I read a recent article on the internet that talked about the potential dangers from getting a Brazilian wax, also known as waxing for a smooth bikini line. They described a case of cellulitis that resulted after such a waxing treatment. In this case, the patient required weeks of IV antibiotics and a surgical drainage to recover. The article described her experience as not unique.
While there are no reliable statistics on waxing-related complications, such waxing complications are extremely rare. Cellulitis is an early stage of infection that starts out as a diffuse redness and comes from a small break in the skin. Bacteria are introduced through this small skin break into the tissues underneath. While such a phenomenon occurs all the time (thinking about the nicks from shaving for minute), cellulitis rarely develops in the vast majority of people. This is because it takes a unique set of circumstances to develop. And these unique circumstances are the right type of bacteria and a person’s susceptibility (or sensitivity) to that bacteria. Patients with compromised immune systems or diabetics are usually at greatest risk. The pubic area is probably slightly more prone to this set of circumstances than any other waxed areas due to the different bacterial types that exist around the genital region.
Waxing, by literally pulling off a few cell layers of the outer skin, causes a temporary inflammatory (redness) reaction. But this should be subsided within 24 hours or so after a waxing treatment. If redness persists or becomes more intense or starts to cover a larger area, then one should see a plastic surgeon immediately. Early cellulitis can be treated and reversed with oral antibiotics. But if you wait for 5 days (like the lady in the article) and have severe redness and a fever, than a hospital course will await you. Cellulitis untreated can turn into an abscess or even necrotizing fasciitis.
While waxing is a very common treatment, there are several guidelines that will help to avoid this possible risk. First, make sure the person performing the treatment is a state licensed cosmetologist or aesthetician and that they perform the treatment regularly. Bikini waxing is more difficult due to the many different directions of hair growth and the sensitivity of the area. Secondly, look at the waxing work station and see that it appears clean and orderly. Is the wax fresh and does it look like it has been used before? (double-dipping) Ask about the type of wax being used. There are now special types of wax that are used just for bikini waxes. Hard or crème waxes may be used based on the type of hair that one has. The wax must not be too hot and most good quality waxing units have a visible temperature setting. After waxing, the treated area should be covered with an antibiotic cream and/or a 1% hydrocortisone cream.
Brazilian or bikini line waxing is a safe and predictable procedure. Because it is close to the genital region, it is not the same as waxing one’s legs or back. Although rare, one should be more aware of any prolonged redness in this area and seek a prompt evaluation if it persists beyond a day or two.
Dr. Barry Eppley
Indianapolis, Indiana