INFORMATION. Grooming standards play a vital role in the
promotion of good order and discipline. The standards also
provide for uniformity and serve an important safety function by
allowing the proper fit and wear of personal protective gear
such as aviation oxygen masks. Reference (a) paragraph
1004.7b(5) directs a clean-shaven face with the exception of a
well-kept moustache. Permanent variance from the established
grooming standards for any reason, including medical, is not
authorized.
a. PFB, also known as pili incarnate, sycosis barbae, and
commonly as shaving or razor bumps, is a common dermatologic
condition principally affecting men and women of African
American or Hispanic dissent who have tightly curled hair. An
infectious organism does not cause it, but instead results from
the leading edge of closely cropped facial hair re-entering the
epidermis of the skin or transecting the wall of the hair
follicle. This results in localized inflammatory reactions over
the affected site. The lesions are typically red, flesh
colored, or darkened firm raised masses on the surface of the
skin. These lesions are usually between 2 to 4 millimeters in
diameter. Hair is often seen within the lesion. The process
can lead to secondary skin infections and, in severe cases,
permanent scaring.
b. This medical condition will only manifest itself in
those predisposed individuals who regularly shave or practice
hair plucking. PFB develops due to the flat, elliptical hair
follicles found in the aforementioned ethnic skin types. The
curvature of the hair follicle and its oblique orientation to
the surface of the skin, which is most frequently observed in
African American individuals, causes the hair to grow as a
spiral with the leading edge perpendicular to and curling into
the skin. Shaving causes a sharpening of the leading edge of
the hair, which in turn penetrates the epidermis or grows with
the follicle itself. Pulling the skin taut when shaving, using
a double edged razor, or dry shaving can aggravate this effect
by causing the cut hair to retract into the follicle. The
condition occurs when the hair has grown to a length of 1 to 2
millimeters from the tip of the hair follicle. The hair will
then curl into the skin to a depth of 2 to 3 millimeters. A
loop of hair will often form on the surface with the tip
imbedded in the skin.
c. PFB is most frequently observed along the neck, chin,
and cheek over areas where there may be multiple directions of
hair growth over a small surface area. Sbased on the type and number of lesions:
(1) Mild - These patients have fewer than 20 small
lesions, a few of which may be infected.
(2) Moderate — These patients have cases marked by 20 to
60 lesions with several infected lesions present.
(3) Severe — These patients have cases marked with
greater than 60 lesions, a significant portion of skin which may
be infected.
d. Currently the mainstays of treatment are prevention and
early intervention methods. Many treatment options are
available, however none is completely curative. Vigilance and
adherence to treatment protocols are the best means of
maintaining astandards.
promotion of good order and discipline. The standards also
provide for uniformity and serve an important safety function by
allowing the proper fit and wear of personal protective gear
such as aviation oxygen masks. Reference (a) paragraph
1004.7b(5) directs a clean-shaven face with the exception of a
well-kept moustache. Permanent variance from the established
grooming standards for any reason, including medical, is not
authorized.
a. PFB, also known as pili incarnate, sycosis barbae, and
commonly as shaving or razor bumps, is a common dermatologic
condition principally affecting men and women of African
American or Hispanic dissent who have tightly curled hair. An
infectious organism does not cause it, but instead results from
the leading edge of closely cropped facial hair re-entering the
epidermis of the skin or transecting the wall of the hair
follicle. This results in localized inflammatory reactions over
the affected site. The lesions are typically red, flesh
colored, or darkened firm raised masses on the surface of the
skin. These lesions are usually between 2 to 4 millimeters in
diameter. Hair is often seen within the lesion. The process
can lead to secondary skin infections and, in severe cases,
permanent scaring.
b. This medical condition will only manifest itself in
those predisposed individuals who regularly shave or practice
hair plucking. PFB develops due to the flat, elliptical hair
follicles found in the aforementioned ethnic skin types. The
curvature of the hair follicle and its oblique orientation to
the surface of the skin, which is most frequently observed in
African American individuals, causes the hair to grow as a
spiral with the leading edge perpendicular to and curling into
the skin. Shaving causes a sharpening of the leading edge of
the hair, which in turn penetrates the epidermis or grows with
the follicle itself. Pulling the skin taut when shaving, using
a double edged razor, or dry shaving can aggravate this effect
by causing the cut hair to retract into the follicle. The
condition occurs when the hair has grown to a length of 1 to 2
millimeters from the tip of the hair follicle. The hair will
then curl into the skin to a depth of 2 to 3 millimeters. A
loop of hair will often form on the surface with the tip
imbedded in the skin.
c. PFB is most frequently observed along the neck, chin,
and cheek over areas where there may be multiple directions of
hair growth over a small surface area. Sbased on the type and number of lesions:
(1) Mild - These patients have fewer than 20 small
lesions, a few of which may be infected.
(2) Moderate — These patients have cases marked by 20 to
60 lesions with several infected lesions present.
(3) Severe — These patients have cases marked with
greater than 60 lesions, a significant portion of skin which may
be infected.
d. Currently the mainstays of treatment are prevention and
early intervention methods. Many treatment options are
available, however none is completely curative. Vigilance and
adherence to treatment protocols are the best means of
maintaining astandards.
