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Warning about hot tubs and jacuzzis

Whilst on my daughters hen do 3 weeks ago we visited a spa and I used the jacuzzi. The next day I had a rash on my stomach which was itchy. After trying dry skin creams and with the rash now affecting my neck and chest i gave up and went to gp. Apparently I have foliculitis from a bacteria in the jacuzzi which doesn't normally bother people too much but because I was on prednisolone my body couldnt fight back. Even really well maintained pools, hot tubs and jacuzzis can carry bacteria.

Unfortunately the cream I was given didn't work and one course of antibiotics has not resolved this rash which has now spread virtually everywhere except my face and is incredibly itchy.

I would never have gone in the jacuzzi if I had known there was even the slightest chance of me catching something. Bear this in mind if you intend to use a jacuzzi or hot tub whilst on pred.

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134 Replies

I hope you managed to get to the wedding!

Sending sympathy xx


Wedding was great even with the rash. Both kids married now and officially not my problem anymore!!


Hope that lasts!!!!!!


Probably wont bug I can dream!!


Don't you believe it!!

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I am still in rose tinted glasses mode. The oldest got married 17 months ago and still manages to keep turning up. I did think of changing locks but they would just make a scene in the street!!


Took us moving to Italy to get rid of the left-behind-belongings... Then they had the cheek to complain we'd chucked things out despite plenty of warnings.


My eldest has never lived at this house yet somehow we have numerous belongings of hers. I just give SIL a bag of her stuff and look at his pained expression when he realises she has even more stuff than he thought!!

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Even when they move to NZ - they send the grandchildren over!!


Probably preferable to the kids ...



Just wish he wasn’t 6’4” with an appetite to match! Still useful for getting things out of tall cupboards - and the attic! Stepladder- who needs a stepladder!

Love him really!

Rest of family arriving in June for a month!


Do they all eat the same?

Not quite as much as him, but they all have “healthy” appetites.

Luckily my grandson is only 6 but hes already 4ft 6 in and growing by the minute!

The only option i have is to move and not tell them where I am!! Mind you I am still convinced that injection they give new born babies in hospital is just a homing device and no matter what you do they will find you!!


Having to use a plane does reduce the dropping in and stealing from the fridge or wardrobe ...


Eldest only lives 5 miles away but uses our house as a toilet stop on her way home from work. Luckily youngest lives 25 miles away so less likely to just appear!!

2,000 km is an effective deterrent ;)

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We moved out, put the house on the market, and told them to sell it. They both got their own place but two years later one followed because he found a job near us!


See!! Homing device!!


Thank you for the heads up. Hope it resolves for you quickly.

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Oh dear. Hope you can find something which relieves the problem soon. I've never been in a hot tub, there is one in the building where I now live, and it's because I've always had an uneasiness about them. Thanks for heads up in case anyone tries to talk me into trying the one here!


I used the one at the gym very occasionally in the early years of PMR (no pred though). I preferred the steam room and sauna.


So sorry to hear about the resulting itchy rash after your dip in the jacuzzi. How awful.

We have our own hot tub that we maintain and it has been really helpful for my PMR. I go in it weekly (for the last 1.5 years) while I’ve been on pred (the last year), without incident. Of course, we control how often the water is changed and the chemical levels, and we have way fewer people who go in it compared to public jacuzzis.

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It's more.likely that public jacuzzis are more prone to having a higher degree of bacteria in them than home hot tubs etc. As you are controlling the quality of water then hopefully you shouldn't have a problem

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I find a steam room very helpful , can't take the hotter , drier sauna heat anymore .

Most good gyms and spas have medical questionnaires , in fact if they don't provide health warnings on their websites or brochures I say don't use them , as they are clearly not well trained in providing care for those with special health issues to prevent emergencies .

They usually ask if you have blood pressure , asthma , allergy or heart issues because you are not meant to steam/ sauna/ jacuzzi without supervision with blood pressure issues .

