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Ask Dr. Peg: Things to consider before your next Brazilian wax

I love this question. Not only is it a good question, it was the first one I received in my new question box in the lobby at Student Health and Counseling. Thank you to whoever put it there. I really like getting questions, but it doesn’t actually happen often. Readers are welcome to email me with questions. I never disclose the name or email address of the questioner, and I always delete the email after I get it, but if that is not enough anonymity for you, please feel free to write your question and put it in the new bright yellow box in SHAC lobby.

To answer your question, it is not dirty to have hair on your pubes any more than it is dirty to have hair on your head. Hair is natural, as normal as fingernails or eyelashes. You will not get sick from keeping your pubic hair, although you could get sick or injured if you remove it. More on that in a minute.

When I first started practice almost 25 years ago, nobody was shaving their private parts. When I did a PAP smear or a genital exam, people had hair down there. All of them. This has changed dramatically in the last 15 to 20 years. Now, bald vulvas outnumber their hairy counterparts in my exam room by a significant factor, and bald scrotums are increasing too.

Why? The reasons range from curiosity to fetishism to keeping up with “the Janeses.”

Pubic hair removal is not new. There is art from ancient Greece and Rome that depicts women and men without pubic hair. In Islamic societies, removal of pubic hair is a religiously-endorsed hygiene practice. In ancient Japanese drawings, pubic hair was traditionally omitted for legal reasons, and in Western cultures nude women were usually represented without pubic hair or definitive vulvar anatomy at all. But life did not imitate art, at least not in this country, until the later part of last century.

In the 1960s in America, skimpy bikinis became popular, and since many women have pubic hair outside the bikini boundaries, shaving and trimming became popular, at least for the upper thighs and lower abdomen. It is not considered fashionable to sport coarse, curly hairs outside the bikini.

In 1987, seven sisters whose names all started with “J” moved to New York City from Brazil. Seeing the market for hair removal methods, they opened a wax salon in NYC in 1987, promoting waxing as a way of removing the bikini-banned curls. And so the term “Brazilian” was born.

In 2000, the popular TV show “Sex in the City” aired an episode where the character Carrie Bradshaw got her privates waxed. Afterward she said she felt like “walking sex.” Millions of people watched this show. This helped legitimize and popularize the practice.

Finally, pornography has played a role. Over the last 30 years, Playboy playmates have changed from sporting a full natural bush to less and less hair as time went on, until now most centerfolds have either a small “landing strip” or no hair at all. Pornography is readily available online with the proliferation of the internet, and women and men looking there for role models of body image will find a plethora of bald vulvas and scrotums.

It is estimated that upward of 88 percent of young women and up to 78 percent of young men in the United States practice pubic depilation (removal of body hair). Rates vary by age group, as do frequency and extent of pubic hair removal. People who engage in this practice report reasons like wanting to attract a sex partner, feeling sexier or cleaner, believing it makes their penis look longer (men, obviously), enjoying sex more without hair, and thinking they need to do it in order to fit in with their peers.

Hair removal methods include trimming, shaving, waxing, plucking, sugaring, chemicals, electrolysis and laser. Amounts of hair removed vary from none to all, with all manner of decorations in between.

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Pubic hair removal has become a political issue in some sectors of society. Some people believe that a bald vulva looks like a child, and that anyone who wants a partner without pubic hair is a secret pedophile. There is even a term for having a preference for hairless genitals: acomoclitism. Who knew?

As a physician, I am more interested in the health risks of behaviors than their political correctness or lack thereof. That brings me, finally, to the question again. While I couldn’t find any literature on the dangers of NOT removing your pubic hair, I did find a few studies on the risks of doing so. Yep, people study everything.

First of all, you can cut yourself. Laceration was the most common diagnosis in one study of emergency room pubic hair injuries. Next was rash, which included infection of the hair follicles and underlying skin, followed by abrasion, which is a scrape. One poor soul accidentally circumcised himself while trying to trim. Major ouch! One percent of the patients seen in that ER for pubic injury had to be admitted to the hospital.

Other kinds of direct damage include burns from the hot wax, irritation from the razor or chemicals, ingrown hairs and contact dermatitis from products. Damage to the skin can cause inflammation, which is sometimes followed by a permanent dark stain called post-inflammatory hyperpigmentation.

You can also get an infection. Most common is a skin infection with Staphylococcus, Streptococcus or Pseudomonas. This can come from germs on your own skin, contamination of the waxing tools, or spread from the person doing your procedure. Getting a sexually transmitted infection directly from a hair removal procedure is beyond unlikely, but there is some evidence that damaging the skin with depilation procedures can make you more susceptible to sexually transmitted infections, like molluscum contagiosum or warts, or even blood borne pathogens that can be transmitted from someone else’s body fluid into your micro cuts.

Finally, if you choose to depilate, especially by shaving, and you don’t keep it up on a regular basis, you can end up with stubble, which can be quite uncomfortable for your partner.

Fashions come and go, from shoes to hats and everything in between. Whatever you do with your body hair is your private business. I don’t have a moral or political stance on pubic hair. My medical opinion is only that you should consider any body modification carefully, and take precautions to avoid complications.

Dr. Peggy Spencer is a physician at Student Health and Counseling. She is also co-author of the book “50 Ways to Leave Your 40s.” Email your questions directly to her at pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous.

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