Juneteenth Special: If White Men Got PFB
Comments on the new USMC Policy on Pseudofolliculitis barbae (PFB).
Caution: INFLAMMATORY (Pun Intended!)
**Note: I wrote this before I realized my expected publication date was Juneteenth. Slavery was based upon one group of people subjugating another based on pseudoscience and distorted social norms. Think about that as you read this article. **
Every war movie seems to have a scene of the G.I. shaving himself with a K bar knife while holding up a small mirror. Due to a new policy on shaving waivers for those with Pseudofolliculitis barbae (PFB), about a year from now thousands of United States Marines will be faced with a tough decision: shave despite the pain and scarring of PFB, or lose their career. Imagine if the majority of those in positions of power (mainly occupied by white men) were afflicted with this condition - would the rules be different? Read on!
An example of pseudofolliculitis barbae (PFB). Credit: American Osteopathic College of Dermatology. Imagine dragging a razor across this skin!
This is the dilemma that is being thrust upon those with condition called Ppseudofolliculitis Barbae or “PFB” who happen to serve in the Marine Corps. For no scientific or operational reason, with no forcing function, the USMC recently changed its decades long policy to a new one that ignores science and borders on inhumane.. specifically, it calls for separation of Marines who cannot comply with a clean shaven face after one year - despite the fact that PFB is a chronic condition when the only real cure is to not shave. This is a huge step backwards.
This decision is already having its impact on psychological safety for the Marines with this condition. The Marines are already the least diverse of our forces, with about 9% of the current 169,000 Marines being Black, compared to about 18% of the country they defend. With approximately 60% of black men affected by PFB, this means that about 10,000 Marines will be personally impacted by this policy change. This is not a “DEI thing”, it’s a leadership issue - but it certainly fits the description of racial discrimination. Whether that is out of intent or ignorance, it doesn’t really matter - the impact will be the same. At its best, the signal says “we don’t care”. As worse, the single sentence “we don’t want you here.” As my friend (the one who inspired the title) said, if White Men got PFB, we would all have beards”!
In reality most Marines will not be forced out because they will force themselves to shave, accepting the pain, burning, and lifelong scars that they will almost undoubtably inflict upon themselves for the privilege of serving their nation. Some will not be able to tough it out and will be kicked out, but knowing Marines as I do, they will pay what some of my friends call a “Black tax“ in order to stay in the service that they love.
I have studied this issue in more detail than almost anyone else I know of over the past five years from a research, safety, Human Factors, and leadership perspective. This policy simply makes no sense. Driving good people out of the service does not increase lethality.
This week’s article focuses on the USMC policy, with specific comments embedded in the announcement message , but the comments will pertain any service that wants to “tighten up standards“ at the expense of its people. I’m always ready to engage with anyone who cares to have an open, data focused conversation on this topic. I served 30 years, signed hundreds of waivers - and had NO CLUE about the real tribulations associated with PFB.
Issue: The new USMC PFB policy will almost certainly have a severe negative impact on readiness and retention, especially for Black Marines.
Background. The Navy and USMC changed PFB policy in 2022 to reflect the impact of research and education on the nature of PFB and the negative impact on service members, both physically and psychologically. Below is an annotated copy of the recent USMC message on PFB Policy. Essentially, it reverts to the pre-2020 policies, policies that were changed due to fleet feedback and research. The reason for the change in 2020 was that PFB is an incurable, chronic condition based on skin and hair type, and due to the negative impacts on advancement, physical wellbeing, and psychological safety. The reason for the recent change is unknown, and does not reflect the results of research, science, or a true understanding of the issues surrounding this condition and the way policy impacts Marines.
Based on my extensive research and experience, this policy will have significant negative impact on Marines with PFB. It will result in significant stress on the force and result in a reduction in retention, advancement, and recruiting lnat a time when we can least afford it.
At a minimum, it will be imperative to recognize its implications and to educate and train leaders to avoid misapplication and misunderstanding in its enforcement. The message is reproduced below with my annotations in bold.