If you do use them the medical health WARNING is not to do what you once did and alternate between steam or sauna and a cold shower as it can worsen your BP symptoms or tachycardia issues.

You are likely to faint or have heart pain.

The jacuzzi should have similar warning signs for people with immunosuppression and allergy issues .

They do warn pregnant women not to use them because of the risk of catching infections from the bacterial stew of a public jacuzzi.

Realistically on Pred and other immuno suppressants we should follow similar guidelines to pregnant women .

I have never really liked the idea of the human soup bowl of a public jacuzzi , even when trying one I can't stop imagining those old cartoons of cannibals with bones through their noses dancing round a big cauldron full of giant carrots and onions, and bugs bunny!

They are , even if well maintained , a regular source of infection .

Another issue with GCA/ PMR is that the jets are very strong in public jacuzzis , and were before that level of power was really soothing , for many with weaker joints , weaker muscles and added neuropathy problems , they can be quite painful at the time and increase your chances of swellings later.

Like YB , been there , done that , wish I didn't have the t-shirt and added medication required afterwards.

In short , with GCA/ PMR on medication , don't use public jacuzzis !

Thanks for the heads up YB, great useful post for all xxx

The rash is not pretty but my biggest bug bear is the itchiness. Its driving me mad!! Even if I didnt take pred in future I would not be going in hot tubs or jacuzzis again.

Fine if you are lucky enough to have your own at home , but yes , fragile skin and public jacuzzis don't mix well.

Just so sorry you had to learn that lesson in such an itchy way , and just before your daughter's wedding too!

But at least you still all had a wonderful day xxx

Even ones at home need to be cleaned properly! The bugs nest in the jets ...


Yes , I am on a water meter here in Wales , with the amount of times we would need to clean and change the water to be sure it was ok to use I don't think my bank balance would stand it!

My friend has a jacuzzi function in her bath that she swears by , which is easier to clean the jets with , if you do find help with hydrotherapy that is probably the way to go.

We are looking into it as my Rheumatologist has advised hydrotherapy as part of the treatment for the joint laxity being caused by the Degenerative Hypermobility Disorder ( EDS confirmation process slowly continues! ) that I have now also been diagnosed with. This is also what he is concluding was part of the cause for early onset GCA/ PMR.

Apparently , it means my joints , vessels and ligaments ( anything with connective tissue) are all about 15 years older than my actual age in years because of hypermobile wear and tear.

I've been telling my family that I must be an OAP on the inside for years , seems now that I was right. 😋😁😂😂😂

Hope you and the OH are muddling on alot better now , take care Brains 😋😘xxx


Luckily we are not on a water meter so keeping our pool clean isnt too expensive.

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Take up any offer of hydrotherapy you can get! I am currently having a course of five weekly sessions through NHS as part of my physio therapy sees ions following my accident at Christmas. I love hydrotherapy and would gladly pay privately for the sessions. I have made more progress in three weeks than in three months previously.

Hope it does the same for you.

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I always love swimming for exercise so when they suggested it I was very eager, what do you do at your sessions?

We have one physio to three patients for half hour x 5 sessions. Two of us have had shoulder bone replacements so we do similar exercises to strengthen muscles. Mostly using submerged floats of different weights and drawing circles with them under water. We also do a version of push ups against side of pool to extend arm forwards. This works for me since the water supports the weight of the arm so no strain whatsoever. Also the heat of the water relaxes the muscles so they work easier. I am not a great lover of swimming, but love hydrotherapy.

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I am sure the hydro pool is kept clean, it's really to do with "spa" ones. Just remember if you do get a rash dont just ignore it.

That's what gp said. He reckons so many people react to this bacteria but they only get a brief rash or other minor reaction because they have immunity unlike us on steroids!!

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The idea has made me itch. I have given them a wide birth since i got glandular fever. I am convince sitting in a tank full of people's sweat and "germs" was where i got it. It was the only place i was in close confines with anyone.


You can also get it from heated swimming pools !!

