A 17-year-old girl presents with a pubic rash which occurred following shaving (Fig. 1). The rash consists of follicular papules and crusts and is mildly pruritic. Questions for the Clinician: What is your diagnosis?What is the obvious cause of the problem?What are common methods of pubic hair removal and their complications?How can clinicians help minimize these complications? Diagnosis: This girl has impetigo, a common and highly contagious bacterial skin infection, caused by Staphylococcus aureus. 1 The infection was no doubt spread locally by pubic hair shaving. Treatment with oral (cephalexin) and topical (mupirocin) anti-staphylococcal antibiotics cleared the infection quickly. What follows is a brief review of pubic hair removal: trends and techniques, as well as complications and strategies to reduce them. Pubic Hair Removal: While trimming or shaving the bikini area is nothing new for women and adolescent girls, more extensive pubic hair removal, once relatively uncommon except for cultural and religious reasons, is now routine. And while the practice has become mainstream in adults and adolescents of both sexes, relatively little has been written in the medical literature about this trend and its associated health consequences. Catering to this trend is a host of personal products designed for pubic hair grooming including specialty razors, electric shavers, and trimmers as well as pubic shaving gels and after-shave lotions. Salons and medical practices are touting pubic hair removal by waxing and lasers. Web sites and popular magazines are offering pubic hair removal tips and products for the novice as well as the experienced. An interesting trend is that of adolescent girls shaving their pubic hair well before they reach Tanner stage 5. Some girls start to remove pubic hair soon after they begin to develop it. It is not uncommon to see 11 and 12-year-old girls with pubic razor stubble. Tanner staging can be tricky in these girls-you have to look for the extent of the stubble, which can be difficult if the shave is close. In the author's experience, girls may learn about shaving their pubic hair from a variety of sources, including their friends, older sisters, magazines, and the internet. Parents may not know their daughter shaves her pubic hair and the reaction to this knowledge may not be positive. Before making any general comments or disclosure about this practice to parents, for example in the setting of an infection, you should obtain your patient's permission first. Younger girls may be surprised at the irritation and folliculitis that may arise from pubic hair removal. Contributing to these problems may be inexperience and poor technique, such as using a blade razor to shave dry skin or using a dull razor. As for pubic hair waxing, a girl's first experience with a "Brazilian wax" may leave her extremely irritated and wishing she had not taken the plunge. Sexually active adolescents may be shocked that they have been auto-inoculating sexually transmitted infections such as molluscum contagiosum and condyloma acuminata throughout their pubic area by shaving. Older adolescents and women with shaving and waxing folliculitis will often continue to shave and wax despite extreme irritation because they simply will not let their pubic hair grow in. In this situation, clinicians should work with patients to help them choose better hair removal techniques and minimize discomfort and irritation (see below). © 2006 North American Society for Pediatric and Adolescent Gynecology.