Self-care for "down there"

I have started writing this post numerous times, but I keep shelving it because I'm never sure how it will be received. But after seeing a staggering number of patients with issues in their nether-regions in the past few weeks (it is one of the top patient questions I get), I figured it's time.  We need to be frank about personal hygiene for the private parts.

First, the shaving.  I'm not exactly sure when being bare become all the craze (for all genders), but if it's not done right, it can lead to lots o' problems.  There is no medical reason to be hairless (as one of my mentors always exclaimed, "Be hairy and be clean"), and there definitely can be medical consequences of shaving improperly.  I have had to drain abscesses (and that is a very sensitive area to be putting a needle), treat infections caused by nicks of the skin and ingrown hairs, and frequently get asked about painful razor burn.  However, if it's your preference to be dolphin-smooth (a nod to The Walking Dead for any fans out there), there are some steps you can take to make it less hazardous:

• Use a clean, sharp razor. Dull razors increase the amount of drag across the sensitive skin and increase risk for razor burn and tiny little cuts that can lead to infection. While we're at it, do NOT share razors with anyone else. Gross.

• Use shaving cream. A lot of people use plain soap or (*gasp*) shave dry.  Just don't.

• Shave in the same direction of hair growth instead of against the grain. Again, it's all about decreasing the drag of the razor against the sensitive skin. You can still get a close shave with a lot less irritation.

• Do NOT shave an area that you cannot see. Use a mirror, do yoga to get more flexible, whatever it takes, but do not blindly swipe at your body with a sharp object. Stitches on the genitals are no fun for anyone.

• Alternatives to shaving with razor include electric clippers (there are special ones for the pubic area, do not use the same one you use on your head), waxing, and electrolysis. Each alternative has its own side effects, but generally lead to less infections.

Next, the cleansing. You don't need the fancy soaps/cleaners, etc. That is all a marketing gimmick, and some cleansers can actually lead to more problems.  Any scent-free, gentle soap is fine for the outside of the genitals, but nothing should go inside. No douches, no bubble baths, no powders or perfumed products (like scented tampons). These can change the acid-base balance of the vagina and lead to infections, like yeast or bacterial infections. Improper hygiene can also lead to irritation and infections for the males.

Finally, a quick note on how safer sex products can impact genital health (which I think deserves an entire separate blog...stay tuned!).  When choosing a personal lubricant, make sure to use a product that is intended to be used for this purpose (no Vaseline, hand lotion, oil, etc.), and it is preferable to use a lubricant that is water-based and not glycerin- or oil-based, which can contribute to infections. Certain products (including spermicides and some types of condoms) can cause infections and skin irritation, which could actually put you at higher risk for certain types of sexually transmitted infections, like HIV.

There you have it. I hope this wasn't too painful for you to read (and maybe I'll have a few less...how do I phrase this?...uncomfortable teens in my office).

If you are concerned about any type of genital irritation or infection, please talk to your health care provider.