itchy sore on leg that won't heal

[MFranc]

About 3 months ago, me and a friend went on a rafting trip. we stayed at a cabin that had a hot tub. one of the nights we were up late hanging out and drinking beer and got ate up by mosquitoes. we boiled in the hot tub for awhile.

now, 3 months later, most of the bites have long since gone away, except for 2 which will not seem to heal. They still flare up and itch, get a small scab and appear as if they are going to heal, but never really do. 1 is on my calf, the other about 2 inches above my knee. It does not seem to spread other than if i scratch the surround hair follicles become mildly irritated for a day or two.

my friend also has 2 or three bites still on his arm and back. Is it possible that these bites got infected from the hottub, perhaps with staph or something?

Standard topical antibiotics (Clindamyacin phosphate, prescribed by my primary care provider) doesn't seem to have any effect either. My mother suggested a daily bleach-water wash which got rid of my brothers impetigo when he was little. Any thoughts or suggestions?

[Bhupinder Kaur, MD]

Hello,
From the symptoms hot tub folliculitis is a possibility but any insect bite and tick bite also needs to be evaluated. Hot tub folliculitis is an infection of the hair follicle with Pseudomonas bacteria and is most commonly seen in people who bathe in a contaminated spa, swimming pool, or hot tub.

I would suggest that you apply calamine lotion and a simple antimicrobial cream like Bactroban or Neosporin on the rash and keep the area clean. For the itching antihistaminics like Benadryl can be taken. If the symptoms persist then topical steroids and oral antibiotics may be needed. Please consult a dermatologist in that case.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[MFranc]

Thank you very much for you're very informative reply to my post. :)
I never knew there was an infection specific to hot tubs!

I tried the bleach-water, that my mother suggested, on the bump on my calf, which was the worst one. I did a 50% bleach mixture, dabbed it on the area for a couple minutes, twice a day, for 3 days. It is no longer raised, never itches and seems to finally be healing rather quickly. The downside is that the surface skin in the area that i washed is rather raw and tender from the bleach.

I will try your more gentle suggestions for the other one, and hopefully avoid the discomfort of the bleach wash, which also smells unpleasant.