As active duty dermatologists in the U.S. Air Force, we call on our service leaders to re-evaluate policies prohibiting facial hair growth in male members. Among the authors, it has been widely accepted for years that these regulations likely do not improve prep, but rather lead to a discriminatory effect against shave waiver holders that particularly affects our Black/African American members.
Black/African American men tend to shave more often than members of other racial/ethnic groups due to a medical condition called beard pseudofolliculitis (PFB). Different from simple irritation from shaving, PFB leads to deep painful, scar-like bumps on the face and/or neck when facial hair is cut too closely. Contrary to the belief of some, PFB is often not manageable with anything other than a shaving profile allowing for a short amount of hair. The idea that these limbs simply need to learn how to shave properly is factually incorrect and contradicts what we as dermatologists know about this condition.
Concerns previously raised by military dermatologists were based on countless experiences in the clinic, with airmen telling us about their perception of how being on a shaving waiver affected their time in the USAF. Members are sometimes kicked out of their units, looked down upon by leaders, questioned about their integrity, passed up opportunities, or excluded from special duties. We also see Airmen who have a clear medical need for a waiver but refuse to take one because they are worried about the impact it could have on their careers. These members endure painful facial breakouts and scarring — or may even choose to have laser hair removal even if they don’t actually want to permanently change their facial hair.
Our renewed call to review these policies is no longer based solely on an anecdote — an article published in the Journal of Military Medicine in July demonstrated a significant association between shaving waivers and promotion delays. While this affected members of all races, it disproportionately affected Black/African American members as they were out of line more often than any other racial group. The study on which this association is based draws on survey data from more than 10,000 active duty male USAF members at facilities worldwide and represents the best available data on the subject that we know to this day.
We are well aware of the common argument against allowing facial hair: that it interferes with the seal of a gas mask, aviator mask or respirator. To be succinct, the data on this is far from complete. We don’t know the minimum beard length needed to control PFB, so we haven’t tested this specific beard length on military-specific masks. In our opinion, as experienced military dermatologists, one-eighth of an inch of beard length is normally enough to control PFB and there is data showing that up to 98% of people tested for a civilian respirator fit for that beard length beard can successfully get a seal. . Clinical studies to determine the minimum length and then test that length for the seal of the mask would be easy and very inexpensive to perform. If the findings of these studies support data from the civilian sector, then they could serve as a starting point for eventually implementing changes to our facial hair policies that make sense and end discrimination against our members. black/african american.
We are also aware that there is abuse of shaving profiles, which is often the source of concern for commanders. There are members on them that don’t actually need to be, and some waiver members choose to let the beard grow to a length or in a way that exceeds what is needed to avoid the discomfort. Our suggestion is not to allow beards of any style or length, but rather that through careful research we can develop regulations that allow a narrow range of facial hair options that maintain a professional appearance, promote preparation and eliminate a source of racial discrimination.
As the world’s premier air and space force, we cannot afford to overlook the talent in our ranks, and we cannot afford to lose members to regulations that may not contribute to readiness. . We must continually re-evaluate policies as new data emerges to ensure they retain added value. If they don’t, we must be prepared to abandon these burdensome regulations, no matter how difficult the culture change that comes with it. In the words of Air Force Chief of Staff General Charles Q. Brown, we must “accelerate change or lose.” We believe that these proposed changes will help ensure that we continue to have the most professional, ready, and equitable air and space force in the world, ready to meet any challenges presented to us.
Lieutenant Colonel Simon Ritchie
Lieutenant Colonel Thomas Beachkofsky
Lieutenant Colonel Casey Bowen
Lieutenant Colonel Emily Wong
Colonel Wendi Wohltmann
Lieutenant Colonel Layne Green
Major Jane Kerford
Major Amanda Leach
Major Amanda Derwae
Lt. Col. Simon Ritchie is an active duty dermatologist in the US Air Force. He leads a small team of other clinicians who recently completed a study published in the Journal of Military Medicine regarding USAF shaving waivers and their impact on promotion rates.
The opinions expressed are solely those of the authors and do not reflect the official policy or position of the US Government, Department of Defense or the US Air Force.
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