Hot Tub rash, where does it come from?

[Bonibelle]

Pseudomonas (and aeruginosa is only one of the many many sp. of this family of water loving organisms) is often found in standing water. (I belive it has been renamed )In any case, it, like gadzillions of other organisms in the environment, is something that we probably encounter routinely and it has no ill effect on us. Given an environment that allows it to reproduce at exponential rates, it can be an opportunistic pathogen, causing the rash and who knows what else. I worked extensively with this family of organisms performing challenges on container closures for a pharmaceutical company. A happy pot of P. Aerugionsa has a very distinct smell. You will all think I am out there, but last month I put my cartridge into my frog system and left the setting far too low, my tub became really cloudy. When I lifted the lid, I recognized that smell. Of course, I have no proof, but I would be willing to bet that the tub was cloudy from P.a. After shocking and setting my bromine where it belonged, we had a tub of foam, frothing foam that I believed resulted from the proteins released from the distruction of the bacteria. (and all of this could be bull, but it made sense to me). When the tub cleared up and things were back in balance, we had no more problem with foam and I didn't use antifoam or anything.
Some of the other critters that Dr. mentions, I wouldn't worry too much about. Some are carried by birds (so if anyone gets them, it would probably be me!)
For my husband and myself, the tub bacteria issue has become a kind of science experiement in itself. Last night while soaking, I told him about this post and we thought over all the ways that the tub can be contaminated. I worried about having mats to keep our feet off the cold deck when we go into the tub. We didn't even think that we cross our door mat (that we wipe our feet on when we come into the house). My son works on a farm. My husband said look at all of the possibilities there...just stepping on the mat that he tracked on and then going into the tub. So this post has provoked quite a bit of thought. We will now use our flip-flops although the tub is only 5 feet from the door. I am buying a new fill hose to fill and top off the tub and hanging it to dry so waterborne contamination can't lurk inside of it.  I always shock after I add water. We thought it would also be important to be sure ALL of the jets get "flushed out" every time we use the tub (even if we just use quiet soak),including the waterfall. The theory being that the water trapped in the hoses could grow if it is not exposed to the sanitizer or the level is a bit low. When you turn them on you could potentially dose the tub with bacteria (if this is wrong please correct me) Thanks so much for this post, J. McD. We have been lucky that we haven't had the rash problem, I want to be proactive and prevent it.

[J._McD]

WOW, thank you Bonibelle, that is some meaningful information.  I have seen over the many years the different conditions that you have described here.  We have all "smelled" different smells from our Hot Tub water before.  It is important to be able to recognize WHEN to pay a attention to the water.

One of the first things we tell our customers, aside from dip strips and test kits, your first tester is sight and smell.  If you can "see" the water (cloudy), or if you can "smell" the water (odor) ALWAYS TEST THE WATER.

Knowing how and where these bacterium come from and how they get into the Hot Tub is very helpful to all of us.  A little knowledge can make a difference.

As for some of the things that doc mentioned, "ring worm" and such I haven't hear of since the '40's and the '50's.  While I know that was a long time ago, these bacteria still exist in society today, a little cleanliness goes a long way for prevention.  That's why we hope everybody wash their hand frequently.  Don't we see that concept being repeated everyday.

Thank you Bonibelle for resolving some of the fear that Hot Tubs are cesspools of infectious bacteria, and the good doc certainly emphasizes the need for proper sanitation.  But, for someone who profits from people on this forum, I believe his post is more frighting than informative or helpful.  Admittidly, he does question his spelling, so I would take that to mean his knowledge is purely superficial and as pointed out by Boni, is off base in some areas.  I searched his web forum and couldn't find any of the bacteria names or issues that he raises.  It is kind of like shouting fire in a crowd and I would suppose he shold do it on his own web instead.  It can result in unnecessary fear.

Use a sanitizer (ozone, chlorine, bromine, ions, baqua, etc.), shock your spa regularly and test the pH and alk.
The better you know your water conditions and what changes them the better off you are.  don't enter the water if it dosen't look good, or if it "stinks".

