Another Possible Hot Tub Foliculitis Incident

[chem geek]

I received a PM from Yunus about a possible hot tub rash incident so I am posting this (with permission) here and will add it to my list here. This appears to be a case where the Frog was turned down too low so the Bromine level wasn't high enough and the amount of silver ion wasn't enough to prevent bacterial growth -- assuming this is hot tub itch bacteria.

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I got Hot tub foliculitis or what I and my doctor think is that and he put me on antibiotics and its gone now (I have a skin condition so I'm more easily susceptible to this) But I read in one of the threads that you were keeping track so I figured I would toss in my data to help out if possible.

Hot Tub is Caldera Hawaiian 380 gallons- 3 weeks old

Bromine (Spa Frog) and Sodium Dichloro-s-Triazinetrione granules, 55% Available Chlorine (I know I was low because I didn't shock the system near enough when I first filled it.) Also my lack of knowledge about the chemicals made me question my own actions and because of that my lack of doing anything is the likely cause of this problem.

No Ozonator in the tub.

Inital shock was 1/2 oz Chlorine granules which bottle says is good for up to 500 gallons to get 2-3ppm. In addition spa frog opened to a setting of 2 and also the spa frog mineral container set to the minimum.

Test strip after waiting a couple hours read similar to this

Total Hardness 250ppm

Total Bromine 1ppm

Total Alkalinity 120-180ppm

ph 7.2-7.8

Use of tub was 1 day later (my noobishness thought spa frog would up the bromine even though test strips still read between 1-2ppm) for probably 30-45 minutes every day for the next 7-10 days with 2 people in the tub. Every other day use following that until about day 20 with 2 people in the tub. Around day 14 we have 4 people in the tub for a little over an hour.

Rash showed up somewhere around day 10 or so but I didnt think anything of it for a week or so.

The only chemicals ever to touch the tub are listed below.

Sodium Dichloro-s-Triazinetrione granules, 55% Available Chlorine

Spa Frog (both cartridges)

PH UP (Sodium Bicarbonate) but I had the rash prior to ever using this chemical

Scale protect - (bottle doesnt say what chemicals are in it) followed directions on the bottle. 4 oz initial then 1 oz per week

Oil eater (bottle doesnt say what chemicals are in it) followed directions on bottle 1/2 to 1 ounce per week

The test strips did read low most of the time. More recently I have opened the spa frog up to a higher setting (1 before max). I also gave a double shock treament to the spa 2 days ago. The reading on my test strips about 30 minutes after that were saying 20ppm bromine, the pool store by my house tested my water and said it was 5ppm free chlorine and 5ppm total. I explained the chemicals I was using and so I think they tested it correctly. Today the spa according to my test strips reads good on everything except bromine which it reads between 10 and 20 but its difficult to be sure because the colors are so close.

[whodyawant]

I too have had problems. We have had our CalSpa since August '08. This forum helped me a great deal when we were shopping. It was new when we bought it. We chose to use the bromine floater. We have refilled it 3 times already because after using it for approximately 3 weeks on a new fill we get a patchy rash that occasionaly itches. The rash is always on me and my husband's ankles. Him on the inside of his ankles and mine on the outside! We are baffled. Some friends told us maybe we have eczema. We never had before and it only comes after the hot tub water is 3 weeks old. My 11 year old daughter uses the hot tub just as often and has no ill effects. This rash will stay on our ankles for several weeks. This last outbreak, we are going on a month now without using the tub and my husband's rash is still not quite gone.

Here's our scenario:

500 gallon hot tub with ozonator

We keep heat at 101

Water is city water (our's is softened but we have a bypass and I let the softened water drain from the hose for awhile before filling)

On new fill we start a "bank" with a dash of dichlor, throw the feeder in with 3 bromine tabs and crack it open only to 1; add 1 oz of mineral protection; and 2 oz spa shock

Weekly we rinse the two filters in clean water high spray; add 2 oz spa shock; and 1/2 oz mineral protection

(our dealer gave us the maintenance plan above and we have done just as they have told us)

At rare times, though, I might see a gummy "ring around the tub" so I would put a recommended dose of Leisure Time's Enzyme in after wiping the ring away.