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We have an outside pool which we heat during the summer and I am seriously thinking about not doing any heating of it again. Especially as grandson uses it and I dont want him getting anything.

If you regularly check the chlorine levels, all should be OK. As folliculitis thrives in swimming pools and hot tubs where the pH is not kept at correct levels. So worry not about your pool if you check the water quality.

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Thats a relief! Especially when our summers dont get that warm and a cold pool isnt that welcoming.

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Yes , as it is your pool you will be conscious of keeping it clean and the chlorine levels right so heating your own pool should be alright and be of great benefit to you while you exercise in it with PMR.

You also know who is going in your pool and can make sure that any of your friends or family are free of potentially infectious rashes before letting them jump in.

It's the Public Pools and Jacuzzis that you need to be wary of , it's often best to take a look at them ( and the cleanliness of the changing rooms ) before using them when you are on drugs that can make your skin fragile or cause low immunity.

If it doesn't look and smell as clean as it should , and if you can't see that they actively clean ( they should have those charts on the wall that show when cleaning has been done each day) Don't Give Up Swimming ! find another public pool.

Swimming is such a good all body exercise for people with PMR , joint problems and blood pressure issues and it can be done at any level you can manage so it's worth continuing , just with a few hygiene precautions to take account for your immunity on Pred .

If you do have any fragile areas of skin and you use a swimming pool my TOP TIP is that you smear a cover of vaseline on it. It waterproofs the area enough while you swim and keeps infection out of any rash , bite, ulcer, scratch or spot you might have . I do this all summer with any skin issue I have and it does work.

An antihistamine before swimming , especially in outdoor pools , if you can take them on your medications also helps prevent any allergy rash occuring that can turn into something more .

And always wash off properly after using a public pool at the Centre , don't wait until you go home .

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I worked in a public pool many years ago - people don't shower and that is the least of the problems. Just DON'T ask ...


Snap !

Were you a Life Guard too ?

I worked at a pool and on the beach , and as you know there are certain pools of times if year that swimming in the sea is alot more hygienic than going in a public jacuzzi or pool.

You see alot working at a pool , which is why you learn what precautions to take in public leisure centres , and which places to avoid , pardon the pun , like the Plague!


Oh yes - one of the more useful things I did at school was life-saving!!!


I definitely wont ask. I antibacterial wipe the shopping trolley!

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Oh my God I am becoming more paranoid by the minute

I live like a teenager, mess wise in my own home....its other peoples germs that bother me! I used to be a bit funny about crossover germs, mainly because i am a strict veggie and hate people touching meat products then touching my food. But as i get older i am terrible. Pred and a dmard have just given a good excuse to demand better hygiene standards. People not washing their hands after the bathroom is a particular issue. I have had lots of cleaning jobs in the past and with gloves etc have cleaned the worst places without an issue. Thats a job. My youngest neice and nephews have been told many a time to wash hands. I even clean my remote controls....house is a mess but remotes clean 😂😂😂


We must have drilled hand washing into our grandson because he does it automatically but if we remind him he shouts out "I know but I am still on the toilet!!"

You see too many people going to public toilets and then just walk out!! Yuk


Thats sounds like me shouting through the door 😂😂😂. I have one neice i never had to tell/ask about. The rest (7altogetber aged 7 to 27) were a lottery!


He does have a hard time hes the only son/grandson/nephew and we all tell him the same thing!!

Bless him.

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Especially when they walk off and turn out to be cafe staff. Double yuk.


I have always said my house is messy but clean.


Just to let everyone know the outcome of dermatology visit. Apparently I have managed to get foliculitis AND a fungal infection on top because of lowered immunity. To br certain they have taken a skin biopsy and issued me with a whole raft of creams and antihistamines till I see them in 3 weeks. I have to say I am really impressed with not only my gp who is of the opinion that steroids work for pmr and although there are side effects the benefits out weigh the cons and she doesnt know what all the scare tactics from some gp's is about but also how quick everything happened with dermatology today.

