Spring break is upon us, and April is National Minority Health Month. Men and women are using razors in ways Annette Funicello and Frankie Avalon would never have dreamed in preparation for the festivities, and white women seem to be having more complications. Finally, a health disparity where minorities may not be experiencing the burden of disease compared to their white counterparts.
An article published on-line a couple of months ago in the “American Journal of Obstetrics and Gynecology” describes a study that had as its goal documenting clinical complications associated with pubic hair removal, especially among adolescents and women from diverse ethnic and racial backgrounds. The researchers’ goal was to report on pubic hair removal practices, complications, and characteristics associated with complications among a clinical sample of low-income, racially diverse women.
These complications are not trivial and include genital burns from waxing, severe skin irritation leading to post-inflammatory hyperpigmentation, vulvar and vaginal irritation and infection, and the spread or transmission of sexually transmitted infections. Less serious complications that may be experienced as a result of pubic hair removal include epidermal abrasion, ingrown hairs, folliculitis, vulvitis, or contact dermatitis.
Participants were recruited from two publicly funded reproductive health clinics at the University of Texas Medical Branch between April 2012 and June 2012. Those who agreed to participate were then handed an anonymous, self-administered, written survey in either Spanish or English, which took approximately 30 minutes to complete.
While prior reports have focused on the frequency of pubic hair removal among primarily white, college-aged women, this study focused on women from underrepresented minorities and found the practice of pubic hair removal has been adopted by women from diverse backgrounds. Actually, more than half of the women surveyed reported removing all pubic hair. This practice was especially common among women who were underweight or of normal weight.
Minor complications resulting from pubic hair removal were common. The authors remind us that this finding is consistent with a review of the National Electronic Injury Surveillance System, which found that the number of emergency room visits for genitourinary injuries related to grooming increased 5-fold in the United States between 2002 and 2010. One third of these injuries were recorded in 2009-2010, suggesting a substantial increase in recent years. Similar to results reported in this current article, most of those injuries were minor, with 83% attributed to shaving with razors. However, 25% of female injuries in the National Electronic Injury Surveillance System report were diagnosed with a laceration, wax burn, or foreign body injury, demonstrating that pubic hair removal can lead to serious injuries.
Interestingly, Hispanic and black women in the study population were less likely to report complications compared to whites. However, it is not clear if this is due to less frequent hair removal compared to whites, which would obviously reduce the chances (i.e., opportunities) of sustaining an injury. It is also not clear why overweight and obese women experienced a much greater risk of sustaining an injury compared to those subjects who were of normal weight, or underweight. The authors speculate that one possibility is that overweight and obese women may have a more difficult time adequately viewing the entire pubic region when removing pubic hair. These women may avoid complications when only partially removing their pubic hair because the insides of the thighs and outside of the vulvar region are easier to view and require less flexibility to remove hair in these areas.
These same characteristics--- limited flexibility and visibility—likely explain why overweight and obese women who remove all of their pubic hair have significantly higher odds of a complication. It would seem that preventive measures need to be taken so that information about safer hair removal practices in women is available to health care providers so they can better serve patients.
Of course, the usual caveats must be invoked here: Study participants were limited to a clinical sample of women in the Texas Gulf Coast region and may not be generalizable to other populations. Additionally, it is difficult to determine the accuracy of the responses because this was a self-administered questionnaire. Finally, the researchers were not able to determine what method of hair removal respondents used when an injury occurred. Future studies will hopefully address some of these issues.
The bottom line for now: Women need to receive health advice on pubic hair grooming from their physician, with an emphasis on teaching safe removal practices, particularly among overweight and obese women.
Let’s not hit the beaches lacerated, infected and in pain. We all prefer our soup bald, but the realities of health might have us thinking twice about our bodies.