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Shaving and STDs

What Is My Risk From Depilation?
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Shaving or removing pubic hair is common worldwide, regardless of socioeconomic background. However, it is more common in women than men, more frequently seen in the sexually active group and the younger generation. How safe is this practice?

In this article, we explore the risks of shaving and STDs, the non-STDs related dermatological issues that can be caused by shaving, and ways to prevent issues revolving around shaving practices.

shaving pubic
Shaving or removal of pubic hair is a common practice worldwide.

Can shaving cause STDs?

No, shaving does not cause STDs. As the name suggests, sexually transmitted diseases (STDs) are passable through sexual intercourse. Without the act of sexual intercourse, shaving alone will not cause STDs.

Can shaving increase the susceptibility to STDs?

Yes, shaving can increase a person’s predisposition to acquiring STDs in the presence of sexual contact. The reason behind it is simple: shaving causes microabrasions, i.e. mini-cuts and mini-wounds on the skin surface that one may not even be able to visualise or feel. With a compromised skin barrier, STDs, bacteria, viruses, and fungi can enter and infect a person much more easily compared to someone without a shaving history and with an intact skin integrity. 

STDs such as herpes viral infection, HPV infection/warts, chlamydia, gonorrhoea, and syphilis are more frequently seen in a person with total pubic hair removal. To exacerbate things, there are suggestive associations of vulvar cancer in women who shave their genital hair frequently. It is unclear whether the increased risk of STDs is solely due to shaving or also due to other factors, such as a more sexually active behaviour observed in this group of patients.

STIs STDs
Sexually transmitted diseases are seen more frequently in individuals with total pubic hair removal.

What type of STDs can be exacerbated by shaving?

Shaving can worsen existing STDs such as herpes, HPV infection (warts), and molluscum contagiosum infection. The microabrasion on the skin surface following shaving allows transfer, inoculation, and entry of the viruses onto the skin with a compromised integrity.

Shaving and associated dermatological conditions

Folliculitis (also known as pseudofolliculitis barbae) is a common benign skin inflammatory condition associated with shaving habits. One may notice red razor bumps over the patch of skin that has been recently shaved. The affected area can be slightly red, raw, itchy, and tender. Occasionally, when it is infected, one may notice tiny white dots (papules) appearing like a pimple. 

Due to the hair on the skin surface being closely shaved off, the hair can curl back into the skin, injuring the follicles and causing an inflammatory response, which manifests as a clinical picture of folliculitis.

folliculitis
Folliculitis is characterised by red razor bumps and white spots, signs of an infection.

What are the similarities between shaving folliculitis and STDs? Can I differentiate between the two?

Shaving folliculitisHerpesHPV wartsMolluscum Contagiosum
SymptomsRed tiny, itchy/tender bumpsSome pimple-like Itchy/tender small fluid-filled bumpsShallow small ulcersFeverishPalpable lymph nodesSkin bumpsCan appear as red/skin-colored/whitishCan be itchySkin bumpsRed to skin colour, small bumpsCan be itchy
CharacteristicTends to be in a linear fashion, following the area of shavingTends to be in grouped/cluster
Can appear over the site of shaving
Can be individually seen or in a linear fashion, following the area of shavingCan be individually seen,Or in a linear fashion, following the area of shaving
Duration Resolve over a few days to weeks following shavingCan last up to 10-14 days before resolvingCan last for months to years Can last for months to year

It is imperative to understand that occasionally, folliculitis can present simultaneously with STDs. Even under professional medical review, it can confuse both physicians and patients. 

Hence, if you have concerns about exposure to STDs and you have noticed unusual bumps over your genital region, it is paramount to get yourself tested for STDs to confirm or rule out any infections. If in doubt, contact your healthcare professionals to check your symptoms. 

The danger of self-diagnosing

In the 21st century, we are generally well-informed via various resources such as the internet, discussion forums, friends, family, etc. One can even ‘Google’ pictures of rashes or medical conditions to compare with one’s symptoms. 

As discussed, non-STD dermatological conditions such as folliculitis can co-exist with STDs. By self-diagnosing, one may have a false sense of assurance that everything is okay and delay receiving appropriate treatment. This, in turn, can lead to passing undiagnosed STDs to your loved ones. 

Your health and your loved ones’ health are equally important. It is worth discussing your symptoms and potential risk of STD exposure with your doctor. Depending on your symptoms and risk of exposure, appropriate targeted STD tests and treatment can be offered.

STD testing
Discuss your symptoms and possible exposure with your doctor.

How can I prevent dermatological symptoms from shaving? If I continue to shave, is there any way to prevent or reduce the risk of STDs?

  • Shaving tips to reduce shaving-associated skin lumps and bumps
  • Consider moistening the skin before shaving
  • Consider shaving gel or cream
  • Ensure your shaving blade is sharp to ensure a sharp cut
  • Shave in the direction of hair growth, not against it
  • Regularly exfoliate the skin gently to reduce ingrown hair growth or skin inflammation
  • Disinfect your shaver and change your shaver regularly
  • Behavioural tips to reduce the risk of STDs
  • Always know your sexual partner
  • Avoid alcohol and drugs during sexual intercourse
  • Be selective and limit the number of sexual partners
  • Consider barrier contraception and use it in the correct way
  • Get vaccination if available, such as in the case of HPV vaccination
  • Practise regular STD testing to screen you and your loved one’s health status, treat on time and protect each other.

References

  1. Mezin-Sarbu E, Wohlrab J. Epilation and depilation in the genital area – motivation, methods, risks and recommendations from a dermatological point of view. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2023; 21: 455–462.
  2. Butler S. M., Smith N. K., Collazo E., Caltabiano L., Herbenick D. Pubic hair preferences, reasons for removal, and associated genital symptoms: comparisons between men and women. Journal of Sexual Medicine. 2015;12(1):48–58.
  3. Shaving Is Correlated to Vulvar Dysplasia and Inflammation: A Case-Control Study. Infect Dis Obstet Gynecol. 2017;2017:9350307. doi: 10.1155/2017/9350307. Epub 2017 Aug 27.
  4. Kirchhof MG, Au S. Brazilian waxing and human papillomavirus: a case of acquired epidermodysplasia verruciformis. CMAJ. 2015 Feb 3;187(2):126-128.
  5. Saleh D, Yarrarapu SNS, Sharma S. Herpes Simplex Type 1. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482197/

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