hot tub folliculitis

[poobear]

Dr. Rock,

I am a 39-year-old woman.  After going into a hot tub one year ago, i still have recurring folliculitis.  It bothers me the most across my pubis, which is where the folliculitis first started.  But i also have it on my chest, neck, back, at times under my arms, stomach, and head. I have been to several doctors, had 3 separate biopsies, and still i am having problems with this.  I have exhausted a lot of money trying to rid myself of this problem.  I have used Brovoxyl washes, Borrow's soaks, vinegar soaks.  Antibacterial soaps like Cetaphil and Hibiclens. I have taken several rounds of antibiotics to include: Cephalexin for over one month, Doxycycline, Septra-DS, Levoquin.  I think after almost 10 days of the Levoquin i started to see some improvement, but i only was on it for 2 wks.  This was 6 months after the original hot tub infection.  It was a miserable spring and summer.  The vingar soaks help to control the infected hair follicals across my pubis, but once i went into a stand up tanning bed, and later used an electric blanket it started up again.  The biopsies did little to help.  All they said was folliculitis, perifoliculitis, and granulomatous folliculitis.  None of the biopsies stated if it was gram stain neg or pos anything. I did have two granulomas taken off that were on my pubis where the infection was bad.  This is the biopsy that said granulomatous folliculitis.  Do you think i will ever be able to rid myself of this?  Do i need to worry my boy friend will get this from me?  Do you think this is a bacterial infection this is still living on?  Is this possible? I understand that pseudomonas is a big problem with hot tubs and infections, but that most antibiotics are resistant to it.  What should i do?  A pharmacist suggested an injectable antibiotic, because most of those are not resistant to pseudomonas.  If so can you suggest an antibiotic? I have seen over 6 different doctors for this.  They just take my money and poo poo me off!!!  I am not looking forward to another sweaty, hot, and itchy summer. Please help!!!!!

[Alan Rockoff, MD]

Hot tub folliculitis caused by Pseudomonas bacteria can be dramatic to look at and have, but it is not chronic.  Whatever you have now is not related to the hot tub incident.  It does not sound contagious either--certainly your boyfriend would have caught it by now if it were.  I think your story sounds most like ordinary bacterial folliculitis.  This is best suppressed by daily cleansing with an antibacterial soap and the regular application of an antibacterial ointment like Bactroban into the nostrils, because that is where the (staph) germs live.  If your dermatologists haven't suggested this, perhaps you can ask one about it.  By the way, if you are picking or squeezing any of these in an effort to clean them out, please don't.  I don't recommend any further biopsies.

Take care.

Dr. Rockoff

[poobear]

Oh, one more thing i almost forgot.  I have also used Muperocin ointment in my nostrils for one week, and have been using hot compresses off and on.  I read that if you stand in the shower for 5 minutes with the water running as hot as you can stand it using a wash cloth over the area of folliculitis it would help the condition to subside.  This does help somewhat, but requires doing this several times per day.  Can you offer any other suggestions.  These spots are usually red some are raised and mostly centered around hair folicles, some are just flat slightly red areas that itch.  Others come to a head and are larger with the folicle involved.

Thank you for you time.

[poobear]

I have been scratching the ones in the chest area.  Yes, this does make it worse.  I have found some relief with the vinegar and hot compress soaks, but still have recurrence.  I never had any problems before i went into the hot tub.  Is this what happens to people after they have been infected in a hot tub?  Will it ever go away?  As for the relationship, it is a fairly new one of about three months.  When i started having recurrence i became very concerned about getting close to him, but have been told this is not contagious.  Even at that, i still have a hard time with this.  

Thanks for your time, also i have tried the ointment in my nostrils, with little help.  How long should a person be using this?

[Alan Rockoff, MD]

At least three months.

Dr. Rockoff

[Kitty2004]

I am a 25 year old female, and about three years ago I got folliculitus (folliculitis) for no reason I could think of...it started as red bumps all over my bikini line and legs. For five months I took various antibiotics (diff. forms of penicillin basically) that would sort of clear it up but it would always come back, especially if I shaved or waxed. My legs were covered, and I went through the summer wearing pants because I was so completely embarassed. I became extremely depressed and self-conscious. I saw doctor after doctor who would prescribe me antibiotics and advise me not to shave or wax my legs. Which, of course, was inconvenient but I was so depressed and desperate that I tried it.
Finally, one doctor suggested I try a naturopath, which I did. After four months or so of seeing her and being on various naturopathic remedies and changing my eating habits (no sugar, caffeine, etc) and growing out the hair I was ready to try shaving...the bumps went away and when I shaved there was no more folliculitis! I don't know which parts of the remedies helped, but I do credit it with changing my life. You might want to try something naturopathic if you've exhausted all avenues of conventional medicine.

[Kitty2004]

I am a 25 year old female, and about three years ago I got folliculitus (folliculitis) for no reason I could think of...it started as red bumps all over my bikini line and legs. For five months I took various antibiotics (diff. forms of penicillin basically) that would sort of clear it up but it would always come back, especially if I shaved or waxed. My legs were covered, and I went through the summer wearing pants because I was so completely embarassed. I became extremely depressed and self-conscious. I saw doctor after doctor who would prescribe me antibiotics and advise me not to shave or wax my legs. Which, of course, was inconvenient but I was so depressed and desperate that I tried it.
Finally, one doctor suggested I try a naturopath, which I did. After four months or so of seeing her and being on various naturopathic remedies and changing my eating habits (no sugar, caffeine, etc) and growing out the hair I was ready to try shaving...the bumps went away and when I shaved there was no more folliculitis! I don't know which parts of the remedies helped, but I do credit it with changing my life. You might want to try something naturopathic if you've exhausted all avenues of conventional medicine.

[poobear]

Kitty,

Can you give me more info about the naturapath treatments you received?  This would be greatly appreciated.