• Behavioural Science
• Dermatology
• Molluscum
• Virology Clinical
• Epidemiology (Clinical)

Before emerging as a fashion phenomenon, removal of pubic hair was primarily done for cultural and religious reasons (eg, this is, with circumcision, one of the items of the fitra in the Muslim religion).

Molluscum contagiosum virus (MCV) is a poxvirus and includes two strains: MCV₁ and MCV₂. MCV is generally observed in children and immunocompromised patients, and sometimes sexually transmitted. There has been an increasing incidence of sexually transmitted MCV (STMC) in the last decade.1 However, there is no proven predominance of either strain in genital lesions.2 We speculate that STMC could be linked to the use of hair removal in the genital area.

We have performed a case study of the 30 new cases of STMC presenting in a private office of dermatology in Nice, France, from January 2011 to March 2012.

Ethical review was waived due to the non use of photography and any potential for identification in this general description of a clinical population.

There were six women and 24 men, median age was 29.5 years. In the 30 cases, the lesions were located on the pubis with extension on the abdomen in four cases and legs in one. In 10 cases, there were associated lesions: pili incarnati in six cases, condylomas in four, staphylococcal folliculitis in two, epidermoid cyst in one and scars in one.

Of the 30 presenting cases, 93% used hair removal: 70% used shaving, 13% clipping and 10% waxing.

In spite of its limitations, this case study suggests that hair removal (laser excluded) could be a risk factor for ‘minor’ sexually transmitted infections (STI) such as STMC and perhaps condylomas. We postulate that, as MCV can spread by self-inoculation (eg, scratching, in children), hair removal (especially shaving) could favour its acquisition, propagation and transmission by micro-traumatisms.3

Future studies should be controlled and consider typing the MCV to see whether the prevalence of MCV₂ has increased, especially in the genital area.

Pubic hair removal is a body modification for the sake of fashion, especially in young women and adolescents, but also growing among men. The reasons for choosing genital hair removal remain unclear, but may be linked with internet-based pornography.4 Another reason cited is an increased sexual sensation. There may also be psychological reasons, as an unconscious desire to simulate an infantile look (like for cosmetic surgery5), or a desire to distance ourselves from our animal nature. Anyway, pubic hair removal may be a risk factor for STMC and perhaps other STI, such as some papillomavirus (condylomas).