BOCA RATON, Fla. -

Paula Small remembers the first time she got a bikini wax more than 20 years ago.

"It was after seeing an episode of Sex and the City," she said.

Small is among a growing number of American women, and men, who are waxing away pubic hair.

"It could be to regain some of their youth, it could be for sexual satisfaction," said Boca Raton hair loss specialist  Dr. Alan Bauman.

Waxing takes many forms but the results are the same; hair is pulled out at the root.

"It sounds barbaric but it's so worth the short term pain," said Small.

Beyond the pain, some physicians are concerned about the risk of infection.

"Waxing can pull off some of the outer layer of the skin and that can increase the chance of bacteria getting in," said Bauman.

Shaving the area can also increase the risk of infection.

"We think that pubic hair is protective in some way because it traps bacteria.  for that very reason, many people have the impression that pubic hair is dirty," said Bauman.

But Bauman said even surgeons are getting away from shaving the pubic area prior to surgery.

"In most modern hospitals they don't remove all the hair from that surgical area," he said.

Leah Spairani, an esthetician at the Wild Hare Salon in Boca Raton, Fla. said people must use care and common sense when choosing to remove pubic hair.

"The key is being sanitary. You can't be double dipping with the waxing sticks.  You must make sure they throw each one away after each dip," Spairani said.

Hard wax tends to stick to the hair and not the skin, making it safer to use.

Spairani also employs a technique called 'sugaring.'

"This is a solution of just sugar, water and lemon juice.  You remove a small amount from the jar, roll it against the direction of hair growth and remove the hair in the direction of growth," said Spairani.

To reduce the risk of infection and irritation after the procedure, apply an over-the-counter topical antibiotic cream and an anti-inflammatory cream with hydocortisone.

Also, avoid shaving for at least two days. 

"Some people may want to 'touch up' the treatment, but shaving on top of waxing is not a good idea," said Bauman.

If there are any nicks from shaving the area or obvious signs of irritation from waxing, doctors suggest avoiding sex, including oral sex, to reduce the risk of contracting a sexually transmitted disease.

"I've been doing this for over 20 years and I've never had a problem, not even an ingrown hair," said Small.