The Herpes Simplex Virus (HSV) is a common infection that causes painful blisters or ulcers, primarily spreading through skin-to-skin contact. There are two main types: HSV-1, often associated with oral cold sores, and HSV-2, the most frequent cause of genital herpes. Genital herpes involves outbreaks of lesions in the pubic region, which leads many to question the relationship between the virus and pubic hair. The biological process of the infection does not involve the hair itself, despite sores appearing in hair-bearing areas.
The Biology of Herpes and Hair Follicles
The definitive answer to whether herpes “grows” on pubic hair is no; the virus does not use the hair shaft or follicle as a growth medium. Herpes simplex virus is neurotropic, meaning it establishes a latent, or dormant, infection within the nervous system. After the initial infection, the virus travels along sensory nerve pathways to nerve cell clusters called ganglia, which for the genital region are the lumbosacral ganglia.
The viral DNA remains hidden inside these nerve cells for the rest of the person’s life, where it is not actively replicating. When a trigger event occurs, such as stress, illness, or local trauma, the virus reactivates. It then travels back down the nerve axon to the skin surface in the same area it originally entered the body.
The lesions that appear during an outbreak are characteristic small blisters and sores that occur on the skin or mucous membranes. These sores may appear near where pubic hair grows, but the virus sheds from nerve endings in the skin tissue, not from the hair follicles themselves. Most genital herpes outbreaks result from viral replication in the epidermal layer of the skin, though herpetic sycosis can rarely affect the hair follicles.
How Genital Herpes Spreads
Genital herpes spreads primarily through direct skin-to-skin contact with an infected person, often involving mucosal or non-intact skin. Transmission occurs during vaginal, anal, or oral sex, as the virus can be present on the skin or mucosal surfaces of the mouth or genitals. The risk of transmission is highest when an infected person has visible lesions, such as blisters or open sores, because the virus is actively shedding from these sites.
The virus can also be transmitted when no symptoms are visible, a process known as asymptomatic shedding. This happens when the virus travels to the skin surface in small amounts without causing a full outbreak. Studies suggest that a significant percentage of transmissions are attributed to sexual contact during these periods when the infected person is unaware they are contagious.
Using barrier protection, such as condoms, helps reduce the risk of transmission, though the virus can be present on skin that is not covered by the barrier. Daily suppressive antiviral therapy taken by the infected partner has also been shown to reduce the frequency of viral shedding and significantly lower the risk of transmission to a sexual partner.
Hair Removal Practices and Outbreaks
Common hair removal methods in the pubic region, such as shaving, waxing, or using depilatory creams, do not cause herpes, but they can act as triggers for an outbreak. These procedures can cause friction, minor skin trauma, or micro-abrasions that irritate the sensory nerves where the virus is dormant. This local irritation can stimulate the latent virus to reactivate and travel to the skin surface, resulting in an outbreak.
The physical trauma to the skin caused by hair removal is one example of the Koebner phenomenon, where a non-infectious skin condition or injury can trigger a lesion in individuals with a pre-existing condition like herpes. Laser hair removal, in particular, can trigger an outbreak due to the heat and irritation it causes to the sensory nerves in the area being treated. Individuals with a history of recurrent outbreaks may be advised to take antiviral medication before and after laser treatment as a preventive measure.
Performing hair removal over an active lesion also carries a risk of autoinoculation, which is the spread of the virus to a different, nearby site on the body. Although the body’s immune system generally prevents the virus from establishing a new latent infection site after the initial one, the physical act of dragging a razor or wax strip across an open sore can temporarily spread the virus to adjacent healthy skin. Therefore, it is recommended to avoid all grooming and hair removal practices in the pubic area until all lesions have completely healed.