No Hair: What's Going on Down There?

by Dr. Ann L. Engelland

(February 15, 2006) There is a fad sweeping the teen and young adult community that has intrigued me for the past few years. I am speaking of the tendency to remove most if not all pubic hair. Although guys have also begun to remove body hair in recent times, the issue at hand is the radical removal of pubic hair in young women.

When I speak to parent groups about trends in adolescent behavior or about teen sexuality, it always comes as a surprise to many parents that at a certain age most girls now begin to remove their pubic hair. I bring the subject up because in my practice I have seen a number of complications from this. As a result, it has become my routine to inquire directly of patients about the methods they are using, why they are doing it and whether they have experienced any difficulty.

So it was interesting to me that the most recent volume of the Journal of Pediatric and Adolescent Medicine ran a comprehensive article by the Mount Sinai dermatologist, Jonathan Trager, that reviewed the history and current practices of hair removal.

When did this fad start? It seems that within the last ten years it has become increasingly popular, to the point where the trickle down effect is impacting even middle school girl. Many of them seem to think that the right and natural thing to do is to begin removing their hair even before they have finished growing it.

Where did this start? Ancient Greek and Roman art depicts bodies without hair and some cultures remove hair as a matter of course at a young age. From my conversations with kids in Larchmont and Mamaroneck it seems to me that the mainstream practice of removing hair among younger women started about the time the television show Sex and the City became popular. The practice has been reinforced and encouraged by revealing waistlines, thong underwear and string bikinis.

How do they do it? Methods include:

  • Shaving, electric and blade
  • Waxing
    • “Bikini” waxing
    • Brazilian waxing-complete removal of all pubic hair
  • Sugaring: similar to waxing but uses melted sugar instead of wax.
  • Tweezing
  • Depilatories, eg Nair
  • Epilation (threading):an ancient Indian technique which extracts hairs by the roots; usually limited to facial and arm hair
  • Electrolysis: permanent destruction of hair follicle by electric current
  • Laser: pulsed light may permanently remove hair

Why do they do it? When I ask, the answers I get vary from “because it’s cleaner” to “because it feels better when I have sex” to “my boyfriend likes it that way” to “just because” to “I don’t know.” I have come to view pubic hair removal as another expression of body art similar to piercing and tattooing. My initial concerns that the fad represented a dangerous glorification of the pre-pubescent body have been partially dispelled by the fact that it has become so mainstream and that girls themselves initiate the process.

So is there a problem? There are complications of pubic hair removal all of which I have seen in my practice. They include:

  • Razor “burn”: generally this is due to poor shaving technique.
  • Folliculitis: this is an irritation -or worse, an infection - of the hair follicles which are exposed and inflamed following hair removal of any type.
  • Contact dermatitis: an irritation following use of soap, shaving, after-shave or depilatory products.
  • Burn: a patient of mine presented to me with serious second degree burns on the labia following Brazilian waxing
  • Spread of infection: physicians in the field worry that hair removal and the consequent tiny nicks, cuts and inflammation can expose a person to bacterial, fungal and viral infections. Sexually transmitted infections (HIV, HPV, herpes, and molluscum) are easily spread in this way.

An unofficial telephone survey of six Larchmont/Mamaroneck salons showed that the cost of a regular bikini wax varies from $15 to $25 and up. Half of those called said they do not do Brazilian waxing and those who do charge $50 to $65. None of the salons contacted do sugaring, and only one said they knew of a dermatologic skin complication of waxing among their clients.

With proper counseling and care, pubic hair removal can be a healthy choice for teens and others. My suggestion is that middle school parents begin to counsel their daughters about this early on when other personal hygiene matters are addressed. For older teens, if they are experiencing any of the complications, their health care provider should coach them in better technique and how to manage irritation and infection.

Dr. Engelland has a practice in Mamaroneck devoted to Adolescent Primary Care. She can be reached at 698-5544.

Have a teen health question? Use the form below to send it to Dr. Engelland. Please note: Dr Engelland cannot respond privately to individual queries online. Comments are welcome and anonymous questions may be answered in future columns. Serious medical problems should be referred to your own physician.

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