I have been unlucky to get both but I would advise people who get a rash after using public hot tubs and jacuzzis to see their gp straight away.


Great advice YB .

I'd just add , don't forget to remind your GP that you are on steroids and that it can cause immunity issues , and let them know about YBs experience .

Many GPs forget , or don't realise just how much effect steroids have on the immune system and skin reactions and there can be a delay in you getting the right antibiotics , creams and tests to stop it spreading and getting worse as they treat your infection like they do for a healthy person.

To stop getting a rash like YB , speed is the key to stopping the spread!

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I did wonder about a fungal infection. My go to rash on my skin.

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Just to let everyone know I am stopping replies to this post although I will leave it up for the rest of today. Thanks for all the replies and suggestions for stopping the dreaded itch.

Sorry to read about this YBB - hope it’s starting to improve now! x

Isnt going so back at the gp's again. Rash spreading!! The beat bit is even though doctor says it is not infectious the receptionist wants me to sit in the corridor!! Already asked her when she qualified as a doctor!!

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Good Luck 🍀 have you had any antihistamine? Ask GP if it’d help? x

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Had strong ones but they work for a couple of hours then I am back to scratching!!

Might have got you to see the Dr quicker ... Cheek! But it's OK for you to "infect" the GP?

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I wouldnt mind but the automatic booking in system in now in the waiting room and comes up with large red writing with exclamation Mark's saying go to the receptionist!!

Think that needs rethinking!!!!

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I was thinking of running around the waiting room on my way to corridor touching everyone but could end up with worse that foliculitis. Mrsnails idea would be fun though

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Yellow flag to go with the name - and a tuneful "Unclean, unclean ..."


😂😂😂- got it, got it,got it

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It's ridiculous after two gps have said it's not infectious but apparently our receptionist know better!! I usually go up an octave or two when stressed but OH decided to propel me towards the corridor chairs before I could get too loud!! He is such a spoil sport some days

😂😂😂 i once had 60osquito bites and that itched and drove me mad. Cant imagine what a full body rash is doing to you.

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No matter how much you try not to scratch you know it's going to happen and unfortunately once you start you cant stop!

I went out for a meal during mossiebitegate (as the family call it). I was like a cow rubbing myself on the wooden bench seat. I hope you get something sorted soon. I am sitting here stratching for you!

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I am the same, rubbing myself up and down on anything convenient!!

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Charming! Don’t forget your bell to ring before you walk!......

Well, at least she let you have an appointment!

Let us know later x


Well I had an interesting appt. Doctor shocked at how much the rash had spread and phoned the dermatologist and now I am seeing specialist 2.30 today!! Our local hospital despite being a major trauma hospital dont have an on call dermatologist so having to go to Portsmouth instead. Tbh I would be willing to travel a lot further to resolve this rash.


What dose of pred are you on?

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I am on 10mg from 15mg

Thanks. I have been thinking about going into some natural hot pools as don't have any broken skin at present. I just think again!

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Unfortunately we are prone to getting stuff and I wouldnt wish this rash on my enemies. I dont want people to change things just be aware of the possibility of catching something.

I use a jacuzzi very week. It is scrupulously clean and significantly helps my PMR. Hope the wedding went well.

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I think its more about where you go but the gp says although it can be spotless it can still breed bacteria. I really enjoyed the jacuzzi but not keen to repeat now!!

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I will still go for the relief it brings. I also swim in the heated pool.

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I think I have been really unlucky. Pools seem to be different for some reason.

Cooler water temp - and greater water volume per bather - uses up chlorine less quickly.

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You can go to the same pool or jacuzzi sometimes every week and have no problem at all , and then one day " BOOM!"

Unfortunately , you have no idea whom may have been in a hot tub or jacuzzi on that day and what they might have had.

Just like us bacteria and fungi love a warm , damp enviroment and it's a perfect condition for a bug family to breed into a city.

Does little to most people , but can cause havoc to you if your immunity is down.

