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Military Grooming Policy Changes Affecting Service Members With Pseudofolliculitis Barbae
Military Grooming Policy Changes Affecting Service Members With Pseudofolliculitis Barbae
According to the US Department of Defense (DoD), proper wear of the military uniform and adherence to grooming standards are essential components of military discipline and unit cohesion.1,2 The DoD posits that personal appearance reflects the professionalism, integrity, and accountability expected of all service members. These standards promote a shared identity and reinforce the discipline required for military organizations to operate as cohesive, unified, mission-oriented teams. Personal appearance embodies integrity, commitment to duty, and respect for institutional norms.1,2 In some situations, grooming standards also carry critical operational relevance; for example, the DoD states that a clean-shaven face is necessary to ensure a proper seal for gas masks and other personal protective equipment used in combat environments, especially when chemical or biological weapons are used.3 The Uniform Code of Military Justice states that service members who fail to comply with grooming standards, unless exempted, are subject to disciplinary action.4
In early March 2025, new directives from the DoD prompted a comprehensive review of personal grooming standards and wear of military uniforms across the uniformed services. The stated goal of these revisions was to enhance discipline, professionalism, and military readiness.5,6 These policy updates reversed several grooming accommodations introduced in prior administrations that allowed greater flexibility in personal appearance and hair-grooming practices for service members. The 2025 revised standards entail re-examination and rewriting regulations that govern grooming standards.
The new grooming regulations are likely to have major effects on service members with pseudofolliculitis barbae (PFB), a chronic inflammatory condition of the facial skin that often occurs due to and is aggravated by repeated close shaving. Through most of their histories, each US military branch has required a clean, smooth-shaven facial appearance that entailed regular (usually daily) shaving of facial hair; however, service-specific grooming instructions and medical guidelines have permitted commanders to authorize temporary or permanent exemptions or waivers for service members with PFB. To obtain a shaving waiver, individuals with PFB work closely with a military medical officer to design a shaving strategy that will not exacerbate PFB. If medical management was unsuccessful, the medical officer usually prepared a recommendation for a shaving waiver that also required approval from the service member’s commanding officer. Waivers were handled on a case-by-case basis and could be temporary (eg, for 3 months), recurring/renewable, or permanent.
The recent policy shifts make it difficult for service members to obtain renewable and permanent shaving waivers, raising concerns about medical outcomes and readiness implications. In this article, we examine the updated facial hair grooming standards across the uniformed services with a focus on the medical, regulatory, and administrative management of PFB.
Background and Policy Shifts
In March 2025, the Secretary of Defense ordered a widespread review of grooming standards in the armed forces.6 In accordance with this directive, the Army, Navy, Air Force, and Marine Corps made revisions to their uniform and grooming regulations. In August 2025, the Secretary of Defense issued a memorandum that reinforced the expectation that service members remain clean shaven and introduced additional limits on medical waivers.7 Under this policy, medical officers must provide written recommendations, while commanders remain the final approval authority. Service members with approved shaving waivers for PFB also must participate in a medical treatment plan for the condition. Importantly, the memorandum directed unit commanders to initiate separation for service members in any branch who continue to require a shaving waiver after more than 1 year of medical management. This directive underscores the DoD’s emphasis on uniformity and cohesion as visible markers of professionalism and the “warrior ethos.”7
Regulatory Framework and Enforcement
Beginning in March 2025, centrally mandated revisions to existing directives introduced more restrictive grooming and appearance standards across all military services. A key area of enforcement involves strict management of medical shaving waivers, particularly those related to PFB, which indicates a reversal of previous accommodations. Because of the lack of effective treatment for intractable PFB, the DoD previously has permitted service members to obtain permanent shaving waivers. The use of long-term waivers reduced administrative burden by removing the need for repeated evaluations and routine renewal paperwork, thereby decreasing the workload for service members, medical officers, and commanders. In the Army and Marine Corps, new grooming standards8,9 eliminate permanent waivers and prohibit pro forma renewals or extensions of existing waivers. Service members with PFB must seek a medical provider who will conduct a new full clinical evaluation, prepare new documentation requesting another temporary shaving waiver, and submit the application for the commander’s review and approval.
