Understanding pubic hair to figure out what comprises genital health

The Hindu

03-05-2025

Pubic hair removal and grooming has ancient roots, based around hygiene and aesthetics in Egypt, Greece, and Rome, and linked to Persian rites of adulthood. By the Middle Ages however, it was linked to soliciting for sex work so much so that women started to use Merkins — pubic wigs — to hide syphilis. Fast forward to the 20th century and beauty standards along with marketing came into play. Razor company Gillette's 1915 advertisement framed body hair as 'unsightly,' and by the 1990s, razor and waxing brands began pushing the myth that pubic hair is unhygienic. The porn industry and media cemented this idea, making hairlessness, especially among women, seem like the norm rather than a choice.
But is pubic hair really unhygienic?
'Body hair is a marker of good health,' says Tanaya Narendra, a sex health expert working at Abhilasha Hospital and IVF care, Allahabad. She explains that pubic hair increases the surface area of the genitals, which makes it easy to regulate temperature and reduce chaffing during the summer. With India being hot most of the year round, pubic hair is a useful tool to maintaining hygiene and health, she points out.
The ill effects of excessive grooming
In women, shaving and waxing can weaken the skin's barrier and immune defences, causing chronic inflammation and making the vulva more vulnerable to conditions such as lichen sclerosus (a chronic skin condition) and vulvar melanosis (increased pigmentation of the vulva), says Dr. Narendra. These grooming methods also disrupt the skin's pH and lipid balance, reducing levels of the protective bacteria Lactobacillus in the microbiome. As a result, the area becomes more susceptible to infections such as , candidiasis (yeast infection) , bacterial vaginosis and urinary tract infections (UTIs).
'Women and girls who removed pubic hair frequently, like weekly or monthly, were the ones who had recurrent UTIs,' says Andrzej Galbarczyk, a public health professor/researcher at Jagiellonian University, Kraków, Poland.. His study found that extreme grooming was linked to a higher risk of recurrent UTIs—three or more per year—suggesting that frequent hair removal may disrupt the pubic area's protective microbial ecosystem.
Frequent grooming also leads to microtears, increasing the risk of sexually transmitted infections (STIs) through bloodstream exposure. A meta-analysis published in BMC Women's Health by Asmaa Eltobgy et al last year, found that the odds of having gram-negative gonorrhoeal and chlamydial infections in pubic hair groomers were found to be statistically significant. Despite the hygiene myth, grooming can cause irritation, compromise protection, and lead to common issues like genital itching.
Excessive grooming can also cause vestibulodynia, a hypersensitive skin condition of the vulva. Shaving and waxing often lead to irritation, ingrown hairs, and folliculitis, which can escalate into staph infections or abscesses. A blocked Bartholin gland (mucus-secreting glands located on either side of the vaginal opening) from poor hygiene or hair removal may cause abscesses and, in some cases, lead to pelvic inflammatory disease (PID). 'A healthy vulva and vagina need the same care as your face,' says Sherry Ross, obstetrician-gynaecologist and author based in Santa Monica, California. stressing regular cleaning to prevent build-up, odours, and infection. Polycystic Ovary Syndrome (PCOS), hirsutism (excessive hair growth), and diabetes can further complicate grooming due to hormonal imbalances, skin issues, and delayed wound healing.
For transwomen with neovaginas, the skin is especially delicate and more prone to dryness, irritation, and heightened sensitivity. Pubic hair removal in this sensitive area can lead to microtears, inflammation, and infections, which may complicate essential practices like daily vaginal dilation by causing pain and worsening skin conditions. Gentle grooming methods and proper aftercare are crucial to reduce these risks and maintain vulvar health, say experts.
The case of men
Men have increasingly embraced pubic hair removal as well, but the anatomical differences between male and female bodies influence how grooming affects health outcomes. In males , the urethral opening and the anus are approximately 18 to 20 cm apart, which significantly reduces the likelihood of cross-contamination by bacteria and, consequently, lowers the risk of UTIs and STIs. In contrast, females have a much shorter distance — around 4 cm — between the vaginal opening and anus, making them more vulnerable to bacterial migration and infections.
However, this doesn't mean grooming is without risk for men. According to Dr. Narendra, men who frequently remove pubic hair often experience boils, microtears, and skin irritation, particularly on the scrotal skin, which is thin, highly vascularised, and prone to trauma. These minor injuries can become entry points for pathogens, potentially leading to folliculitis (inflammation of hair follicles), abscesses, or even secondary infections.
These issues are compounded by the fact that in India, it is still taboo to talk about genital health. Numerous patients have said that their attempts at conversation with medical professionals about pubic hygiene have not gone well, leaving them to opt for do-it-yourself remedies or turn to wellness gurus. 'Many patients come with chemical burns on vulva because they used a hair removal product that was not the right pH or was not designated for intimate areas,' says Dr. Narendra, who says she has seen young patients with scar tissue and altered cellular architecture of the vulva due to a lack of knowledge and understanding about their own bodies and products.
Body image issues
The physical toll apart, the emotional toll of body image issues can be just as significant. Dr. Ross explains that women often feel insecure about their vulvas. 'I hear comments like: 'My lips are too big,' 'too bumpy,' 'too dark,' 'too uneven,'… or 'My boyfriend/girlfriend tells me my labia are not pretty.'' She attributes this to the influence of porn and social media, which lead adolescent girls to obsess over the 'perfect' vulva. Dr. Ross emphasises the need for self-awareness: 'Everyone needs a roadmap.' She says she gives mirrors to her teen patients to help them understand their anatomy, empowering them to prevent sexual dysfunction and to build a healthier connection with their bodies. She also stresses the importance of discussing pubic hair removal practices and sexual history during consultations, to ensure comprehensive care.
The importance of educating ourselves, especially in light of the rise in social media-promoted products targeting young women and trans individuals has never been more crucial. 'Whether you were born with a vagina or had one created, it is important to clean the vulva, but you don't have to do too much internal cleaning,' says Dr. Ross, emphasising that the vagina naturally maintains its pH balance, and disrupting this can lead to infections.
The digital world is rife with inaccurate medical advice. 'Dr. Google' can lead to confusion, conflicting advice, and further issues. Taking charge of our health is key. 'Educating those with a vulva and vagina is the first step to dispelling dangerous genital hygiene recommendations,' Dr. Ross says.
It's time to shift the way women view their bodies, particularly vulvas and vaginas. The shame and anxiety surrounding sensitive topics into pride and comfort must go. Women need to become better health advocates, not only for their genitals but also overall wellness. People must seek a reliable healthcare provider to partner with on their health journey.
(Neelanjana Rai is an independent journalist covering global health, indigenous communities, innovations and environmental issues. [e-mail])