UNCLASSIFIED// ROUTINE R 081955Z OCT 19 MID110000023514U FM CNO WASHINGTON DC TO NAVADMIN INFO CNO WASHINGTON DC BT UNCLAS NAVADMIN 231/19 PASS TO OFFICE CODES: FM CNO WASHINGTON DC//N1// INFO CNO WASHINGTON DC//N1// MSGID/GENADMIN/CNO WASHINGTON DC/N1/OCT// SUBJ/BUPERSINST 1000.22C MANAGEMENT OF NAVY UNIFORMED PERSONNEL DIAGNOSED WITH PSEUDOFOLLICULITIS BARBAE (PFB)// REF/A/MSG/COMNAVSAFECEN NORFOLK VA/261941Z NOV18// REF/B/DOC/BUPERS/27DEC04// REF/C/DOC/MILPERSMAN 1900-120/9NOV18// NARR/REF A IS ALSAFE MESSAGE 18/008, FACE SEAL GUIDANCE UPDATE. REF B IS BUPERSINST 1000.22B, MANAGEMENT AND DISPOSITION OF NAVY PERSONNEL WITH PSEUDOFOLLICULITIS BARBAE (PFB). REF C IS MILPERSMAN 1900-120, SEPARATION BY REASON OF CONVENIENCE OF THE GOVERNMENT - MEDICAL CONDITIONS NOT AMOUNTING TO A DISABILITY.// RMKS/1. This NAVADMIN announces the release of BUPERSINST 1000.22C, Management of Navy Uniformed Personnel Diagnosed with Pseudofolliculitis Barbae (PFB), which supersedes reference (b). The purpose of this updated instruction is to provide policy and guidance to ensure personnel safety and mission readiness of Service members diagnosed with PFB and to minimize the potential for any increase in the risks to mission and force. This update comes as the Navy is continuing to grow the size of the force and must work to retain every skilled Sailor while maximizing their personal readiness. This update also includes the most current Bureau of Medicine and Surgery (BUMED) approved PFB treatment options which allow affected Service members to better manage shaving related skin conditions throughout their naval service. Affected Service Members are provided the opportunity to receive varying treatment regimens based off either an initial diagnosis or re- diagnosis with the intent of returning to, or maintaining, a routine shaving regimen. The dynamic nature of career and movement of a Service Member from command to command requires proactive treatment management from both the command and the individual to ensure expeditious and uninterrupted Service Member readiness. 2. PFB is caused when tightly curled beard hairs, sharpened by shaving, curve back and re-enter the skin, resulting in facial inflammation, bumps and infections. While not considered a major medical condition, it primarily affects males and can potentially increase the risk for a safety hazard if not properly addressed or treated. 3. In 2018, the Naval Safety Center reviewed and reissued a safety advisory on the effects of facial hair on the efficiency of face seals of breathing protection devices. Reference (a) re-emphasized the previous findings which concluded that facial hair represents a significant safety risk to the Service Member and subsequent risk to shipmates who are dependent upon the ability of every crew member to perform their duties. The report confirmed facial hair in an operational environment minimizes personnel safety and readiness as well as adds risk to mission and risk to force. 4. The following major policy improvements are contained within this revision: (a) PFB Evaluations. Service Members suffering from facial irritation after shaving will be referred to a health care provider for evaluation, diagnosis and treatment. Health care providers, in coordination with commanding officers (CO), will prescribe a treatment regimen aimed at returning the Service Member to normal grooming standards. COs, in coordination with the chain of command of the Service Member, will ensure compliance and that the Service Member understands the requirements of the prescribed treatment regimen. Prescribed treatment regimens may include periods of no shaving which may be interrupted when operational, maintenance and training requirements or assigned duties necessitate the removal of facial hair/shaving, as determined by the CO. (b) Permanent No-Shave Waivers. Because of the safety risks that facial hair introduces in operational, training and maintenance environments and taking into account that proper treatment can in most cases help Service Members manage their PFB, *permanent no- shave waivers* are no longer authorized. Service Members previously issued a *permanent no-shave waiver* will obtain a medical re- evaluation and new treatment regimen within 6 months of the release of the revised BUPERSINST 1000.22C. Service Members assigned to a region or on deployment where PFB re-evaluations and treatments are not available are temporarily exempt from the 6-month re-evaluation requirement, and will follow the guidance of their CO for shaving until re- evaluation and treatment are available. At no time will hair growth exceed one-quarter of an inch between directed shaving periods. (c) Medical and Laser Treatment Failures. Service Members with PFB who have been medically determined to be non-responsive to initial medical and laser treatments will be re-evaluated annually to determine suitability for continued treatment and return to normal grooming standards as directed by their health care provider or medical treatment facility. Annual re- evaluations provide for skin texture changes that normally occur as Service Members age and become more susceptible to PFB treatments. In such instances, a modified grooming routine will be established and approved by the CO. However, the maximum authorized facial hair length of one- quarter of an inch still applies. (d) CO Authority. If the operational, training and maintenance conditions require, the CO may direct under such circumstances, daily shaving until the situation permits return to the prescribed PFB medical treatment. CO directed interruptions to prescribed shaving regimens must account for the ability of an individual Service Member to continue duties and responsibilities in order to ensure compliance with all safety policies and requirements. 5. PFB affected Service Members unable to obtain a medical evaluation or a treatment regimen for any situation not covered by this instruction will follow a modified grooming routine established by their CO. In such cases, the maximum allowable facial hair growth between shaving periods will be one- quarter of an inch. 6. Administrative requirements for the management of Service Members with PFB will be implemented in line with BUPERSINST 1000.22C and reference (c). 7. Questions and comments regarding this NAVADMIN should be addressed to CAPT George Doyon, OPNAV N131, at george.doyon1(at)navy.mil or Mr. Robert B. Carroll, OPNAV N13X, at robert.b.carroll(at)navy.mil. 8. Released by Vice Admiral John B. Nowell, Jr, N1.// BT #0001 NNNN UNCLASSIFIED//