The Air Force also has adopted a stricter stance on shaving waivers. Under previous guidelines, service members diagnosed with PFB were eligible for a 5-year waiver that did not require annual renewal.10 However, the new 2025 guidelines eliminated this option. Now, waivers are subject to increased scrutiny and may be extended only for service members with severe, well-documented cases of PFB. In addition, the waiver must be approved by the commanding officer.11 The updated policy does not specify whether an existing waiver can be continued (ie, rolled over) or if a complete de novo waiver is required.
The new policies that eliminate long-term waivers introduce logistical and administrative requirements that are likely to be time consuming, at multiple levels of the military. In the Army and Marine Corps, it is immaterial whether the request comes from a new recruit or from a seasoned service member who has had a shaving waiver for their entire career. Under the new policy, every waiver requires a formal medical appointment with a licensed health care provider, documentation and case review, completion of a standardized waiver form with the provider’s signature, and signed approval by the commanding officer.8
Across military services, available data indicate a substantial rise in shaving waivers over the past decade. Between 2021 and 2023, the number of active-duty Air Force personnel with PFB-related shaving waivers increased from 10,965 to 18,991.12 Meanwhile, the Army has reported that more than 40,000 new shaving waivers were issued in 2024.13 While Black service members comprise roughly 15% of the active-duty force, they account for 66% of shaving waiver holders.14
Implications and Perspectives
Shaving waivers had provided a medically and administratively supported avenue for managing PFB within the relevant service requirements; however, the new policies have mandated a shift toward more regulated timelines for waiver evaluation and renewal, prohibition of permanent shaving waivers, and shortened durations of temporary shaving waivers.15 These changes impose higher time demands and administrative responsibilities on affected service members, on the chain of command, and on the US Army Medical Department.
The new guidelines reintroduced a command-level policy for PFB that differs from the clinically focused recommendations outlined in the Army’s official medical guidance on PFB.8,15 The new directives also explicitly tie an individual’s potential eligibility to remain in the Army—across active, reserve, and National Guard components—to their ability to meet the new facial-hair grooming standards.8 The policy sets a clear benchmark for retention: failing to meet grooming standards for 12 or more months within a 24-month period automatically launches a process that leads to administrative separation. Similarly, a new Marine Corps directive authorizes administrative separation for Marines who require a medical grooming waiver for more than 1 year.11 These branch-specific changes appear to implement a broader DoD policy outlined in the August 2025 memorandum, which represents a tightening of medical shaving waivers across all branches by limiting them to no more than 1 year in duration before triggering a review for administrative separation.7 Additional implications also may include increased utilization of laser hair removal (LHR) for service members for whom conservative management has failed and who wish to pursue more definitive options. Given the potential career implications of PFB, LHR may become a more frequently considered intervention among military and civilian dermatologists. In the civilian sector, TRICARE covers LHR for active-duty service members when deemed medically necessary and unavailable at their military treatment facility.14 Consequently, civilian dermatologists may see an increase in referrals from military personnel seeking LHR to maintain compliance with grooming standards under the new policy framework.
Final Thoughts
Military personnel, their chain of command, and the military medical system are keenly aware of the DoD’s newly mandated policy changes regarding grooming standards. There are many circumstances in which military personnel (eg, active-duty service members, reservists, National Guard members) receive medical care from civilian providers, who may not be up to date on changes in the military’s approach toward grooming. Civilian dermatologists may be the first to diagnose or treat PFB in prospective recruits and should be aware that under current DoD policy, failure to meet grooming standards can lead to premature separation from military service. Civilian providers who are aware that the DoD’s policies on shaving and waivers have changed dramatically can discuss these implications when evaluating or counseling patients with a history of or risk for PFB. Previously published guidelines for service members seeking a shaving waiver for PFB are listed in eTable 1.10,16-23 The current changes, which remove various accommodations that previously had been introduced, are detailed in eTable 2.7-9,15,24
The grooming policy changes, particularly in the Army and Marines, require de novo waivers, which are likely to increase health care costs as measured in time and dollars. Each waiver cycle involves medical evaluation, documentation, and chain-of-command review. The cumulative work of these recurring requirements becomes considerable when scaled across the force.
As the military’s grooming policies evolve, ongoing evaluation of their effects on service members and unit readiness remains important. Continued data collection, transparent communication, and collaboration among military institutions and health care providers may help ensure that future policy updates maintain operational standards while also supporting the health and well-being of the force.
