Skin irritation brought on by either shaving, clipping or waxing the genital area could explain the recent increase among healthy adults of a minor sexually transmitted virus called molluscum contagiosum, the researchers suggest.
"Genital hair removal has become a fashion phenomenon in the last decade," noted case study lead author Dr Francois Desruelles, of the department of dermatology at Archet Hospital in Nice.
"At the same time, the number of cases of molluscum contagiosum has risen," he added.
This association needs to be confirmed by controlled studies, Desruelles said. But he believes the growing popularity of genital hair removal, seen in men as well as women, may raise the risk of molluscum contagiosum.
Genital warts as well
The practice may also increase the risk for developing genital warts due to infection with papillomavirus, he said.
Desruelles and his colleagues describe their observations in a letter published in the journal Sexually Transmitted Infections.
The molluscum contagiosum rash is usually seen in children or people with impaired immune systems, but it is also sexually transmitted. To look into a possible link between the condition and hair removal, the authors studied 30 infected French patients who sought the services of a private skin care clinic in Nice in 2011 and 2012.
The average age of the patients was about 30 years, and 24 of them were men. To varying degrees, all displayed the telltale signs of infection: pearl-like, raised skin bumps. In four cases, the bumps had spread up the abdominal region; in one, they had moved down the thigh.
Almost all of the patients had undergone pubic hair removal, the investigators found. Shaving was the method of choice for 70%; 10% chose waxing and 13% chose clipping.
One-third of the patients suffered from an assortment of other skin issues, such as warts, bacterial skin infections, cysts, scars, and/or ingrown hairs. But the authors theorized that ultimately the pox virus may have spread through "self-infection", meaning scratching irritated skin, which was likely provoked by the hair removal process.
Genital shaving in particular appeared to elevate infection risk.
Laser hair removal OK
"Laser hair removal doesn't seem to be involved in this association," Desruelles said, "because there are no microscopic cuts or bleeding during the removal of hair. For the same reason, waxing could be less 'at risk' than shaving."
However, genital shaving may have some "positive aspects", Desruelles said, noting that the practice may help curb the spread of pubic lice. Bloomberg News recently reported that with 80 percent of American college students now waxing, clipping, and shaving away all or some of their genital hair, pubic lice cases have dramatically dropped.
Dr. Anupam Jena, an assistant professor in the department of health care policy and medicine at Harvard Medical School in Boston, said "it's certainly reasonable" to envision a connection between genital shaving and viral risk, but more research is needed before drawing a direct causal link.
"If you were to tell me that the rates of this STI [sexually transmitted infection] are higher in men or women who do hair removal of this kind I wouldn't be surprised," he said. "But it's hard to say whether this is a matter of cause and effect, or whether people who undergo this hair removal are more likely to engage in sexual activities that might increase their risk for contracting STIs to begin with."
The hygiene at the particular place where these patients underwent hair removal may have played a role in the findings, Jena added.
"For now, in terms of whether or not individuals should interpret this to mean that they shouldn't undergo hair removal of this kind, I would say there's no need for alarm," Jena said.
The rash associated with molluscum usually disappears within a year without treatment and without scarring, according to the U.S. Centers for Disease Control and Prevention.
For more on molluscum contagiosum, visit the U.S. National Institutes of Health.