4/25/2023 | By Donna Brody

As a resident of North Carolina’s Outer Banks, writer Donna Brody has plenty of firsthand experience with hot tubs. Here she explores the benefits and risks of hot tubs, especially for senior adults. She offers suggestions for how to enjoy the luxurious travel treat safely.

Here in the coastal community where I live, hot tubs are as commonplace as seafood restaurants, flip flop shops, and sunburn. Real estate agents, rental companies, spas, and hotels often tout them as a selling feature for properties and businesses. While excited visitors may be quick to don a bathing suit and take the plunge, locals roll our eyes and shudder at the thought of ever taking such a risk. We’ve heard enough horror stories about thriving bacteria and mysterious illnesses to avoid public hot tubs like the plague.

Are hot tubs really so bad that everyone should steer clear? The answer is yes – and no. While a soak in a hot tub does offer therapeutic benefits, they pose some dangers, too. And, for senior adults, the harms can be magnified.

Basic benefits and risks of hot tubs

There is a big difference between having a hot tub on your own deck for your family’s use and sitting in a communal hot tub at a hotel or rental property.

For homeowners who are diligent in maintaining the cleanliness and proper chemical balance, sliding into the hot tub at the end of a long day can be a frequent treat.

The potential benefits of soaking in a hot tub include stress relief, muscle relaxation, pain relief – possibly benefiting chronic conditions such as arthritis and fibromyalgia – and improved sleep, and possibly even better cardiovascular health and improved insulin sensitivity, say the experts at

Woman in hot tub. Image by Kurhan. Outer Banks resident and writer Donna Brody dives into the benefits and risks of hot tubs, providing suggestions for enjoying them safely.

So where does the danger from hot tubs lie? It is “communal” hot tubs, like those found in hotels, rental properties, and fitness centers that are likely to pose the greater risks.

“By their nature, hot tubs present a bacteria risk that swimming pools – though also chemically treated and shared with strangers – do not. There are certain types of microorganisms that seem to proliferate in them,” says Aaron Glatt, chair of medicine at South Nassau Communities Hospital and spokesperson for the Infectious Disease Society of America.

One reason that excessive bacteria can pose a hazard in hot tubs and not in public swimming pools is the temperature of the water. Water, especially warm water, opens a person’s pores, allowing microscopic particles to pass to the open pores of another bather. “It can lead to a lot of superficial skin infections,” Glatt says. “You don’t really see that in colder water.”

Related: Tips for solo travelers

These microorganisms can cause skin conditions sometimes dubbed “hot tub rash.” Surprisingly, the rash can be worse in areas covered by your bathing suit because the fabric enables the bacteria to adhere to the skin for a longer period of time.

Steam from the hot tub can also increase the chances of microorganisms being inhaled through a bather’s nose and mouth.

Hot tubs also pose a bigger maintenance challenge than pools because the warm water not only increases bacteria, it also uses the chlorine chemicals faster.

Increased risks as we age

There are other risks associated with hot tub use that affect older individuals. One of these is heart complications.

“Be cautious when using a hot tub if you have heart disease. When you soak in hot water, your body can’t sweat. Your blood vessels instead need to widen to cool you off. This makes your blood pressure drop,” writes Stephanie Watson at WebMD. “In response to falling blood pressure, your heart rate speeds up. This isn’t a problem for healthy people, but if you have heart disease, it can strain your heart.”

Other contraindications for hot tub use include

  • People with open sores or cuts
  • Diabetics with foot issues
  • People prone to dizziness or falls
  • Anyone with a compromised immune system
  • Someone receiving treatment like chemotherapy

For the generally healthy who want to take advantage of hot tub benefits outside of their own home, here are some practical tips:

hot tub testing strip, by Brad Calkins. One way to skirt hot tub risks.
  • Visually check the cleanliness of the hot tub before entering. The water should be clear and odorless. Cloudy water or any kind of odor, even a strong chemical odor, could signal poor maintenance or even over-sanitizing. For extra safety, buy your own test strips at a pool supply store before your vacation to test the water yourself.
  • Avoid crowds. If the hot tub is crowded, take a pass, even if it empties out later. Check with the hotel or property owner about how often the tub is cleaned and if professionals are performing the maintenance.
  • Inspect the temperature – 100 degrees Fahrenheit is adequate; don’t go in if the temp is over 104 degrees.
  • Stay hydrated by drinking water while soaking and don’t stay for more than 20 minutes.
  • Avoid alcohol in the tub, since it dehydrates you.
  • Always shower when you get out.

By following these guidelines, you may still be able to reap the benefits of this luxurious treat.

Donna Brody

Donna Brody is a former community college English instructor who retired to the Outer Banks of North Carolina. She enjoys freelance writing and has self published three romance novels. Besides writing and traveling with her husband, she keeps busy visiting her seven grandchildren.

Donna Brody headshot