- Department of the Air Force. Air Force Instruction 1-1: Air Forcestandards. August 18, 2023. Accessed November 14, 2025. https://static.e-publishing.af.mil/production/1/af_cc/publication/afi1-1/afi1-1.pdf
- Department of the Air Force. Air Force Instruction 1-2: Commander’s responsibilities. May 8, 2014. Accessed November 14, 2025. https://www.af.mil/Portals/1/documents/csaf/afi1_2.pdf
- Tshudy MT, Cho S. Pseudofolliculitis barbae in the US military, a review. Mil Med. 2021;186:e52-e57. doi:10.1093/milmed/usaa243
- Uniform Code of Military Justice. 892. Article 92. Failure to obey order or regulation. Accessed November 14, 2025. https://ucmj.us/892-article-92-failure-to-obey-order-or-regulation/
- The White House. Restoring America’s fighting force. The White House Newsletter. January 27, 2025. Accessed November 14, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/restoring-americas-fighting-force/
- Nava V. Hegseth orders review of US military standards, including grooming, after they were loosened under Biden. New York Post. March 12, 2025. Accessed November 14, 2025. https://nypost.com/2025/03/12/us-news/hegseth-orders-review-of-us-military-standards-including-grooming/
- Secretary of Defense. Grooming standards for facial hair. Memorandum for senior Pentagon leadership, commanders of the combatant commands, defense agency and DoD field activity directors. August 20, 2025. Accessed November 14, 2025. https://media.defense.gov/2025/Sep/15/2003799859/-1/-1/1/GROOMING-STANDARDS-FOR-FACIAL-HAIR.PDF
- Driscoll D. Army Directive 2025-13 (Facial Hair Grooming Standards). Secretary of the Army. July 7, 2025. Accessed November 17, 2025. https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN44307-ARMY_DIR_2025-13-000-WEB-1.pdf
- US Marine Corps. MARADMIN 124/25: uniform and grooming standards for medical conditions. March 13, 2025. Accessed November 17, 2025. https://www.marines.mil/News/Messages/Messages-Display/Article/4119098/uniform-and-grooming-standards-for-medical-conditions/
- United States Navy uniform regulations NAVPERS 15665J. MyNavy HR. Accessed November 17, 2025. https://www.mynavyhr.navy.mil/References/US-Navy-Uniforms/Uniform-Regulations/
- Novelly T. Medical beard waivers nearly double in Air Force and Space Force in just 3 years. Military.com. April 8, 2024. Accessed November 17, 2025. https://www.military.com/daily-news/2024/04/08/medical-beard-waivers-nearly-double-air-force-and-space-force-just-3-years.html
- Slayton N. Medical shaving waivers could soon get you kicked out of the Army. Task & Purpose. June 28, 2025. Accessed November 17, 2025. https://taskandpurpose.com/military-life/army-medical-shaving-waivers-separation/
- Keller E. Razor bumps can now get you kicked out of the marines. Black men will likely suffer the most. The Independent. May 27, 2025. Accessed November 17, 2025. https://www.the-independent.com/news/world/americas/us-politics/marines-grooming-shaving-waiver-black-men-b2758653.html
- Defense Health Agency. 2.3.2.4.8. Laser therapy for pseudofolliculitis barbae (PFB) of the face and neck. In: TRICARE Operations Manual 6010-59.M. April 1, 2015. Revised May 15, 2024. Accessed November 17, 2025. https://manuals.health.mil/pages/DisplayManualHtmlFile/2024-06-10/AsOf/TO15/C17S3.html
- Degoes JJ. Medical guidance for shaving protocols. Department of the Air Force. Accessed November 17, 2025. https://www.af.mil/Portals/1/documents/2025SAF/Tab_4_Medical_Guidance_for_Shaving_Profiles.pdf
- Department of the Army. Army Regulation 670-1. Uniform and insignia: wear and appearance of Army uniforms and insignia.January 26, 2021. Accessed November 14, 2025. https://cdn.shopify.com/s/files/1/0468/8107/9449/files/ARN30302-AR_670-1-26-JAN-2021.pdf?v=1615263762
- Department of the Army. TB MED 287. Pseudofolliculitis of the beard and acne keloidalis nuchae. July 16, 2025. Accessed November 14, 2025. https://api.army.mil/e2/c/downloads/2025/09/29/89dfa985/tb-med-287-jul2025.pdf
- DeFilippi GR. Department of the Air Force guidance memorandum to DAFI 36-2903, dress and personal appearance of Department of the Air Force personnel. Department of the Air Force. July 11, 2025. Accessed November 17, 2025. https://static.e-publishing.af.mil/production/1/af_a1/publication/dafi36-2903/dafi36-2903.pdf
