The health risks of grooming your pubes, explained

Talking about pubic hair grooming was once taboo. Those days are long gone.

Look no further than popular celebrity books or hit TV shows like Girls or Broad City, where pubes are discussed casually and frequently. Scientists have also begun to examine grooming trends. For a new study in JAMA Dermatology, researchers asked more than 3,000 American women about their pubic hair-care habits.

Fully 84 percent reported they had done some form of pube modification in their lifetime. Of those groomers, 62 percent reported going all the way — removing every last centimeter of hair down there.

The reason for pubic hair maintenance most commonly cited by women in the study: hygiene.

That finding alarmed some gynecologists, because it confirmed the persistence of a myth. In fact, grooming your pubic hair doesn’t make you any cleaner. There's some evidence that pubic-hair removal reduces the chances of lice transmission to one's nether regions— but that's about the extent of the proven public-health advantage.

We called blogger and San Francisco OB-GYN Dr. Jen Gunter to find out more. (Sorry guys — Gunter only treats women so the conversation focused on the one sex. For tips about safe male grooming, see here or here.) Our conversation was edited for length and clarity.

Julia Belluz: You talk to women about their genitals every day, and presumably pubic hair comes up. What do you hear from your patients about it?

Jen Gunter: There is a cultural trend in America [favoring] hairless labia. I hear quite commonly from a lot of women of all ages that having pubic hair is abnormal, that there’s no reason it’s there, and they’re shocked when I tell them it has a function.

JB: So what purpose does pubic hair serve?

JG: Pubic hair is like eyebrows. We think the primary function is physical protection — trapping dirt, debris, keeping a physical barrier for the genital tissues, especially the vaginal opening, which is more sensitive.

JB: The JAMA Dermatology study suggested a major reason women remove their hair down there is actually because of hygiene concerns. But you noted on your blog that having less hair isn’t cleaner — and also comes with health risks.

JAMA Dermatology

JG: There’s zero data to say it’s more hygienic. That’s the equivalent of saying it’s more hygienic if you shave your head or eyebrows. There are also a lot of unknowns: We don’t know if removing pubic hair could affect the way you perceive touch on your genitals, and we don’t know if it can affect skin colonization with bacteria and fungi.

It’s possibly less hygienic, though we don’t know for sure. Removing your pubic hair comes with the risk of injury [from shaving, waxing, and lasers].

JB: What general advice do you give to women about their pubic hair removal?

JG: I say that pubic hair has a function, and that obviously there’s a wide range in what some women have. Whatever you decide you want to do, accept that you're doing it for cosmetic reasons. That doesn’t make it wrong. I dye my hair. We all do cosmetic things to make ourselves feel better or because we like how it looks. So just accept it’s a cosmetic choice.

JB: Are there any methods of hair removal you advise against?

JG: I caution against laser [pubic] hair removal. It’s permanent, and if you end up with a problem you can’t undo it. I have also seen cases of irritation that started after laser removal.

The skin around the labia is quite sensitive, and anecdotally I have seen quite a few cases of irritation triggered by laser hair removal.

JB: I was reading that waxing is associated with burns, inflammation of the hair follicles, abscesses, vaginal infections, and skin tears. What injuries have you most commonly seen in your practice? And what do you recommend for safe waxing?

JG: The injuries I have seen after waxing have been mostly skin irritation and areas of skin that are broken down from a first-degree kind of burn. I haven’t seen vaginal infections from waxing, but I’ve seen abscesses from ingrown hairs as a result of hair removal.

You want to make sure you’re in a salon that doesn’t double-dip their sticks. They use popsicle sticks to dip the wax and put it on. And you want to see a whole pile of popsicle sticks out. Those sticks are going to pick up bacteria from the skin, and heat is a great culture medium.

JB: What about the best methods for shaving down there? I read in another study — about pubic grooming injuries that presented at ER departments — that shaving is by far the removal method most often associated with injury.

JG: My personal opinion is that there is probably a higher incidence of ingrown hairs from shaving versus waxing. I don’t know if that’s because women haven’t had the education to shave correctly compared to men. If men shaved their faces the way women shave their labia, men’s faces would be chewed up.

Many women use razors for too long a time. I remember, when I was dating, I probably used to have razors that were older than some boyfriends. So I don’t know whether, if shaving was done correctly, there would be better outcomes. I think people need to change their razors frequently, and remember that when you’re shaving you’re introducing microscopic nicks to the skin.

JB: Are there any health concerns with even tiny razor cuts?

JG: We know there are microscopic abrasions in the skin after shaving. This is studied in surgical patients. So say you shave, have sex, and get exposed to something like [human papillomavirus]. You’re more likely to get an infection in places with microscopic breaks in the skin. We know that specifically with HPV.

JB: That sounds scary. How much of a risk is that in absolute terms?

JG: We don’t see a lot of people coated in HPV. So to keep it in perspective, we’re not seeing women come in with warts [caused by HPV] all over their vulva two months after shaving. We’re talking about theoretic possibilities, because a lot of it hasn’t been studied. The absolute risk is probably quite low.

JB: You wrote a recent blog post, "I don’t thread [my eyebrows] because there are reports of [HPV] transmission from esthetician to customer." Please explain.

JG: There have been reports of people getting HPV in their eyebrow hairs from threading. So I never thread.

The bottom line: If you have a method that’s working for you, then great. If you are having any kind of chronic genital irritation, you might want to consider your hair removal might be playing some role.

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