Our Ph and TA stay in the correct ranges and we rarely have problem keeping it balanced EXCEPT that the bromine level is always on the high end, even when the floater is cracked open to 1 or less.

When we can, we use the tub 3 to 4 times a week, all three of us at the same time, and soak for 30 minutes to an hour.

My questions to you ChemGeek are:

1. Could both my husband and I have a reaction to bromine? Or perhaps one of the other products I use?

2. Considering the area we get the rash, could it be something to do with the ozonator? Our ankles hang over the ozonator jet when we are in the tub, but my daughter is shorter and of course, too busy swimming around the tub when she is in it!

3. Perhaps we should try our luck at chlorine considering we have an ozonator? Is chlorine indeed more compatible with chlorine?

My instincts are telling me it could be something to do with the ozonator (just a gut feeling). What do you think? I have searched this forum over for months, but it makes my head swim after reading all the different theories and advice, but I don't see anyone with actual solutions to their troubles.

I don't want to have to sell it, but is sure sucks to be "grounded" from the pool everytime we get a rashy spot or two.

[chem geek]

Take a look at the table in this link and see if your rash seems to be bacterial or chemical in nature. Bromine sensitivity is personal so some may have it and others not. It's possible your ozonator is too strong and causing ozone to come out into the bulk water and be irritating -- do you smell any ozone (electrical smell)? An ozonator is a mixed bag with either bromine or chlorine. With bromine, it reactivates bromide to bromine, but can also oxidize bromine to bromate. With chlorine, the ozonator can oxidize chlorine to chlorate. So with chlorine, you can end up using more chlorine with the ozonator than without, though this depends a lot on the specific situation (people have seen it go either way). The main issue with the ozonator will be if you use Dichlor then bleach since it exacerbates the tendency for the pH to rise.

I suspect that the problem is the high bromine level and that is probably due to the ozonator reactivating too much bromide to bromine so you probably don't need your feeder at all, at least for a while. You could just try taking out the feeder and see if you can get to normal bromine levels and then see if rashes reappear. You might also see if there is a way to control the intensity or on-time of your ozonator.

Richard

[whodyawant]

Take a look at the table in this link and see if your rash seems to be bacterial or chemical in nature. Bromine sensitivity is personal so some may have it and others not. It's possible your ozonator is too strong and causing ozone to come out into the bulk water and be irritating -- do you smell any ozone (electrical smell)? An ozonator is a mixed bag with either bromine or chlorine. With bromine, it reactivates bromide to bromine, but can also oxidize bromine to bromate. With chlorine, the ozonator can oxidize chlorine to chlorate. So with chlorine, you can end up using more chlorine with the ozonator than without, though this depends a lot on the specific situation (people have seen it go either way). The main issue with the ozonator will be if you use Dichlor then bleach since it exacerbates the tendency for the pH to rise.

I suspect that the problem is the high bromine level and that is probably due to the ozonator reactivating too much bromide to bromine so you probably don't need your feeder at all, at least for a while. You could just try taking out the feeder and see if you can get to normal bromine levels and then see if rashes reappear. You might also see if there is a way to control the intensity or on-time of your ozonator.

Richard

Thanks so much. I knew I could count on Chem Geek! I looked at the link and the only indicator there that it could be bacterial is the fact that bacterial occurs in under 24 hours. We usually get a few small dry patches within 24 hours that continue to get worse even when we don't go back in the hot tub. Of course, if we do go back in in the next day or two it worsens much quicker. However all the other things in the graph indicate chemical. I took the feeder out and it only took 48 hours for the bromine level to drop from obove 6 to 1. So I put the feeder back in last night, just checked and it is reading 3 on bromine. I will keep my eye on the bromine level and remove the feeder if it gets above the ideal range. Ph and TA still remain perfect. I thought we'd try changing over to chlorine on next fill, but that will have to wait a month or two since we expect temperatures around 20F - 30F for then next month.

Oh... and we don't use dichlor with bleach. We have only put dichlor in on a new fill (about 2 Tbls) and that is all.

If this post makes you think of something different, let me know. Otherwise I will post on how the lowering of the bromine level works for us.

[Hillbilly Hot Tub]

I just took this doctors class in Atlantic City, he was great and boy did it open eyes to a bunch of different water born issues. Made it clear to the difference between the actual hot tub bug or a reaction to chemicals. He also exspalined that over time people can develop a reaction to chemicals they never had an issue with before and that it never goes away, will just keep getting worse the more you exspose yourself.