- Miller RI. Air Force guidance memorandum to AFI44-102, Medical Care Management. Office of the Surgeon General. September 5, 2023. Accessed November 17, 2025. https://milreg.com/File.aspx?id=3068
- Department of the Navy. BUPERS Instruction 1000.22C: management of Navy uniformed personnel diagnosed with pseudofolliculitis barbae (PFB) update. Published March 2022. Accessed November 17, 2025. https://www.mynavyhr.navy.mil/Portals/55/Messages/NAVADMIN/NAV2022/NAV22064txt?ver=bc2HUJnvp6q1y2E5vOSp-g%3D%3D
- Headquarters, US Marine Corps. Marine Corps uniform regulations. May 1, 2018. Accessed November 17, 2025. https://www.marines.mil/portals/1/Publications/MCO%201020.34H%20v2.pdf?ver=2018-06-26-094038-137
- US Marine Corps. Advance notification of change to MCO 6310.1C (pseudofolliculitis barbae), MCO 1900.16 CH2 (Marine Corps Retirement and Separation Manual), and MCO 1040.31 (Enlisted Retention and Career Development Program. January 21, 2022. Accessed November 17, 2025. https://www.marines.mil/News/Messages/Messages-Display/Article/2907104/advance-notification-of-change-to-mco-63101c-pseudofolliculitis-barbae-mco-1900/#:~:text=No%20Marine%20shall%20be%20processed,4
- Commandant of the Marine Corps. Marine Corps order 6310.1C. Pseudofolliculitis barbae. Department of the Navy. October 9, 2012. Accessed November 17, 2025. https://www.marines.mil/portals/1/Publications/MCO%206310.1C.pdf
- Headquarters, Department of the Army. TB MED 287. Pseudofolliculitis of the beard and acne keloidalis nuchae. July 16, 2025. Accessed November 17, 2025. https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN44381-TB_MED_287-000-WEB-1.pdf
According to the US Department of Defense (DoD), proper wear of the military uniform and adherence to grooming standards are essential components of military discipline and unit cohesion.1,2 The DoD posits that personal appearance reflects the professionalism, integrity, and accountability expected of all service members. These standards promote a shared identity and reinforce the discipline required for military organizations to operate as cohesive, unified, mission-oriented teams. Personal appearance embodies integrity, commitment to duty, and respect for institutional norms.1,2 In some situations, grooming standards also carry critical operational relevance; for example, the DoD states that a clean-shaven face is necessary to ensure a proper seal for gas masks and other personal protective equipment used in combat environments, especially when chemical or biological weapons are used.3 The Uniform Code of Military Justice states that service members who fail to comply with grooming standards, unless exempted, are subject to disciplinary action.4
In early March 2025, new directives from the DoD prompted a comprehensive review of personal grooming standards and wear of military uniforms across the uniformed services. The stated goal of these revisions was to enhance discipline, professionalism, and military readiness.5,6 These policy updates reversed several grooming accommodations introduced in prior administrations that allowed greater flexibility in personal appearance and hair-grooming practices for service members. The 2025 revised standards entail re-examination and rewriting regulations that govern grooming standards.
The new grooming regulations are likely to have major effects on service members with pseudofolliculitis barbae (PFB), a chronic inflammatory condition of the facial skin that often occurs due to and is aggravated by repeated close shaving. Through most of their histories, each US military branch has required a clean, smooth-shaven facial appearance that entailed regular (usually daily) shaving of facial hair; however, service-specific grooming instructions and medical guidelines have permitted commanders to authorize temporary or permanent exemptions or waivers for service members with PFB. To obtain a shaving waiver, individuals with PFB work closely with a military medical officer to design a shaving strategy that will not exacerbate PFB. If medical management was unsuccessful, the medical officer usually prepared a recommendation for a shaving waiver that also required approval from the service member’s commanding officer. Waivers were handled on a case-by-case basis and could be temporary (eg, for 3 months), recurring/renewable, or permanent.