You are usually alright with the right precautions at a pool you know well with good cleaning policies.

But you do need to use caution , especially in pools of jacuzzis in busy hotels or on holidays .

Thanks for the warning.

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Thanks for the warning- hope the visit to the dermatologist went well. X

Spa folliculitis is something I’ve gotten two or three times BEFORE getting PMR, but not since. It’s caused by pseudomonas (sp?), I believe, and the toughness of your hide has something to do with whether you get it or not. (My husband never got it, though we were in the same spas for the same length of time).

NEVER get in a spa with cloudy water! I brought spa test strips with me to hotels with spas to pre-check the chlorination before getting in. Haven’t had “spa bites” in years.

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I dont think I am ever going to go in a jacuzzi or hot tub again.

I am so happy for the home hot tub we have. My achy body loves it, and it’s lovely to do isometric exercises while lolling in the enveloping warmth.

That sounds like bliss

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What great advice , spa test strips before you go in , I'm definitely getting some of them , thanks.

A link to American Osteopathic College of Dermatology about it:


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Thanks for the link. That is exactly how it started even down to one piece costume and showering afterwards.

Sorry you had problem with hot tub. My experience is quite different. I have hot bath every night, and soak 15-20 min to relax before going to sleep. Never had an issue, but water is fresh for each bath. I also use community swimming pool 2x a week and it has hot tub... again no problem.

Guys have tougher hides than gals to begin with. I’ve gotten spa folliculitis several times all over my torso and thighs, and my husband who was right there soaking with me each time was just fine.


This is interesting because loads of people on this site get continuous uti's and i wonder how many have been in a jacuzzi or hot tub!!

Its a good question, especially those who get persistent or repeat infections.

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Unfortunately , my repeated UTIs didn't come from having a bit of fun .

I actually hadn't been in a pool for ages because of the weather.

I can see how it could happen though.

Maybe adding a smear of vaseline in the private areas as well as over any little spots or scratches and being extra careful in the showers afterwards to clean inside my costume will be a good idea too.

I think it makes a big difference to have a proper shower afterwards. Vaseline may work but stuff from the pool might stick even more!

I was reading up on this because it's an interesting problem, and read that a shower afterwards will not prevent infection. The only solution is to avoid exposure. But they do encourage proper washing and especially making sure swimwear is cleaned after every use. :(

I saw that as well. I did shower within half an hour of being in the jacuzzi . My7p rash started on my stomach exactly where my one piece costume had covered and it's worse there because your costume holds the germs on your skin

If i go somewhere like a pool these days i wash off with medical grade antibacterial soap and wash my costume in 3 stages- soak in antibacterial soap, wash in non-bio then a full wash without soap. I love swimming but somehow it doesn't seem worth it 😂😂😂


I know. I enjoyed the jacuzzi but definitely not going anywhere near them now. Even if not on pred I would have to think again.

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I find vaseline works really well to waterproof and protect any spots, scratches , bites , rashes or fragile bits on my skin when I go swimming now , it also stops the skin over the spots getting damp in a way that slows down the healing.

I think I will just test if the vaseline layer will work in the same way .

You're so right . I always shower at the Leisure Centre straight from the pool and usually use the bidet or wash my private areas with water from a squeezy bottle if there isn't one .

It's a good idea to shower straight away and not wait until you get home , as by that time if there was an issue with the water the damage has already been done.

As yet , touch wood , my precautions have left me bug free from pools.

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Its the pools that just have the poolside showers that really get on my nerves.

I am just glad i never forgot and took my costume off like i do in tbe womens changing rooms. 😅

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Our pool has proper changing cubicles luckily. Mnd you I could frighten children with this rash. I look like a big red blob!!

Think it is piglette who found it meant she got to swim in peace ...

Bit drastic but I think the life guard would throw me out to be fair!!

What do swimmers slather on themselves when they do channel swims or swims across large murky lakes?