PRINT SHARE MARADMINS : 124/25 R 131600Z MAR 25MARADMIN124/25MSGID/GENADMIN/CMC WASHINGTON DC MRA MP// SUBJ/UNIFORM AND GROOMING STANDARDS FOR MEDICAL CONDITIONS// REF/A/MSGID/MSG/R211430ZJAN22// REF/B/MSGID/DOC/MCUB/MCO 1020.34H/01MAY2018// REF/C/MSGID/DOC/MP/MCO 6310.1C/09OCT2012// NARR/REF A IS MARADMIN 019/22/REF B IS MCO 1020.34H/REF C IS MCO 6310.1C// POC/MPO/EMAIL: SMB_HQMC_MPO@USMC.MIL/TEL: 703-784-9371/9372/ GENTEXT/REMARKS/1. Purpose. This MARADMIN provides interim guidance and announces upcoming policy changes regarding exceptions to policy (ETP) for uniform and grooming standards based on a medical condition. The strength of the Marine Corps has always been its people. Ensuring the health, resilience, and discipline of our Marines and Sailors is essential to sustaining our warfighting capability and maintaining the high standards required to remain ready for any challenge. These standards ensure we remain the world’s premier fighting force, ready to fight and win with unwavering readiness, discipline, and lethality.
2. Background. All personnel authorized to wear the Marine Corps uniform must comply with Marine Corps uniform and grooming standards per reference (b). Medical conditions may necessitate temporary modifications. Examples include a Service member recovering from surgery requiring a brace or sling, a Service member diagnosed with Pseudofolliculitis Barbae (PFB) or other facial skin conditions/wounds needing to temporarily refrain from clean-shaving, or an injured Service member requiring alternative footwear.

JPC - PFB is a chronic condition. To equate it with a temporary condition like a broken arm is inappropriate, medically inaccurate, and misleading. This does not comport with the National Institute of Health definition of PFB and shows a dramatic misunderstanding of its cause and treatment from a medical perspective.
3. Immediate Action: 3.a. Military Medical Officers (MO): When a medical procedure or condition necessitates modifying a Service member’s uniform or grooming standards, as defined by reference (b), the MO will provide a written waiver recommendation for the specific modification(s).
3.b. Commanding Officers (CO): COs will review the MO's recommendations and, in consultation with the MO, approve or disapprove the ETP. 3.c. Service members with approved ETPs: Affected personnel must retain and readily produce a copy of their approved ETP whenever deviating from the standards outlined in reference (b). This ETP may be presented in either hard copy or digital format.
JPC - Chits were eliminated in 2022 because they resulted in institutional bullying. Subjecting individuals to constant questioning of their integrity creates a situation where they are automatically on the defensive. For example, one staff member reporting to my commad in 2021 with an authorized beard was stopped and asked about it, sometimes quite aggressively, nine times during his first week.
4. Amplifying Information on PFB.
4.a. PFB is a medical condition that may require modified facial grooming, education, and treatment time. This interim guidance reaffirms existing treatment plans and clarifies commanders’ responsibilities in supporting those protocols, with the ultimate goal of returning Service members to grooming standards and ensuring maximum warfighting readiness.
4.b. Interim Guidance for Facial Grooming Modifications: 4.b.1. PFB has a four-phase treatment approach outlined in detailing reference (c). During these phases, a MO may recommend modifying groomingstandards and endorse the use of clippers. The following is a summary of each phase: 4.b.1.a. Phase I, Control of mild cases: Avoid shaving for up to4 weeks until all lesions have subsided while undergoing medical treatment.
4.b.1.b. Phase II, Control of moderate to severe cases or those casesunresponsive to Phase I: Avoid shaving for up to 8 weeks if initially starting Phase II or up to an additional 4 weeks if continuing from Phase I, with hair removal by depilatory treatment according to treatment plan.
4.b.1.c. Phase III, Cases Unresponsive to Phase II Treatment: Continue Phase II protocols for up to an additional 4 weeks; the MO may then recommend continued treatment based on the patient’s response and, if necessary, a further period of modified grooming standards.
4.b.1.d. Phase IV (Optional), Control of cases unresponsive to PhaseIII or recurring frequently: Referral to dermatology for possible laser treatment. This treatment is government-funded, but a Service member is not required to undergo laser treatment.