The recent policy shifts make it difficult for service members to obtain renewable and permanent shaving waivers, raising concerns about medical outcomes and readiness implications. In this article, we examine the updated facial hair grooming standards across the uniformed services with a focus on the medical, regulatory, and administrative management of PFB.
Background and Policy Shifts
In March 2025, the Secretary of Defense ordered a widespread review of grooming standards in the armed forces.6 In accordance with this directive, the Army, Navy, Air Force, and Marine Corps made revisions to their uniform and grooming regulations. In August 2025, the Secretary of Defense issued a memorandum that reinforced the expectation that service members remain clean shaven and introduced additional limits on medical waivers.7 Under this policy, medical officers must provide written recommendations, while commanders remain the final approval authority. Service members with approved shaving waivers for PFB also must participate in a medical treatment plan for the condition. Importantly, the memorandum directed unit commanders to initiate separation for service members in any branch who continue to require a shaving waiver after more than 1 year of medical management. This directive underscores the DoD’s emphasis on uniformity and cohesion as visible markers of professionalism and the “warrior ethos.”7
Regulatory Framework and Enforcement
Beginning in March 2025, centrally mandated revisions to existing directives introduced more restrictive grooming and appearance standards across all military services. A key area of enforcement involves strict management of medical shaving waivers, particularly those related to PFB, which indicates a reversal of previous accommodations. Because of the lack of effective treatment for intractable PFB, the DoD previously has permitted service members to obtain permanent shaving waivers. The use of long-term waivers reduced administrative burden by removing the need for repeated evaluations and routine renewal paperwork, thereby decreasing the workload for service members, medical officers, and commanders. In the Army and Marine Corps, new grooming standards8,9 eliminate permanent waivers and prohibit pro forma renewals or extensions of existing waivers. Service members with PFB must seek a medical provider who will conduct a new full clinical evaluation, prepare new documentation requesting another temporary shaving waiver, and submit the application for the commander’s review and approval.
The Air Force also has adopted a stricter stance on shaving waivers. Under previous guidelines, service members diagnosed with PFB were eligible for a 5-year waiver that did not require annual renewal.10 However, the new 2025 guidelines eliminated this option. Now, waivers are subject to increased scrutiny and may be extended only for service members with severe, well-documented cases of PFB. In addition, the waiver must be approved by the commanding officer.11 The updated policy does not specify whether an existing waiver can be continued (ie, rolled over) or if a complete de novo waiver is required.
The new policies that eliminate long-term waivers introduce logistical and administrative requirements that are likely to be time consuming, at multiple levels of the military. In the Army and Marine Corps, it is immaterial whether the request comes from a new recruit or from a seasoned service member who has had a shaving waiver for their entire career. Under the new policy, every waiver requires a formal medical appointment with a licensed health care provider, documentation and case review, completion of a standardized waiver form with the provider’s signature, and signed approval by the commanding officer.8
Across military services, available data indicate a substantial rise in shaving waivers over the past decade. Between 2021 and 2023, the number of active-duty Air Force personnel with PFB-related shaving waivers increased from 10,965 to 18,991.12 Meanwhile, the Army has reported that more than 40,000 new shaving waivers were issued in 2024.13 While Black service members comprise roughly 15% of the active-duty force, they account for 66% of shaving waiver holders.14
Implications and Perspectives
Shaving waivers had provided a medically and administratively supported avenue for managing PFB within the relevant service requirements; however, the new policies have mandated a shift toward more regulated timelines for waiver evaluation and renewal, prohibition of permanent shaving waivers, and shortened durations of temporary shaving waivers.15 These changes impose higher time demands and administrative responsibilities on affected service members, on the chain of command, and on the US Army Medical Department.
