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Pubic hair removal is becoming increasingly common among women and men worldwide. A recent study in the JAMA Dermatology found that almost 84% of women reported pubic hair grooming at some time in their lives with only 16% reporting they never groomed. Men increasingly are removing hair from their pubic area as well, including from the scrotum. Depending on the method used (laser, waxing, shaving), individuals can develop complications from grooming, including nicking the skin, ingrown hairs, and even abscesses.

Now, a new report from UCSF raises another concern—pubic hair grooming has been found to be linked to a heightened risk of acquiring a sexually transmitted infection (STI). The research, led by Dr. Benjamin Breyer of UCSF’s Department of Urology, was published on December 5, 2016 in the online version of journal Sexually Transmitted Infections.

 

Extreme grooming

The study found that the association seems to be strongest among those who groom their pubic hair frequently and intensively—a practice dubbed ‘extreme grooming’ by the researchers. To find out what impact this growing trend might be having on rates of sexually transmitted infections, the researchers polled a nationally representative random sample of U.S. adults about their intimate grooming habits.

Among a sample of 14,000+ 18-65-year-olds, 7,580 (56% of whom were men) completed a survey that asked questions about the intensity (trimming or complete removal) and frequency (from daily to annually) of their pubic hair grooming, as well as the type of grooming they typically used.

‘Extreme’ groomers were classified as those who removed all their pubic hair more than 11 times a year, and ‘high frequency’ groomers as those who trimmed their pubic hair daily or weekly. Almost three out of four (74%) respondents said they had groomed their pubic hair before, with more women (84%) than men (66%) saying they had done so. Participants were also asked about their sexual history. Some 7,470 said they had had at least one sexual partner.

Among the groomers, 17% were classified as ‘extreme’ and 22% as ‘high frequency’, with 1 in 10 falling into both categories. Overall, groomers tended to be younger, more sexually active, and to have had more annual and total lifetime sexual partners than those who said they didn’t groom their pubic hair. The number of sexual partners among extreme groomers was higher than it was for any other category of groomer. An electric razor was the most common grooming tool among men (42%), while a manual razor was more common among women (61%). Around one in five men and women used scissors.

 

The risk of sexually transmitted infection

In all, 13% (943) respondents said they had had at least one of the following: herpes; human papilloma virus (HPV); syphilis; molluscum; gonorrhea; chlamydia; HIV; or pubic lice. After factoring in age and the number of lifetime sexual partners, any type of grooming was associated with an 80% heightened risk of having a sexually transmitted infection compared with no grooming.

The magnitude of the risk also seemed to be linked to the intensity and frequency of grooming. Among high frequency and extreme groomers, the practice was associated with a 3.5- to 4-fold heightened risk, particularly for infections that arise through skin-on-skin contact, such as herpes and HPV. By contrast, low intensity/frequency grooming was associated with a doubling in risk of a lice infestation, suggesting that grooming might make it harder for lice to breed successfully.

It is important to note that this is an observational study as opposed to a gold standard randomized controlled trial so no firm conclusions can be drawn about cause and effect. In addition, the researchers were not able to determine the timing of grooming relative to the acquisition of the infection or account for either safer sex practices or risky sexual behaviors.

The researchers suggested that grooming might be a proxy for higher levels of sexual activity and, therefore, increased risk of exposure to and infection with STDs. They also mentioned that the grooming might cause tiny skin tears through which bacteria and viruses can easily pass. Personally, I think the former is the most plausible explanation although, of course, further research is needed to sort out these possibilities.

Either way, the researchers suggest evidence of pubic grooming could be a useful prompt for clinicians to ask about safer sex practices or to suggest delaying sex to allow the skin to heal.

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