“A quarter of Americans are injured and hospitalized by tidying up 'down there',” the Mail Online reports. The headline is prompted by a survey which asked 7,570 adults about pubic hair removal and “grooming” (such as waxing). The researchers found that removing all pubic hair, and frequent hair removal, were most likely to cause injuries.
Pubic hair removal has become more common in recent years. This could be due to the mistaken assumption that grooming is more hygienic (as we discussed in 2016). Some commentators have also cited the influence of pornography, where shaven genitals are the norm.
The researchers found 66.5% of men and 85.3% of women who responded to their survey had removed or groomed pubic hair at some point in their lives. However, it’s not as dangerous as the Mail Online headline suggests – while 25.6% of people reported at least one injury, these were almost all minor and only 1.4% reported injury that required medical attention.
Cuts, burns, rashes and infections were the main problems. Waxing seemed to cause fewer injuries than shaving, although researchers say more study is needed before it can be recommended as a safer option.
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The study was carried out by researchers from the University of California, the University of Texas Dell Medical School and the Washington University School of Medicine, all in the US. It was funded by the Alafi Foundation, the Hellman Foundation and the National Institute of Diabetes and Digestive and Kidney Diseases.
It was published in the peer-reviewed medical journal JAMA Dermatology.
The Guardian carried a balanced and accurate report of the study. In contrast, the Mail Online’s reporting was muddled, misleading and sensationalised. For example, the website states: “A quarter of groomers have suffered severe injuries,” although the injuries were mostly minor.
The Mail also inaccurately reported that “more than a third of people surveyed by government health researchers” said they’d had five or more injuries – although this figure applies to only one third of the 25% of people injured, not one third of people questioned. The report also includes findings from other studies as if they were part of the new study which could further mislead the reader.
This was a cross sectional study, using a web-based survey targeted at US adults aged 18 to 65. The researchers contacted more than 10,000 adults in a “nationally representative” sample.
This type of study can give a snapshot view of what people are prepared to say in a survey about their grooming habits. However, it can’t guarantee people answer truthfully.
Also this methodology leaves any results open to the accusation of selection bias. People who take the time to complete the survey may not be representative of the general publication.
Researchers randomly recruited people to take the survey through sampling of the US postal service database. An email request was sent out in January 2014 asking people to take part in the online survey.
The survey asked questions about people’s grooming habits, experience, injuries and infections.
To ensure people weren’t excluded because of lack of internet or computer access, those without access were provided with internet facilities to complete the questionnaire. Participants also received a small points-based incentive equivalent to one dollar.
The results were analysed to find out the extent and nature of the problem, and to identify factors that seemed to increase the risk of injury.
Almost half of the people contacted declined to take part in the survey. Of the 52.5% people (7,570) who did take part:
The most common problems were:
This may reflect the types of hair removal methods used. Shaving with a non-electric razor was the most common method (47.5%) followed by electric razor (26.9%), scissors (18.4%) and waxing (2.6%).
For women, those who reported waxing as their main method of hair removal were less likely to have repeated frequent injuries (adjusted odds ratio (AOR) 0.11, 95% confidence interval [CI] 0.03 to 0.43). For men (who were less likely to wax) the type of hair removal method made no difference to injury rate.
Women and men who removed all pubic hair regularly (more than 10 times per year) were more likely to report having an injury (women: AOR 2.21, 95% CI 1.53 to 3.19; men: AOR 1.97, 95% CI 1.28 to 3.01).
The position adopted while grooming made some difference to the severity of injury. People were more likely to get an injury that needed medical attention if they carried out hair removal lying on their back (perhaps because they could not see what they were doing) or if other people were carrying out the hair removal.
The researchers said their research showed that “pubic hair grooming is a widespread practice” and so “injury prevention efforts are necessary”. They said their study “may contribute to the development of clinical guidelines or recommendations for safe pubic hair removal”.
Pubic hair removal is now common practice, and this study suggests it is not without risk. It seems sensible to find out more about how it can be done more safely, with least risk of injury, as it seems unlikely that the practice will fall out of fashion any time soon.
However, although the study provides useful information about peoples’ experiences of pubic hair removal and injury (at least in the US), it doesn’t tell us which is the safest method. Although waxing was linked to fewer repeated injuries among women, previous studies suggest it can be harmful if done incorrectly, leading to severe injury or infection.
Similarly, although frequent removal of all pubic hair is linked to higher risk of injury, we don’t know why this is. It may simply be that doing anything more often means you have more opportunities to make a mistake.
The research has some limitations. It’s notable that almost half of people contacted didn’t take the survey. It may be that the people who refused to do the survey were less likely to carry out pubic hair grooming or removal, or more likely to be embarrassed at the thought of answering questions about it.
Because the research relies on people’s own reporting of their experience, we don’t know how accurate it is. People may be too embarrassed to give true answers, may forget minor injuries, or people who suffer major injuries may be more likely to respond to the survey. All of these things could skew the results.
While people may choose to remove their pubic hair for cosmetic reasons, there are no medical benefits to the practice, and it could increase your risk of contracting a sexually transmitted infection, as we reported on last year.