Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

Surveillance Snapshot: Pseudofolliculitis barbae Cases in Active Component Service Members, 2000–2022

Image of Cover4_7614288. Current grooming standards of the U.S. military mandate facial shaving to ensure adequate fitting and sealing of protective masks, but a shaving waiver may be issued for medical reasons such as Pseudofolliculitis barbae, or for religious reasons, among others.

Pseudofolliculitis barbae, also known as “razor bumps” or “shaving bumps,” results from an inflammatory, foreign body reaction of the skin, caused by shortened and sharpened hair piercing to the epidermis and dermis.1 While PFB can affect any person who regularly shaves, literature demonstrates an increased prevalence for persons with tightly curly hair, particularly African American and Hispanic individuals, including service members in the U.S. military.1-3 Current grooming standards in the U.S. military mandate facial shaving to ensure adequate fitting and sealing of protective masks.1 A shaving waiver may be issued for medical reasons such as PFB, or for religious reasons, among others.1,4 

This Surveillance Snapshot describes the frequency of PFB cases among active component service members of the U.S. military from 2000 through 2022. A PFB case was counted once per year if the ACSM demonstrated either two outpatient or theater medical data store encounters within 60 days, or one inpatient encounter within the year. Overall, the frequency of PFB cases increased over the surveillance period and varied greatly by race/ethnicity, disproportionally affecting Non-Hispanic Black service members (Figure). Non-Hispanic Blacks, who have historically comprised 16-18% of the U.S military in the past 20 years,5-7 constitute a majority (63.5%) of PFB cases. The frequency trend is well out of proportion to the change in troop strength. The increase in reported cases from 50 in 2000 to 2,404 in 2022 may warrant further study. 

This graph depicts the frequency of Pseudofolliculitis barbae (PFB) cases according to race/ethnicity among active component service members of the U.S. military from 2000 through 2022. Four lines on the x-, or horizontal, axis represent 3 racial/ethnic groups, namely Hispanic, Non-Hispanic Black, and Non-Hispanic White, while a fourth line represents “Other/unknown” service members. Each line connects data points that chart, on the y-axis, the annual numbers of reported PFB case counts for each racial/ethnic group for every year from 2000 to 2022. Overall, the frequency of PFB cases increased over the surveillance period, but with a noticeable rise in cases between 2021 and 2022 for all racial/ethnic group categories. Starting in 2006, Non-Hispanic Black service members consistently had far higher numbers of PFB cases, noticeably increasing between 2007 and 2008, and spiking dramatically from 2021 to 2022. From 2008 until 2021, Non-Hispanic Black service members reported around 600 cases per year; that number exceeded 1,400 cases in 2022. From 2008 until 2014, Non-Hispanic White service members reported just in excess of 200 PFB cases per year, but from 2015 to 2021 those cases fell to under 100, in line with Hispanic and Other/unknown service member case numbers. In 2022 Non-Hispanic White service members reported nearly 450 cases, Hispanic service members reported just under 400 cases, and Other/unknown service members reported around 150 cases.

References

  1. Tshudy T, Cho S. Pseudofolliculitis barbae in the U.S. military, a review. Mil Med. 2021;186(1-2):52-57. https://doi.org/10.1093/milmed/usaa243
  2. Perry P, Cook-Bolden F, Rahman Z, Jones E, Taylor S. Defining Pseudofolliculitis barbae in 2001: a review of the literature and current trends. J Am Acad Dermatol. 2002;46(2):113-119. https://doi.org/10.1067/mjd.2002.120789
  3. Gelman A, Norton S, Valdes-Rodriguez R, Yosipovitch G. A review of skin conditions in modern warfare and peacekeeping operations. Mil Med. 2015;180(1):32-37. https://doi.org/10.7205/MILMED-D-14-00240
  4. Department of Defense. DoD Instruction 1300.17: Religious Liberty in the Military Services. 2020. Accessed August 1, 2023. https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/130017p.pdf
  5. Barroso A. The changing profile of the U.S. military: smaller in size, more diverse, more women in leadership. 2019. Pew Research Center. Accessed August 2, 2023. https://www.pewresearch.org/short-reads/2019/09/10/the-changing-profile-of-the-u-s-military
  6. Department of Defense. 2017 Demographics Profile of the Military Community. 2017. Accessed August 2, 2023. https://download.militaryonesource.mil/12038/MOS/Reports/2017-demographics-report.pdf
  7. Department of Defense. 2021 Demographics Profile of the Military Community. 2021. Accessed August 2, 2023. https://download.militaryonesource.mil/12038/MOS/Reports/2021-demographics-report.pdf

Author Affiliations

Defense Health Agency, Armed Forces Health Surveillance Division, Epidemiology and Analysis Section

You also may be interested in...

Topic
Jun 6, 2024

Medical Surveillance Monthly Report

The Medical Surveillance Monthly Report, a peer-reviewed journal launched in 1995, is the Armed Forces Health Surveillance Division's flagship publication. The MSMR provides monthly evidence-based estimates of the incidence, distribution, impact, and trends of health-related conditions among service members.

Report
May 3, 2024

2022 DOD Worldwide Numbers for TBI

.PDF | 1010.17 KB

TBICoE is the Defense Department’s office of responsibility for tracking traumatic brain injury data in the U.S. military. Here you’ll find data on the number of active-duty service members—anywhere U.S. forces are located—with a first-time TBI diagnosis in the calendar year 2022. The data is also broken down by each branch of the armed services.

Report
May 1, 2024

MSMR Vol. 31 No. 5 - May 2024

.PDF | 3.55 MB

The May 2024 MSMR features a report on mortality surveillance of active duty U.S. soldiers from 2014 to 2019; followed by three related reports on respiratory investigations, surveillance and forecasting, on: an outbreak of influenza and SARS-CoV-2 at the Armed Forces of the Philippines Health Service Education and Training Center, September–October ...

Article
May 1, 2024

Outbreak of Influenza and SARS-CoV-2 at the Armed Forces of the Philippines Health Service Education and Training Center, September 25–October 10, 2023

This report describes an investigation of a respiratory outbreak at the Armed Forces of the Philippines Health Service Education and Training Center by the Walter Reed Army Institute of Research-Armed Forces Research Institute of Medical Sciences and Armed Forces of the Philippines Collaborative Molecular Laboratory, demonstrating a common source ...

Topic
Apr 25, 2024

Armed Forces Health Surveillance Division

The Armed Forces Health Surveillance Division plays a critical role in force health protection. As the central epidemiologic resource for the U.S. Armed Forces, AFHSD conducts medical surveillance to protect all those who serve our nation in uniform and allies who are critical to our national security interests.

Article
Apr 1, 2024

Reportable Medical Events at Military Health System Facilities Through Week 9, Ending March 2, 2024

This report provides a monthly updatea of Reportable Medical Events documented in the Disease Reporting System internet (DRSi) by health care providers and public health officials throughout the Military Health System. Reportable Medical Events are a critical tool for monitoring, controlling, and preventing the occurrence and spread of diseases of ...

Skip subpage navigation
Refine your search
Last Updated: September 13, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery