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Pubic hair grooming may leave people exposed in more ways than one, including a heightened risk for sexually transmitted infections (STI), according to findings from a sample of U.S. adults who shared their intimate grooming habits.

After adjusting for age and lifetime sexual partners, ever having groomed or removed pubic hair was associated with an 80% increased risk of a self-reported STI, wrote , of the University of California San Francisco and San Francisco General Hospital, and colleagues.

Additionally, among individuals who reported a STI, frequent and complete removal of pubic hair was linked to a 3.5- to four-fold heightened risk, particularly for infections that occurred through skin-on-skin contact, they wrote in .

Breyer told 乌鸦传媒 that his group hypothesized that "grooming serves as a proxy for sexual activity. In addition, we hypothesize that grooming might cause micro-tears in the epidermis or superficial layers of skin which may permit bacterial and/or viral penetrance," he said.

However, Breyer also noted that this is an observational study so "no firm conclusions can be drawn about cause and effect."

Pubic hair removal methods that have gained popularity include shaving, laser hair removal, and waxing, including thewhere all hair is stripped away.

The researchers surveyed more than 14,000 U.S. residents (ages 18-65) on their pubic hair grooming practices, STI history, and sexual behaviors. They specifically inquired about the intensity (trimming or complete removal) and frequency (from daily to annually) of pubic hair grooming, as well as the tools usually used. Extreme grooming was defined as removal of all pubic hair more than 11 times per year, while high-frequency groomers were those who trimmed their pubic hair daily or weekly.

The researchers asked about history of cutaneous STIs (herpes, human papillomavirus, syphilis, and molluscum), secretory STIs (gonorrhea, chlamydia, and HIV), and lice.

A total of 7,580 people (56% men) completed the survey, with 7,470 reporting at least one lifetime sexual partner. The researchers found that nearly three out of four (74%) respondents reported having groomed their pubic hair, with more women (84%) than men (66%) saying they had done so. Among the groomer cohort, 17% were classified as "extreme," 22% as "high frequency," and one out of 10 people fell into both categories.

Types of grooming tool varied by sex with a greater percentage of men using electric razors (42% versus 12%), while women opted for non-electric razors (61% versus 34%), and wax (5% versus 0%). Scissor usage was similar among both male and female groomers (19% versus 18%).

Compared with no grooming, ever having groomed was positively associated with a history of self-reported STIs (OR 1.8; 95% CI 1.4 to 2.2), including cutaneous STIs (OR 2.6; CI 1.8 to 3.7), secretory STIs (OR 1.7; CI 1.3 to 2.2), and lice (OR 1.9; CI 1.3 to 2.9).

Despite an observed association, the researchers were unable to determine the timing of grooming in relation to acquisition of infection, or account for either safer sex practices or risky sexual behaviors.

"Statistical confounding may explain some of our results despite controlling for age and number of sexual partners," Breyer told 乌鸦传媒, again stressing that the results do not imply causation.

The authors stated that they would like to see prospective studies on the topic "to confirm [their] cross-sectional findings and to elucidate the underlying mechanisms for insight into new STI risk-reduction strategies," as well as to further explore safe sex practices.

They suggested that "evidence of grooming could be a useful prompt for clinicians to ask about safer sex practices, or to suggest delaying sex to allow the skin to heal."

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