Vulvar folliculitis in adolescents often caused by waxing, shaving

OB/GYN News, July 1, 2003 by Kate Johnson

PHILADELPHIA -- The female fight against unwanted hair has descended to the pubic region: Many teens are now removing all of their pubic hair, increasing their risk of developing vulvar folliculitis.

"Grooming of the pubic hair can now be considered normal adolescent behavior, which means you should almost expect to see pubic folliculitis in adolescent girls," Dr. Jonathan Trager said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.

The majority of problems he sees in this area come from either shaving or waxing the pubic area, both of which traumatize the hair follicle.

"Laser hair removal may not be as traumatic, but girls can still have problems with laser treatment, including pain, swelling, redness, and pigment changes," said Dr. Trager, a pediatric dermatologist and adolescent medicine specialist in Great Neck, N.Y.

"Folliculitis can even happen within 24 hours of the procedure, and it can be very uncomfortable--either very sore or very itchy Girls are very upset by it, and sometimes they come to accept it as the price of looking a certain way but they don't have to accept it," he told this newspaper.

Suggesting that teens abandon pubic hair removal is not helpful.

"This suggestion usually doesn't go over too well, so we need to find ways of improving this for them," he said.

For example, these patients should learn good shaving techniques, such as using triple blade razors along with a good shaving gel, shaving with rather than against the direction of the hair follicle, and shaving less frequently.

"I routinely give girls something to treat the irritation after shaving or waxing, such as a mild hydrocortisone lotion. If the area is infected, I prescribe a topical antibiotic lotion or a systemic antibiotic if it is severe," he said.

In addition, Dr. Trager cautioned that pubic hair shaving also poses the risk of spreading various infections, including molluscum contagiosum, genital warts, and impetigo.