Unwanted Hair Or STD? Brazilian Waxing Raises STD Risk?

French researchers report that women who get a kind of bikini wax known as a Brazilian are at greater risk for catching a virus that causes molluscum contagiosum, which makes the skin in intimate areas break out in red, pink, or white bumps. Before getting into the news about this new STD, some basic definitions may be helpful.

What Is a Brazilian Wax?

A Brazilian wax is a hair removal technique in which the hair on and around the vulva (both the inner and outer folds, or labia), anus, perineum (region between the anus and vulva), and buttocks is completely removed by the application of a combination of hot beeswax and tall oil.

The recipient of the wax puts on a paper G string and then a technician puts talcum powder (baby powder) on the skin. Then the technician applies the hot wax. The wax is allowed to cool and stiffen, and then the technician removes both the hardened wax and body hair. Tall oil is added to the mix to make it easier to remove larger pubic hairs.

What Are the Types of Brazilian Waxes?

In the standard Brazilian, a tiny strip of pubic hair, also known as the "landing strip" (or in less polite company, as the "happy trail") is left untouched. In a "full Brazilian," also known as a Hollywood wax or "sphynx," all the pubic hair is removed.

What Is Molluscum Contagiosum?

Molluscum contagiosum is a viral infection of the skin. The virus only affects the outermost layer of the skin, causing it to form pink, red, or flesh-colored bumps that range from the size of a pinhead (less than 1 mm or 1/10 of an inch) to the size of a pencil eraser (2 to 5 mm or up to almost 1/4 inch in diameter). In the elderly and in people who have compromised immune system, the bumps may be as much as 12 mm (1/2 inch) in diameter.

The virus is spread by skin-to-skin contact, and on towels, damp clothes, and surfaces on which bare bottoms have sat. Entire elementary school gym classes can pick up the infection from contaminated exercise equipment. Children aged 10 to 12 and adults often pick up the infection around swimming pools. Although molluscum contagiosum is a sexually transmitted disease (STD), by no means all cases involve sexual contact. The infection tends to be especially severe in people who have eczema, hay fever, or asthma.

Bumps can occur almost anywhere on the body except the palms. Hundreds of bumps may appear where the skin has been shaved, and dozens of bumps may appear on the hands, arms, torso, neck, lips, and ears.

Molluscum Contagiosum Eventually Goes Away on Its Own

The virus that causes molluscum contagiosum eventually goes away on its own, but it may take as long as 4 years for the skin to return to normal. Molluscum contagiosum is never a serious medical condition except in people who have immune systems weakened by HIV, chemotherapy, or steroid use. The virus can result, however, in a considerable cosmetic challenge.

The bumps caused by molluscum contagiosum can be removed surgically, or they can be treated with a keratolytic agent, a chemical that dissolves the skin. Keratolytics are considered inappropriate for children. There are no EU- or FDA-approved antiviral medications for the condition, although people who have both HIV and this skin infection usually have changes in their antiretroviral drugs.

The Bane of Bare Beachgoer

A soon-to-be-published article in the Journal of Sexually Transmitted Diseases discusses a mini-epidemic of molluscum contagiosum on the French Riviera. Doctors report 30 cases of the infection, 24 in women and 6 in men, 93% of whom had removed pubic hair by getting a Brazilian wax. This report has led to a general warning to the public that Brazilian waxing and other traumatic depillatories increase the risk of skin infection. So what should the hair-conscious bare bather do to prepare for bikini season?

Ten Tips For Safer Removal Of Body Hair

Nobody wants to have skin covered with unsightly bumps that may take as long as 4 years to disappear. Some simple precautions, however, make contracting molluscum contagiosum a lot less likely.

1. If you have a Brazilian wax, don't have sex and don't go to the pool for at least 2 days.

Many people who carry the molluscum contagiosum virus don't develop symptoms. Pelvis-to-pelvis contact can transmit the infection from an asymptomatic partner to an uninfected partner if the skin is broken or irritated. This is an example of a general principle regarding skin infections, as follows:

2. Broken skin, or irritated skin, is a lot more susceptible to infection than healthy skin.

Until your skin heals after getting a bikini wax, it's important to avoid situations in which you are exposed to the virus. This means no going from the salon straight to the pool or waxes just before a hot date. 

3. "Skin penetrating ingredients" make your skin more susceptible to infection with the molluscum contagiosum virus.

Many skin products contain peppermint oil, orange oil, or alcohol to help skin care ingredients penetrate the skin. These ingredients also help viruses penetrate the skin. Be careful about skin-to-skin contact for 2 hours after using skin care products with these ingredients.

4. The darker your skin, the more problems you will encounter with Brazilian waxing.

And shaving with a razor, especially for Black men, is even worse. People who have dark brown or black skin should rely on depillatory creams, with a special precaution:

5. Always read the label.

The International Wound Journal reports the case of a 32-year-old man who suffered severe burns on his penis after treating his pubic hair with what turned out to be lye.

6. Laser hair removal, ironically, can stimulate hair growth.

In people who have relatively "tough" skin, laser hair removal can stimulate dormant hair follicles to produce new hairs. The hairs appear in locations other than where laser treatment removed others. Laser hair removal is more likely to be successful on the arms and on the underarms than on the face and in the pubic region.

7. Antibiotic creams, ointments, and capsules won't prevent molluscum contagiosum.

Some hair removal salons provide their clients with antibiotic creams after waxing or shaving unwanted body hair. These creams usually help prevent staph infections, but they have no effect on viral infections.

8. Women who get Brazilians may encounter different sexual expectations.

In March of 2013 the The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University published a study of the diaries of 2,453 women aged 18 to 68 who wrote about 49,287 sexual experiences (not all of them resulting in intercourse, the differences in outcome being the reason for the study). The Kinsey researchers found that women who remove pubic hair tend to have more casual relationships with their sexual partners, tend to receive more manual-genital sex, and tend to use other vaginal hygiene products.

9. Removing pubic hair the wrong way can send you to the ER.

In the United States, the National Electronic Injury Surveillance System keeps track of visits to the emergency room due to pubic hair removal accidents. In the most recent year for which there are data, no fewer than 15,000 Americans had to get emergency treatment for lacerations of the genitals, usually due to shaving. Most patients in ER with this problem were women.

10. Removing pubic hair isn't "weird" or uncommon.

A study of females aged 12 to 20 in Houston, Texas sponsored by the Department of Gynecology and Obstetrics at the Baylor College of Medicine found that 3% sported tattoos, 57% had body piercings, and 70% shaved pubic hair regularly. In this sample, however, shaving pubic hair was not found to have any relationship to frequency of sexual intercourse. That is, just because a teenager removes pubic hair doesn't mean sex is going on.

The bottom line recommendation that can be gleaned from the medical research on molluscum contagiosum and related diseases is that it is always best to be gentle to your skin. And if you choose a method of traumatic hair removal, avoid situations in which you could pick up an infection until your skin heals.