I think it's a type of wax that insulates them


Many years ago , many! they used goose fat or sometimes lanolin , obviously lanolin although quite water resistant and moisturising can cause irritation and allergies for some.

Both were unreliable in different temperatures and smell foul!!

By the time I trained as a coastal lifeguard and took part in long distance swimming things had progressed to good old vaseline . Especially , around the armpits , toes, fingers , ears , between the thighs , creases of knees and elbows and under the edges of your costume , wetsuit and swimming cap . Basically a good smear all over for cold water, long distance swims.

From what I heard on a BBC4 documentary sometime recently they are still going with the good old favourite for most sporting activities , Vaseline.

I did try the odd special formula while wild swimming a few times , nonsense , came out looking like a chaffed raspberry!!

That's why I have always put Vaseline on with any skin issues , sunburn or rashes when swimming of any level , in any water or on hot days during activity near straps of clothing to stop skin breakages from moisture.

It helps stop chaffing with thin skin near your costume edges too for normal swimming.

I also wear very supportive sports swimwear , either swim shorts with a tankini with cross back and proper adjustable strap inner bra ( this is good if you are by a swimming pool or the sea in hot weather because you can roll it up like a bikini to catch some Vitamin D ) or a full sports swimsuit with short legs and same bra inset for putting under my wetsuit.

Shorts Wetsuits are also good for shoulder and hip support if you are really suffering with painful joints or your PMR for any length of swimming for physio as they act like compression supports and keep you warm . Believe it or not , no one bats an eyelid at my local pool when I turn up to the Ladies swim in this and my sunglasses!!

Keep swimming!

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The mind boggles at the impression you must make. I would think I was seeing things. Mind you I was the diver who always wore a dry suit even when it was hot. I must have looked odd in the height of summer


Black with a silvery shimmer and dark glasses , they probably think the place is being invaded by a wobbly psychopathic ninja !

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I've actually not owned a swimsuit for at least twenty years. I'd go swimming in the sea if I could get myself organized to do so.

In a wetsuit when it's warm it's a great thing to do , not just for body but mind too.

Not Me! Usually they have them on the Cruise Ships but l never go in them, always err on the side of caution!


It sounds really paranoid avoiding them but there is no way on this earth I would have gone in had I known about the risks sooner.

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Just thank goodness it didn’t go crazy on the day of the Wedding, the Pred probably kept a lot of it at bay!

Just so pleased you’ve had such good service today! The NHS is The Best when it’s Urgent!

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It's not paranoia when you know these things happen , and are common , it's just good sense.

And we all know you are a sensible girl at heart , no matter the rumours!😋😁

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There is lots of evidence to suggest otherwise but we will leave it at that!!

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Oh dear. Keep us posted on how you are able to resolve the rash. It sounds horrible, can't stand itching like that! I shall steer clear of hot tubs for now. I sometimes get ringworm at the pool in Florida but the cream I have (forget the name) resolves it eventually.

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Ooh , if you remember the name let us know , it will help us remember what to get quickly if we have the same problem x

Definite something to add to our little book of helpful things!!

Hydrocortisone cream works wonders for itching, but even better: a generic copy of Vagisil cream - it has a numbing effect that keeps you from scratching.

It’s 20% benzocaine and 3% resorcinol.

The off brands (store brands) are dirt cheap and better than anything I’ve found for itchy bug bites (we have fire ants and no-see-ums, as well as a few mosquitos). I’ve even used it on poison ivy, though the hydrocortisone is necessary, too.

Would imagine that “vagicaine” (Walmart’s knockoff) would help with “spa bites” as well.

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Before yesterday I had spent so much at the chemists I could have bought the damn thing.

I knew there was risk associated with communal tub use. Have always been squeamish about using other's spas, even my clean friends.


You have definitely been proven right on that one. Its not something I will be doing again, well not without a full hazmat suit.

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Sorry to hear about the rash. I never go into jacuzzi's. I always think of lebrosy in warm swirling water. Sorry If I have put you off.

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