The connection between waxing and STDs

I am going to be discussing a hairy subject, so if you are a bit squeamish, you might want to forgo this post. Last week some friends and I hosted a bridal shower. Amongst the comments made by the bride to be was one that concerned ‘manscaping.’ The practice goes by various names, Brazilian wax, bikini wax being two of the most common.   What this practice entails is waxing part or all of the pubic hair, creating a denuded pubic area.   There are many reasons for waxing this area: It is beach weather, and you want to get rid of the strays; you are going on vacation/honeymoon, and want to give that area a little extra attention. The reasons are multiple and there is no judgment here. However, you are putting your health at risk if you do anything more than ‘trim the hedges’.
“All Jennifer (not her real name) wanted was a smooth bikini line. But within 24 hours of getting a bikini wax at a reputable New York City salon, an infection crept in. She developed a fever of 102, chills, and pain in her left thigh. “I thought I’d caught a cold, “she says, “but after five days, the pain was worse.”

Her doctor diagnosed her with cellulitis, a potentially life-threatening bacterial infection of the skin and the underlying tissue. Jennifer spent the next 15 days in the hospital hooked up to an IV that pumped her full of antibiotics and heavy-duty painkillers. She also had surgery to drain the infection. “One doctor said I could have lost my leg!” she recalls. “It took me months to recover physically and emotionally from the whole ordeal- a steep price to pay for a little vanity.”

While there are no reliable stats on body wax related complications, Jennifer’s experience wasn’t unique. This past March, the state of New Jersey nearly banned Brazilian bikini waxes after two women landed in the hospital as a result of them (one of the women filed a lawsuit against the state cosmetology board). And in 2007, an Australian woman with type 1 diabetes almost died of a bacterial infection she got after a bare-it-all wax.”

“What makes them risky? “Pubic hair is there for a reason to protect the sensitive skin and mucous membranes in the genital region,” explains Linda K. Franks, M. D., an assistant clinical professor of dermatology at the New York University School of Medicine. “Getting a wax literally strips away that layer of protection.”

Waxing can also pull off tiny pieces of the skin’s outermost layer, creating a portal through which bacteria can enter the body. What’s more, the process creates inflammation, which can trap bacteria beneath the skin. All of this sets the stage for skin infections (including staph), folliculitis (infection of the hair follicles), and ingrown hairs.

Krant and Sandra Johnson, M.D., a dermatologist in practice in Fort Smith, Ark., break down a few other possible risks of waxing:

  1. STI. While last week’s study looked at the risk of contracting the virus Molluscum contagiosum, it’s certainly not the only sexually transmitted infection that waxing can up the risk for. “Any infection that requires contact to spread will be more easily caught if there is any damage to the skin in the area,” Krant told HuffPost in an email. “This can be  anything from obvious cuts all the way to microscopic torn follicle roots that aren’t visible on the surface. Herpes, HPV (genital warts and possibly cervical cancer), HIV, and other STIs also have increased risk with skin trauma.”
  2. Infection. “Removing the hair, especially in the Brazilian waxing fashion, where the hairs are removed from the gluteal cleft areas, increases the risk not only of STIs but of ‘self-TI’s,'” Krant says. “In other words, pulling the hairs out of those areas increases the risk that tiny skin tears will get bacteria in them that was never meant to be inside the skin. It can cause surface infections and even deeper cellulitis in some cases.” The skin infection impetigo is a common issue, too, according to Johnson. “I have also seen ringworm worsened with waxing,” she says.

One other gross-but-true fact? If your treatment involves using sticks in a communal pot of wax, beware of practitioners “double dipping” those sticks back into the pot. “If sticks are being used, and a stick with wax does get rubbed against an infected area of the skin and then put back into the pot for more wax,” Krant says, “it’s possible an infection could be transferred to another area of the skin, including the face or underarms.”

  1. Burns. While a qualified professional should know how to keep wax hot enough to work without hurting the skin, burns can happen. “In addition, not so much for bikini waxing, but eyebrow, lip, and chin hair waxers need to be very careful because if they are using any antiaging or acne creams that may contain a retinoid (vitamin A derivatives retinol, retinyl palmitate, tretinoin, adapalene, tazarotene),” Krant says, “their skin will be extra susceptible to getting burned and peeled off by waxing since those creams loosen the attachment of skin cells and cause increased exfoliation.”
  2. Infected ingrown hairs. “Pulling a hair out by its roots means a new, thin and weak baby hair will start growing in its place, which naturally has less strength and thickness toward the tip to find its way out of the surface in a straight shot,” Krant says. “It can often get caught and get stuck under the surface, leading to an irritated bump that can become infected and long-lasting.” For tips on preventing ingrown hairs, check out WebMD’s tips here.
  3. Scarring.  “Waxing irritates the skin, which when done repeatedly (especially not well), it can cause chronic skin irritation and scarring,” Johnson says.

So, while it is nice to be well groomed, there are inherent dangers with too much bare skin.   In the words of Mellie Grant, of SCANDAL fame, maybe we should all be “1976 down there.”

Until next time,

Dr. Polly