Incidently, I did find some bacteria test strips on Leslie's web site, 10 tests for $20.  It would be nice to better understand our water better, because this is a serious issue of concern.  You can also contact your health departments to inquire how or where to find bacteia testing kits, while they might cost a few bucks, the information can be very helpful and assuring to say the least.

[Dr. Spa™ Ret.]

Quite obviously you didn't search my forum very well. Ring worm had a long discussion only a few weeks ago, and Dermatitis and excema (try searching with the correct spelling "eczema") are frequently mentioned.

The point of my original post was simply to point out that a "rash" can be caused by MANY things. It's easy to make an assumption as to what caused it. In fact, many people have commented on my forum as to their personal doctors making an assumption and being COMPLETELY wrong. Maybe you'll get lucky in your assumption, but more than likely you may wind up wasting a lot of your time and money trying to combat something that isn't there. Worse even, would be to treat for something that doesn't exist and your problem (rash) gets worse. I see this time and time again.

The ONLY way to truly determine the cause of a rash is to have a DOCTOR that is WILLING to take the time to do a PROPER diagnosis.

If there's anything else you "haven't hear of" the internet is a good place to do some research. I will keep doing the things I feel I "shold" do and will post about that which I feel I'm knowledgeable about.......... Even if my spelling is not acceptable to you.  

Here's 4 more for ya;

herpes simplex
Xerosis
Streptococcus
Mycobacterium marinum

(the herpes is a new one for me, I'll leave the link http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4011510&dopt=Abstract )

[J._McD]

Quite obviously you didn't search my forum very well. Ring worm had a long discussion only a few weeks ago, and Dermatitis and excema (try searching with the correct spelling "eczema") are frequently mentioned.

The point of my original post was simply to point out that a "rash" can be caused by MANY things. It's easy to make an assumption as to what caused it. In fact, many people have commented on my forum as to their personal doctors making an assumption and being COMPLETELY wrong. Maybe you'll get lucky in your assumption, but more than likely you may wind up wasting a lot of your time and money trying to combat something that isn't there. Worse even, would be to treat for something that doesn't exist and your problem (rash) gets worse. I see this time and time again.

The ONLY way to truly determine the cause of a rash is to have a DOCTOR that is WILLING to take the time to do a PROPER diagnosis.

If there's anything else you "haven't hear of" the internet is a good place to do some research. I will keep doing the things I feel I "shold" do and will post about that which I feel I'm knowledgeable about.......... Even if my spelling is not acceptable to you.  

Here's 4 more for ya;

herpes simplex
Xerosis
Streptococcus
Mycobacterium marinum

(the herpes is a new one for me, I'll leave the link http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4011510&dopt=Abstract )

Thanks for your input doc, we all find it helpful.  Your spelling did throw me aff a bit.  But it is not our job or our intent to assume what it is, diagnose it, identify it or treat the things you speak of, only to sanitize, not only for the reason why, but when to sanitize as well.  

The aforementioned is best left to medical doctors who are admittedly in "Practice" and their assumption is typically what they "think" it to be.  I have know many instances where the Hot Tub was blamed incorrectly for many different things that were not produced or picked up in the Hot Tub.  It is blamed only because it is a Hot Tub.

For the benefit of new Hot Tubbers, if the children are using the spa that is clean and clear of any bacteria, (an assumption for the moment if you will) and one of the children gets out to get his squirt gun and then gets back in, the child can and will infect the users in the Hot Tub with pseudomonas bacteria.  It is commonly found on the ground, grass, deck or pavers that WET feet come in contact with it.  THIS IS WHEN WE NEED TO BE SURE THE SPA IS SANITIZED.

Typically, the bacteria on our skin is common to one another in the immediate family, otherwise we would be sanitizing our lips before we kiss each other, BUT if you have an invited guest in the Hot Tub, you will have uninvited body bugs and again is a good time to be sure the sanitizer level is where it needs to be.

