Are Cruise Ship Hot Tubs Safe?

Read our quick and dirty guide before you settle in for a relaxing soak.

Few cruise rituals feel more indulgent than sinking into a steaming hot tub as the waves roll by. Endless ocean views, massaging jets, cocktail in hand—it’s the picture of seagoing relaxation. But while the bubbles invite you to unwind, experts warn that cruise ship hot tubs can harbor risks, from itchy rashes to severe respiratory illness.

Hot tubs are marketed as both relaxing and luxurious: you’ll find them on sunny pool decks, in adults-only retreats, and even in private balcony suites. Yet the same features that make them appealing—warm water, constant use, and shared space—also create prime conditions for harmful bacteria and fungi.

Skin Concerns You Might Not Expect

“Hot tubs can be safe if they are properly maintained and sanitized,” says Michele Green, M.D., a New York City-based board-certified dermatologist. “However, many skin conditions can arise from contamination.”

One of the most common is folliculitis, often referred to as “hot tub rash.” This inflammation of the hair follicles shows up as red, itchy bumps, and, as Dr. Green explains, “can be caused by bacterial infections, such as Pseudomonas aeruginosa, or fungal infections, including tinea versicolor or Malassezia.”

Other potential issues include:

– Dermatitis: High chlorine or bromine levels can trigger dry, itchy, or burning skin.
– Fungal flare-ups: Warm, damp environments can worsen yeast infections or athlete’s foot.
– Worsening chronic conditions: “Individuals with eczema or psoriasis may want to avoid cruise ship hot tubs,” Dr. Green cautions, since exposure can exacerbate flare-ups.
– Infection risks with cuts or wounds: Even the smallest of scrapes or scratches can provide an entry point for bacteria.

Beyond Rashes: Legionnaires’ Disease

Skin problems aren’t the only concern. In October 2024, the Centers for Disease Control (CDC) reported multiple outbreaks of Legionnaires’ disease linked to cruise ships. Between November 2022 and June 2024, investigators identified 12 cases—10 of which required hospitalization—across two ships.

Here’s the real twist: The culprit wasn’t the public hot tubs on deck, but private whirlpools inside passenger cabins. Found in select suites on lines such as Royal Caribbean, Celebrity, Regent Seven Seas, Norwegian, and MSC, these private hot tubs are typically maintained by the ship’s crew — drained and disinfected periodically during the voyage. Unlike public tubs, they are subject to lighter regulatory oversight and have been tied to health concerns when protocols are insufficient. That gap, as the CDC found, allows Legionella to flourish.

What Is Legionnaires’ Disease?

According to the CDC, Legionnaires’ disease is a severe form of pneumonia caused by inhaling water droplets contaminated with Legionella bacteria. Hot tubs are a particular risk because bubbling jets aerosolize water into a fine mist.

Symptoms typically develop two to 10 days after exposure, and include cough, fever, muscle aches, and shortness of breath. Untreated, the illness can be life-threatening for older adults, smokers, and those with weakened immune systems.

While outbreaks are rare compared to the number of people who cruise each year, the CDC’s findings highlight how design and maintenance gaps in private tubs can turn luxury into liability.

How Cruise Lines Handle Hot Tubs

Public hot tubs fall under the CDC’s Vessel Sanitation Program, which inspects recreational water facilities, such as pools and whirlpools, during routine checks. Most ships sanitize these tubs daily—and sometimes multiple times a day—to control bacterial growth.

Private balcony tubs, however, don’t receive the same oversight. After the outbreaks, the CDC urged cruise lines to inventory all hot tub–style devices, review sanitation protocols, and even consider redesigning tubs to limit aerosolization and bacterial growth. Despite this, there has been no public confirmation that cruise lines are broadly removing private balcony tubs on new builds or restricting their use.

Who Should Skip the Soak

Hot tubs aren’t for everyone. While most healthy adults can enjoy them with minimal risk, certain groups should be cautious or avoid them altogether:

– Pregnant travelers: High water temperatures can raise core body temperature, which is unsafe in pregnancy.
– Elderly passengers: Age-related health conditions and weaker immune systems increase the risk of infection and overheating.
– Immunocompromised travelers: Cancer patients, transplant recipients, or anyone with a suppressed immune system are more vulnerable to infections.
– Those with asthma or chronic lung disease: Conditions like Chronic Obstructive Pulmonary Disease (COPD) or severe asthma make it harder to fight off respiratory illnesses such as Legionnaires’ disease.
– Young children: Children, including infants and toddlers, are particularly susceptible to overheating and are generally discouraged from using hot tubs.
– Individuals with skin conditions or open wounds, such as eczema, psoriasis, or even minor cuts, can provide easy entry points for bacteria and fungi.

Smart Traveler Takeaways

With a few precautions, you can lower your risk while still enjoying a soak at sea:

– Favor public hot tubs: These are more likely to be regularly inspected, tested, and chlorinated.
– Avoid private balcony tubs: Unless the cruise line provides clear evidence of regular sanitation, it’s safer to stick to the main deck spas.
– Check the water: Green recommends avoiding tubs that look cloudy, murky, or neglected. Clear, odor-free water is a safer bet.
– Limit your soak: Dermatologists advise keeping sessions to 15–20 minutes to protect the skin’s natural barrier.
– Shower before and after: A quick rinse helps reduce exposure to both bacteria and chemicals.
– Don’t ignore symptoms: “If you develop a rash after a cruise ship hot tub, it is best to consult with a board-certified dermatologist for proper treatment,” says Dr. Green.

Cruise-ship hot tubs can be part of the fantasy of life at sea, but they’re not without risks. With a little awareness and the willingness to ask questions, you can enjoy that hot soak under the stars safely and return home with nothing but good memories.