The new guidelines reintroduced a command-level policy for PFB that differs from the clinically focused recommendations outlined in the Army’s official medical guidance on PFB.8,15 The new directives also explicitly tie an individual’s potential eligibility to remain in the Army—across active, reserve, and National Guard components—to their ability to meet the new facial-hair grooming standards.8 The policy sets a clear benchmark for retention: failing to meet grooming standards for 12 or more months within a 24-month period automatically launches a process that leads to administrative separation. Similarly, a new Marine Corps directive authorizes administrative separation for Marines who require a medical grooming waiver for more than 1 year.11 These branch-specific changes appear to implement a broader DoD policy outlined in the August 2025 memorandum, which represents a tightening of medical shaving waivers across all branches by limiting them to no more than 1 year in duration before triggering a review for administrative separation.7 Additional implications also may include increased utilization of laser hair removal (LHR) for service members for whom conservative management has failed and who wish to pursue more definitive options. Given the potential career implications of PFB, LHR may become a more frequently considered intervention among military and civilian dermatologists. In the civilian sector, TRICARE covers LHR for active-duty service members when deemed medically necessary and unavailable at their military treatment facility.14 Consequently, civilian dermatologists may see an increase in referrals from military personnel seeking LHR to maintain compliance with grooming standards under the new policy framework.
Final Thoughts
Military personnel, their chain of command, and the military medical system are keenly aware of the DoD’s newly mandated policy changes regarding grooming standards. There are many circumstances in which military personnel (eg, active-duty service members, reservists, National Guard members) receive medical care from civilian providers, who may not be up to date on changes in the military’s approach toward grooming. Civilian dermatologists may be the first to diagnose or treat PFB in prospective recruits and should be aware that under current DoD policy, failure to meet grooming standards can lead to premature separation from military service. Civilian providers who are aware that the DoD’s policies on shaving and waivers have changed dramatically can discuss these implications when evaluating or counseling patients with a history of or risk for PFB. Previously published guidelines for service members seeking a shaving waiver for PFB are listed in eTable 1.10,16-23 The current changes, which remove various accommodations that previously had been introduced, are detailed in eTable 2.7-9,15,24
The grooming policy changes, particularly in the Army and Marines, require de novo waivers, which are likely to increase health care costs as measured in time and dollars. Each waiver cycle involves medical evaluation, documentation, and chain-of-command review. The cumulative work of these recurring requirements becomes considerable when scaled across the force.
As the military’s grooming policies evolve, ongoing evaluation of their effects on service members and unit readiness remains important. Continued data collection, transparent communication, and collaboration among military institutions and health care providers may help ensure that future policy updates maintain operational standards while also supporting the health and well-being of the force.
According to the US Department of Defense (DoD), proper wear of the military uniform and adherence to grooming standards are essential components of military discipline and unit cohesion.1,2 The DoD posits that personal appearance reflects the professionalism, integrity, and accountability expected of all service members. These standards promote a shared identity and reinforce the discipline required for military organizations to operate as cohesive, unified, mission-oriented teams. Personal appearance embodies integrity, commitment to duty, and respect for institutional norms.1,2 In some situations, grooming standards also carry critical operational relevance; for example, the DoD states that a clean-shaven face is necessary to ensure a proper seal for gas masks and other personal protective equipment used in combat environments, especially when chemical or biological weapons are used.3 The Uniform Code of Military Justice states that service members who fail to comply with grooming standards, unless exempted, are subject to disciplinary action.4
In early March 2025, new directives from the DoD prompted a comprehensive review of personal grooming standards and wear of military uniforms across the uniformed services. The stated goal of these revisions was to enhance discipline, professionalism, and military readiness.5,6 These policy updates reversed several grooming accommodations introduced in prior administrations that allowed greater flexibility in personal appearance and hair-grooming practices for service members. The 2025 revised standards entail re-examination and rewriting regulations that govern grooming standards.
The new grooming regulations are likely to have major effects on service members with pseudofolliculitis barbae (PFB), a chronic inflammatory condition of the facial skin that often occurs due to and is aggravated by repeated close shaving. Through most of their histories, each US military branch has required a clean, smooth-shaven facial appearance that entailed regular (usually daily) shaving of facial hair; however, service-specific grooming instructions and medical guidelines have permitted commanders to authorize temporary or permanent exemptions or waivers for service members with PFB. To obtain a shaving waiver, individuals with PFB work closely with a military medical officer to design a shaving strategy that will not exacerbate PFB. If medical management was unsuccessful, the medical officer usually prepared a recommendation for a shaving waiver that also required approval from the service member’s commanding officer. Waivers were handled on a case-by-case basis and could be temporary (eg, for 3 months), recurring/renewable, or permanent.