Doc, because pseudomonas is #1 and is the most common bacteria, do you have any information where these other bateria forms are picked up from to be introduced into the breeding ground of Hot Water?  That information would be both interesting and helpful.

I think the point of this thread is to be aware of HOW these bacteria CAN be introduced into the water so that we can be a little more proactive and learn.  

Rather than to focus on the "cause" of the rash, I believe the source and how it is introduced is more beneficial to prevent the unintentional introduction or exposure, not the knowledge of it's existence or presence in society.

[Bonibelle]

Ok guys, I guess the possibilities are endless...what could happen or what could grow in the tub.  It took me 2 years to buy a tub and one of the drawbacks was the issue of clean water. If you could visualize all of the potential health threats from microbes that you encounter EVERY day..every time you use a restroom, everytime you open a door....every time you pick up a salt shaker in a restaurant you would be astonished!!! My husband and I did a mini microbiology program for my kid's classes at school. We asked the kids to pick the spots that they thought would be the dirtiest in terms of micro organisms. They of course tested toilet seats, floors and thing that either seemed like they should be gross or things that looked dirty. The winner, however was the kid that tested the computer keyboard!
I am at the point of no need to panic and  with all the help on here, I will learn to keep my tub healthy. One point is that no matter how much you think you already know, there is so much that you probably don't. I am going to find out what the bacteria strips at Leslies are all about.

[ramdom]

Everything else........

In no paticular order, probably not all spelled correctly, and not a complete list;

sensitivity/allergy to chemicals
Grovers disease
unbalanced pH
schistosomes
Dermatitis
excema
Leptospirosis
Toxoplasmosis
Salmonella
Austrobilharzia variglandis
avian schistosome
ring worm

So that's why my brother-in-law wouldn't go for a soak! He said hot tubs were unsanitary cesspools and behold! they are!

[Brookenstein]

My question I guess, is how often is hot tub rash (whatever the cause) even a problem?  What percentage of hot tub owners have a problem, and if they have a problem how often do they get it?

I'm pretty much as far from a germophobe as you can be and I must say I'm not concerned about it in my hot tub or practically anywhere else for that matter.  I do believe in/practice proper hygeine and sanitization for the spa, but I don't give potential problems a thought.  Way too much else in the world that could/can/will go wrong for me to get hung up on this.

My children and I have very sensitive skin... I triple rinse the laundry, have to use special soap, special detergent, etc. and have not had any problem with the spa in our 2 months of ownership.

[Bonibelle]

Brooke, You have a great attitude and obviously have the hot tub routine down. I think the "real" rash (from the bacteria) happens when things get out of control. I just found out at  a family party that my nephew and a friend bought a soft tub for their house. They filled it, heated it and jumped in. The tub was used, they never cleaned it, never checked anything as far as ph, etc and they didn't use any sanitizer. He said he was in and out of it,  but in for a total of about 4 or 5 hours that first day.  He got the rash and it was a pretty bad case. I think the point of J.mcD's post was to make everyone aware of how the tubs could become contaminated and that you can prevent the problem all together by keeping you water quality in check and not introducing things that could throw it way out.

[Vinny]

I think you got to keep everything in perspective.

People have been swimming and or soaking in lakes, ponds, streams, pools and even tubs for years. The only ones that are sanitized are pools and tubs and people don't catch diseases in them all the time.

I myself have seen some questionable pools that people swam in and I even have used my tub with slightly cloudy water after hitting it with 6 to 10 PPM chlorine a few hours before without any ill effects. I will say that both my kids used to dunk their heads under the water in the tub and both got ear infections (1st time ever) - so I believe something was up with not soaking in chlorine; the solution was not to dunk their heads.

I did nuke my tub when I first got it "just in case" but I think you can't get too concerned about the daily soaking and sanitizing and worry about IF your going to get the dreaded rash.

