Mother always said, “Wear clean underwear in case you got in an accident.” I’m not sure where that phrase came from, so if somebody knows, you’re more than welcome to send Nursie poo an email with that information. It does make a larger statement about hygiene though.  The end result of most accidents is less than clean underwear.

So, I’m called for a new patient who was complaining of a rash. I grabbed my nurse practitioner stuff and walked to the exam room. The first thing everyone should know about newer practitioners, whether they be doctors or nurse practitioners, they are always a little perplexed by some skin lesions. It takes a while to get used to what you see when you look at the skin.

Into the room we go and sitting on exam tables is a twenty-something male who tells me it itches, “down there.” Deep sigh, because itching in the genital area has a lot of potential possibilities. I ask the patient to drop trou, so to speak, and to include his underwear. Okay, I am a fantastic nurse practitioner, but there is no way in God’s little green earth that I can see your skin through your underpants. I am always amazed by the fact that men don’t understand that when asked to pull their pants down so I can see their genitals… So, for all the men out there, do us that favor and pull them down too, more so if the problem is in that area. We all know some of them aren’t afraid to send random men and women pictures of their penis so there should be no reason to have a problem with pulling them underpants down for a medical exam. Okay, I am done with that rant, for now (Want to see more? #starshiptroopers).

Thankfully, it was easy to diagnose as our young friend had removed all of his pubic hair and was quite cleanly shaven down there. He had a lot of little bumps with pustules, and it was obvious that this was all essentially ingrown hairs. This is an obvious result of pubic hair removal or any hair removal for that matter. The remedy in the situation is straightforward; soap, and water and keep the area clean. I didn’t prescribe hydrocortisone cream since as I’ve said before, sometimes medication isn’t the best thing. In this case, using steroids on the skin can cause the skin to become thinner. Although, it is less likely in a younger than an older person. Nursie poo took time to educate this person on why removing body here may not be the best idea, at least in that manner.

I get it we shave our bodies for a lot of reasons; the illusion of youth, we think it’s unsightly, or we think it’s a sign of poor hygiene. Nothing really could be further from the truth and here’s some food for thought about hair removal.

We’ve all heard of the product called Nair or similar hair removal products (Avoid it on the nether purse gentlemen…it does not feel so good there and I only had a second-hand transfer from my leg…). The base in Nair is essentially a very strong base, sodium hydroxide; sodium hydroxide is also known as lye, which is very caustic, and if left unchecked, can burn the skin very badly. In a sense, the Nair kills the hair follicles and causes easy removal, but it also irritates and burns the skin. Most respond, “well it’s no worse than a sunburn.” In truth, even the sunburn can damage the skin. A chemical burn is far worse and has the potential to damage the lower layers of the skin. Essentially, the outcome could be skin cancer from the breakdown of the healthy skin cells and developing new cells.

Shaving in and of itself is fraught with trouble as well, as our young friend with the genital rash found out. When hair is shaved, it isn’t completely removed. Basically, the hair is cut short a lot like mowing lawns. As with mowing lawns, if the blade gets too close, it can tear up the surface. What this means on a person is that the razor blade makes micro nicks or cuts on the surface of the skin. These allow infections to enter the skin, which causes pustules to form. Of course, this is isn’t usually deadly; it’s just uncomfortable. However, skin is designed to protect the body and to insulate it and what all those cuts do is open people up to the possibility of a larger infection.

Okay so waxing. Once again, some surface burning, hair being ripped out literally, and how clean is the shop that is ripping your hair out of your skin? Many of these places are regulated by the local Health Department on some scale; there is no metric for the cleanliness standards they should maintain.

So as much as body hair might be unsightly, it does perform a real function in that it protects the skin, adds insulation, and it does a great job of catching crumbs when eating cookies in bed.