JPC - All of these treatments are known to be quite painful (creams and lasers can cause burning, itching, and inflammation, are mostly ineffective, and cost time and money. As noted, this is a chronic condition and these “treatments” are known by dermatologists to be merely mitigations. The only effective treatment for PFB is to not shave.
4.b.2. Medical Evaluations: As with other medical conditions requiring modified uniform and or grooming standards, MOs will recommend, and COs will approve or disapprove the modification. This change replaces the previous guidance in reference (a).
4.b.3. Documentation: When modified facial grooming standards are authorized, NAVMC 11830(02-25) will be used to document the ETP.The new NAVMC aims to improve communication between the member, medical providers, and command teams throughout the four-phase treatment plan.
4.b.4. Command Monitoring: COs with Service members diagnosed with PFB must actively monitor the four-phase treatment plan, as outlined in reference (c), to assist the Service member in returning to compliance as defined in reference (b).
5. Administration.
5.a. NAVMC Form 11830 (02-25). This form is not yet available through standard channel at forms.documentservices.dla.mil. In the interim, download the draft form from the Manpower & Reserve Affairs, Manpower Plans & Policy Division, Manpower Military Policy Branch (MPO) website at https:(slash)(slash)www.manpower.marines.mil/Plans-and-Policies/Manpower-Plans-and-Policy/Manpower-Military-Policy-MPO/Uniform-Grooming-Mods-Related-to-Medical-Conditions/. 5.b. Administrative Separation. Marines needing a uniform or grooming ETP based on a medical condition for over one year may be considered for administrative separation due to incompatibility with Service.
JPC - The new ADSEP policy after one year if this condition (which is chronic) is not resolved will drive thousands out of the service for no reason. It puts an axe over the head of all affected and will negatively impact their mental health. There are probably well over 10,000 Marines in the program who will immediately be placed under threat of termination for a condition that they cannot control.
6. Coordinating Instructions:
6.a. Within 90 days of this MARADMIN's release, all Service members with a current PFB diagnosis must be re-evaluated by a Medical Officer. Re-evaluation will assess the Service member's current treatment protocol and determine the need for further treatment. If the MO determines that the Service member's condition warrants an ETP, the MO will use the revised NAVMC to facilitate communication between the Service member, medical, and COs.
6.b. Effective immediately, this MARADMIN supersedes reference(a) and aligns the treatment of PFB with all other medical conditions impacting modifications to uniform and/or grooming standards.
JPC: The impact of the three items above falls disproportionately on Black Marines. This will not be lost on them. Approximately 60% of Black men have this condition, and over 80% of those with PFB are Black. Significant research by the USAF showed that the policy causes delays in promotion and advancement by up to a year due to the presence of facial hair. This has a discriminatory impact on Black Marines. They know this, and no amount of “training” will change the perception that they are being targeted by this policy.
7. The changes in this MARADMIN will be incorporated into a forthcoming Marine Corps Order. 8. This message applies to the Marine Corps Total Force.
9. Release authorized by Brigadier General David R. Everly, Director, Manpower Plans and Policy Division.//
My Recommendations:
1. Create a training package for leadership to understand the first and secondary impacts of both PFB and the new policy. The author has a video script for use if desired.
2. Be prepared for increased mental health challenges for the Marines impacted by the increase stress associated with this potential policy change.
3. Leaders conduct listening sessions with Marines affected by PFB. Ask them about how it is impacting them now and in the future.
Finally, my main recommendation: Rescind this outdated and destructive policy and allow good Marines to continue to serve despite a chronic but easily controlled (with a short beard) medical condition.
References:
https://blog.usni.org/posts/2021/07/22/revisiting-the-navys-beard-guidance-with-an-eye-toward-inclusion
https://www.navytimes.com/news/your-navy/2022/04/05/how-the-navys-beard-policy-discriminates-against-black-sailors/
https://academic.oup.com/milmed/article/186/7-8/187/6040786
https://blog.usni.org/posts/2022/07/20/bring-back-beards
https://pmc.ncbi.nlm.nih.gov/articles/PMC6585396/