

Bacteria such as E. coli, Salmonella, and Cryptosporidium can infect the digestive system through contaminated water, with symptoms appearing within hours to days. 

Prevent infections by maintaining proper chlorine levels, cleaning filters regularly, and avoiding swallowing hot tub water.

Hot tubs, while relaxing, can be a breeding ground for bacteria like Pseudomonas aeruginosa, which Texas Eyes notes often cause eye infections such as keratitis. 

Even well-maintained water can irritate eyes due to chemicals like chlorine. People who wear contact lenses, have weakened immune systems, or recent eye injuries are especially vulnerable, as germs can get trapped under lenses or exploit existing damage. 

Symptoms of bacterial conjunctivitis from hot tubs include red, irritated eyes, thick yellow or green discharge, excessive tearing, and light sensitivity. 

Severe infections, particularly in contact lens wearers, can lead to intense pain, blurred vision, and corneal damage, requiring urgent medical care. 

To reduce risk, Texas Eyes and other health authorities recommend removing contacts before entering hot tubs, wearing swim goggles, and avoiding dunking your head. 

Maintaining proper water chemistry, cleaning surfaces, and practicing good hygiene before and after use can further protect your eyes from these preventable infections.

• Personal Cleanliness: Always shower before entering the hot tub to remove dirt, sweat, and lotions.
  
  

• Water Quality: Regularly check and maintain proper chemical levels to keep the water clean and safe.
  
  

• Temperature Control: Monitor the water temperature and keep it at a safe level to prevent burns or overheating.
  
  

• Soak Time: Limit time spent in the hot tub and avoid frequent use to reduce health risks.
  
  

• Infection Prevention: Take steps to prevent skin and eye infections by keeping the water clean and avoiding open wounds.
  
  

• Special Precautions: Children, seniors, and people with health conditions should follow extra safety measures.