Are you thinking about intimate hair removal? Here we are talking about some of the precautions you should consider. Interesting to note the main observation that there is no medical justification for pubic hair removal. Italics, here, are mine.
From the dermatological perspective, it should first be pointed out during consultation that pubic hair removal makes no sense medically and entails significant risks depending on the employed method.
Structured recommendations are particularly important for self-use. The personal integrity of the genital area is preserved especially with shaving, chemical depilation and waxing, which predestines these methods to be the first self-attempted and beginners’ methods. At the same time, these entail the greatest risks for complications that arise due to improper and inexperienced handling. It appears important to plan the procedure in three steps: preparation, actual procedure and after-treatment.
For preparation, acquiring suitable materials and instruments and planning a protected spatial and temporally relaxed environment are important. Chemical epilation can be recommended as a beginner method with few complications. However, commercially available cosmetic agents should be recommended and production of one's own formulations should be strongly advised against. Especially in chatrooms on social networks, mixtures and production methods that are highly dubious and risky from a dermatological perspective are communicated. In direct consultation, recommendation of a specific preparation for chemical epilation has therefore proved successful. It is important to point out the limited duration of application and that use should be limited to the relevant area.
Before every mechanical epilation or depilation method, the area in question should be disinfected with a suitable antiseptic preparation. A commercially available alcohol-free octenidine dihydrochloride solution is suitable. Alternatively, a hydrophilic octenidine dihydrochloride 0.1% cream on a cost-price basis (according to NRF 11.145.) can also be recommended. Use of aftershave or alcoholic solution mixtures must be advised against because of the irritant effect. Use of other antiseptics like polyhexanide or chlorhexidine is also possible. However, use of suitable preparations and observation of the specific exposure time to the substance should be observed. Inexperienced users should initially be advised to shave only in the region of the mons pubis or only on directly visible areas.
When using freshly disinfected disposable razors with fixed blades and integrated protective rubber strips running parallel to the blades to regulate spacing there is a small risk of injury, just as with dry shaving. Use of free blades, cutthroat razors or razors with free interchangeable blades should be avoided. In addition, it should be noted that only personal instruments should be used.
Before the actual shaving, longer public hair should be trimmed with blunt-ended scissors or electric clippers. Immediately before shaving, the hair-bearing areas should be alternatively moistened or ideally prepared with suitable shaving gel or foam. The razor should be passed over skin held as taut as possible and should take the relief structure of the anatomical region into account. Because of this, shaving the labia, the underside of the root of the penis and the scrotal skin is particularly difficult and risky. A suitable seat and stable body position should be ensured. Sitting on a toilet bowl is unsuitable both because of hygiene considerations and because of the limited spatial freedom of action.
Positioning a mirror can also be useful. However, this also results in risks due to the optical reversed mirror image. A clean damp cloth should be kept ready for removing shaved hair and to clean the shaving field. Immediately after shaving, the shaved area should be sprayed with an antiseptic solution (see above). After disinfection, the use of a low-viscosity, aqueous, urea-free protective barrier preparation of acidic pH (pH ≤ 5.5) is recommended. Vaginal or lubricant gels are unsuitable. Minor injuries can be treated with zinc oxide-free wound ointment, for example with added dexpanthenol, madecassoside or aloe vera. Cosmetic agents containing substances known to have sensitising potential should be avoided.
The use of waxing or sugaring requires somewhat more experience and practice. In addition, the principle of mechanical epilation is painful and is therefore of limited suitability for use in the genital area.24 Various application mixtures are used (for example, hot wax, cold wax and halawa), which makes an overall evaluation from the dermatological perspective difficult. Liquid hot wax should be avoided because of the danger of thermal injury of adjacent areas of mucosal junctions or mucous membranes. The assistance of a second person is generally advisable for the use of cold wax. Pulling out the hairs causes deliberate trauma of the hair follicles, which also leads to a particular risk of complications, especially infections. Careful disinfection must therefore be ensured here in particular. However, since the microbiota of the follicles cannot be completely eradicated even with the use of low-viscosity antiseptics and a sufficiently long contact time, bacterial complications cannot be fully avoided. With sugaring, a method that is widespread in the Arab world, a mixture of an aqueous sugar solution and lemon juice (halawa) is heated (breaking down sucrose into fructose and glucose to give invert sugar), applied to the hair-bearing areas, and, after sufficient time to harden, removed with a skin spatula in the direction of hair growth. The epilation produced thereby is said to be less painful than waxing. This method is also often practiced with an assistant.
There is mixed evidence for the use of equipment-based epilation methods (laser, intense pulsed light, electrolysis). The advantage of these methods is that epilation is usually long-lasting or permanent. These methods should be used by an experienced and competent therapist.
The usefulness of the application depends on a number of factors, in particular the pigmentation of the hairs to be removed and the surrounding skin, as well as on the use of equipment with suitable physical parameters and setting options. In addition, these methods are more expensive and are therefore available only to clients in a position to pay for them.
The available drug options for epilation are subject to the approval criteria of the drugs in question and do not concern the genital region. The ornithine decarboxylase inhibitor eflornithine hydrochloride monohydrate is particularly important; this is licensed in cream form as a finished medicinal product in a concentration of 11.5% for the treatment of facial hirsutism in women.
Sex-specific pubic hair has a physiological function especially in regulation of the cutaneous microbiota in the genital region.
There is no medical evidence to justify the benefit of epilation or depilation of pubic hair.
Pubic hair removal is practiced with varying frequency depending on age, sex and culture, but overall by the majority of sexually active people.
Various methods are used for epilation or depilation of pubic hair, which differ with regard to their material cost, their effect and their complication risk.
The complication risk of the individual techniques varies greatly with the method in itself, individual factors and the experience and skill of those using them.
Shaving and waxing methods are used most commonly.
Recommendations have been lacking hitherto for users who seek advice.
Careful preparation (materials, seated position, protected location), procedure (disinfection, wetting, pubic shaving gel, hair removal, damp cloth to remove cut hairs, possibly a mirror) and aftercare (disinfection, protective barrier cream) are recommended.
The above article is taken from the following and not my own work. For further supporting information, please refer to the full text shown here:
Christine Brägelmann, Linn Wölber, Laura Susok, Waltraud Anemüller, Wiebke Prüßmann, Irina Ivanova, Dennis Niebel, Update vulval dermatology – diagnostics and therapy, JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 10.1111/ddg.15541, 23, 1, (65-86), (2024). https://doi.org/10.1111/ddg.14993
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