When I first started looking into buying the tub I read that never use the tub without sanitizer in it. But after finding Doc's site and reading Vermonter's regiment, I knew that the tub would be safe without soaking in chlorine.

As been posted here and on Doc's site there are people who don't use the amount of sanitizer I use and have clean looking water and no issues. D1 even advertizes their Vision system as a chlorine alternitive and only use chlorine when the spa looks cloudy.

I don't think there's a need to worry about all the things that can grow in the hot tub ... what about a big asteroid hitting the planet, now that's something to worry about!

[Bonibelle]

It's funny Vinny, when I get out of my hot tub, I can look down from the deck to my koi pond. I have  been in there bare footed and up to my armpits in pond sludge, dead frogs and decomposing plants (spring cleaning time) but it never worried me and I never got anything from that mess. The hot tub is a different story and I guess it is just because you expect it to be clean and if it is not, then you did something wrong.

[Gomboman]

Very good information Bonibelle. What is your background? Are you a Microbiologist or some kind of  scientist? Thanks again for the input.

[Bonibelle]

I am a MAD scientist  

[Snowbird]

This is a great thread and hopefully it won't end up in the dead horse file.  I knew there could be problems with the tubs, but never this much.  Apparently the biggest enemy is a casual attitude.  In the end a properly mainteined tub that is used thoughtfully should never be a problem.

Regarding the Doc' posts - I never met the guy, but I don't believe for a minute he uses this forum to scare people into buying his merchandise.  If that is what you think - shop someplace else.  If you think he is full of BS, do a little research and show him why he is wrong.  But it isn't fair to make unfounded accusations.

Bonnibelle - your post has made me think about my set up too.  Even though our tub is indoors we can still track junk in it that shouldn't be there.  We have been fanatical about being clean before getting in the tub.  We are finally finished spackling and sanding and have 2 coats prime on the walls so dust is no longer the problem it was.  

A few days ago the tub had an unusual smell to it.  We tested and shocked and it is okay now but we used it anyway.  I felt little tingles on my skin and had to shower to stop it.  My wife was unaffected.  Wonder what that was.  Taking a water sample to the dealer tomorrow afternoon.

Go Steelers!

[Bonibelle]

Know what Snowbird, it may have been nothing! Sometimes we think too much.  
And Gombo, I was being silly, I have a clinical lab background, no big deal but I have lots of experience with microbiology and contamination control. My husband and I worked together for years growing, fermenting and evolving (if you will) all sorts of microorganisms for studies in the pharmaceutical industry. That is probably why we can't stop the contamination discussions in the tub. If my tub gets funky again (hopefully it won't) I will send a sample with him and see what grows from it.  (Funklogongothermopholus. hotubius )

[Vinny]

Chlorine is a wonderful chemical that disinfect most things, if given the proper amount of time.

When I started using my tub, I was putting in at least 3 PPM after I soaked. Now I use 1.5 PPM per person after soaking and another 1.5 PPM every other day after the soak and as far as I can tell, my tub is clean and I am assuming bacteria free. I monitor the combined chlorine and lately it is usually below 0.5 PPM. If the chlorine was killing and combining with anything (bacteria, dirt ...) I would be seeing greater combined chlorine readings (at least that's my logic).

Water can get away from anyone, we get busy and that 5 minute dosing doesn't happen. Snowbird, you said you shocked it and went in, how high was the chlorine and how long did you wait before going in? You might have had a chlorine reation, not a rash reaction. I know that if I keep my chlorine dosing to 1.5 PPM every other day I don't get cloudy water but if it get's away from me I put in at least 6PPM to "shock" it.

As Bonibelle said, she's been in pond sluge to which I'd say "yuk".  No way you'd get me in that without waders! I would think that whatever gets put into a hot tub needs time to grow. If it starts out low, which it should and quardruples in 50 minutes of soaking .. chlorine is my best defence with O3 doing whatever it does!