He is a very pleasent guy and will answere any questions I can throw at him to do with microbiology.

Yunus states that he has no ozone in the tub. We have found that with Nature 2, a good working ozone is a must for the system to work properly with the low chlorine recipe. If your sanitizer drops to low to kill the bugs, the mineral sticks kill time is very slow, so bad things can start growing quicker. With the ozone, it helps kill them quickly untill you bring your sanitizer risdual back up. bear in mind, ozone has no risdual, only works while tub is filtering and only kilss in the imediate area it touches, so don't ever reley on it alone. We also do not suggest mineral systems to customers that had more than a couple of people using the tub unless you are going to keep the sanitizer reading up higher.

[whodyawant]

I just took this doctors class in Atlantic City, he was great and boy did it open eyes to a bunch of different water born issues. Made it clear to the difference between the actual hot tub bug or a reaction to chemicals. He also exspalined that over time people can develop a reaction to chemicals they never had an issue with before and that it never goes away, will just keep getting worse the more you exspose yourself.

He is a very pleasent guy and will answere any questions I can throw at him to do with microbiology.

Yunus states that he has no ozone in the tub. We have found that with Nature 2, a good working ozone is a must for the system to work properly with the low chlorine recipe. If your sanitizer drops to low to kill the bugs, the mineral sticks kill time is very slow, so bad things can start growing quicker. With the ozone, it helps kill them quickly untill you bring your sanitizer risdual back up. bear in mind, ozone has no risdual, only works while tub is filtering and only kilss in the imediate area it touches, so don't ever reley on it alone. We also do not suggest mineral systems to customers that had more than a couple of people using the tub unless you are going to keep the sanitizer reading up higher.

What did the doctor say about potassium peroxymonosulphate? Is that irritating people, or one of those chemicals one can develop an allera reaction to? Oh, and is potassium peroxymonosulphate the same as "MPS"?

[chem geek]

Yes, potassium peroxymonosulphate is the same as MPS. It is also called monopersulfate, hence the MPS abbreviation.

The MPS product is actually a triple salt of compounds (K₂SO₄•KHSO₄•2KHSO₅). The product is not pure and the most pure version of the product typically sold has 43% MPS. The following is the typical composition at this purity level which is Oxone made by Dupont that is rebranded by many other manufacturers/distributors:

43% postassium monopersulfate (KHSO₅)

23% potassium bisulfate (KHSO₄)

29% potassium sulfate (K₂SO₄)

3% potassium peroxydisulfate (K₂S₂O₈)

2% magnesium carbonate

The most irritating component in the above is the peroxydisulfate. It is highly reactive so will not persist a long time (probably not more than an hour or so), but if you soak too soon after adding MPS then you will be exposed to it. If silver ion is present, say from N2, then it will tend to break down the peroxydisulfate quickly producing highly reactive trivalent silver ions and these will react quickly oxidizing whatever is in the water. So typically users of N2 do not get as irritated using MPS as users not using N2, at least from what I can tell from reports on this forum. The next most irritating compound in the above is the monopersulfate (MPS) itself, but at normal levels this is usually somewhat comparable to normal sanitizer levels though chemical sensitivity is a personal thing (i.e. different people have different sensitivities).

The easiest way to know if MPS is the irritating component is to stop using it and use chlorine instead to oxidize bather waste and reactivate your bromine. However, you (whodyawant) wrote that you had an ozonator so, as I wrote before, my best guess would be that your ozonator is too strong (and/or you are adding too much MPS or chlorine) and is reactivating too much bromine. You reported that your bromine level was high so I would get that under control first. A high oxidizer level of any type, be it bromine, MPS, ozone, or chlorine (without CYA being used) could be potentially irritating. So try to get your bromine under control first, then if the irritation persists try using chlorine instead of MPS. Note that residual MPS can get reported as total bromine (or total chlorine) unless you have a test strip or other test that specifically distinguishes MPS from bromine/chlorine.

I, too, am interested in knowing what the doctor/microbiologist had to say with regard to the various chemical sensitivities of chlorine, bromine, MPS and ozone.

Richard