The recent policy shifts make it difficult for service members to obtain renewable and permanent shaving waivers, raising concerns about medical outcomes and readiness implications. In this article, we examine the updated facial hair grooming standards across the uniformed services with a focus on the medical, regulatory, and administrative management of PFB.
Background and Policy Shifts
In March 2025, the Secretary of Defense ordered a widespread review of grooming standards in the armed forces.6 In accordance with this directive, the Army, Navy, Air Force, and Marine Corps made revisions to their uniform and grooming regulations. In August 2025, the Secretary of Defense issued a memorandum that reinforced the expectation that service members remain clean shaven and introduced additional limits on medical waivers.7 Under this policy, medical officers must provide written recommendations, while commanders remain the final approval authority. Service members with approved shaving waivers for PFB also must participate in a medical treatment plan for the condition. Importantly, the memorandum directed unit commanders to initiate separation for service members in any branch who continue to require a shaving waiver after more than 1 year of medical management. This directive underscores the DoD’s emphasis on uniformity and cohesion as visible markers of professionalism and the “warrior ethos.”7
Regulatory Framework and Enforcement
Beginning in March 2025, centrally mandated revisions to existing directives introduced more restrictive grooming and appearance standards across all military services. A key area of enforcement involves strict management of medical shaving waivers, particularly those related to PFB, which indicates a reversal of previous accommodations. Because of the lack of effective treatment for intractable PFB, the DoD previously has permitted service members to obtain permanent shaving waivers. The use of long-term waivers reduced administrative burden by removing the need for repeated evaluations and routine renewal paperwork, thereby decreasing the workload for service members, medical officers, and commanders. In the Army and Marine Corps, new grooming standards8,9 eliminate permanent waivers and prohibit pro forma renewals or extensions of existing waivers. Service members with PFB must seek a medical provider who will conduct a new full clinical evaluation, prepare new documentation requesting another temporary shaving waiver, and submit the application for the commander’s review and approval.
The Air Force also has adopted a stricter stance on shaving waivers. Under previous guidelines, service members diagnosed with PFB were eligible for a 5-year waiver that did not require annual renewal.10 However, the new 2025 guidelines eliminated this option. Now, waivers are subject to increased scrutiny and may be extended only for service members with severe, well-documented cases of PFB. In addition, the waiver must be approved by the commanding officer.11 The updated policy does not specify whether an existing waiver can be continued (ie, rolled over) or if a complete de novo waiver is required.
The new policies that eliminate long-term waivers introduce logistical and administrative requirements that are likely to be time consuming, at multiple levels of the military. In the Army and Marine Corps, it is immaterial whether the request comes from a new recruit or from a seasoned service member who has had a shaving waiver for their entire career. Under the new policy, every waiver requires a formal medical appointment with a licensed health care provider, documentation and case review, completion of a standardized waiver form with the provider’s signature, and signed approval by the commanding officer.8
Across military services, available data indicate a substantial rise in shaving waivers over the past decade. Between 2021 and 2023, the number of active-duty Air Force personnel with PFB-related shaving waivers increased from 10,965 to 18,991.12 Meanwhile, the Army has reported that more than 40,000 new shaving waivers were issued in 2024.13 While Black service members comprise roughly 15% of the active-duty force, they account for 66% of shaving waiver holders.14
Implications and Perspectives
Shaving waivers had provided a medically and administratively supported avenue for managing PFB within the relevant service requirements; however, the new policies have mandated a shift toward more regulated timelines for waiver evaluation and renewal, prohibition of permanent shaving waivers, and shortened durations of temporary shaving waivers.15 These changes impose higher time demands and administrative responsibilities on affected service members, on the chain of command, and on the US Army Medical Department.
The new guidelines reintroduced a command-level policy for PFB that differs from the clinically focused recommendations outlined in the Army’s official medical guidance on PFB.8,15 The new directives also explicitly tie an individual’s potential eligibility to remain in the Army—across active, reserve, and National Guard components—to their ability to meet the new facial-hair grooming standards.8 The policy sets a clear benchmark for retention: failing to meet grooming standards for 12 or more months within a 24-month period automatically launches a process that leads to administrative separation. Similarly, a new Marine Corps directive authorizes administrative separation for Marines who require a medical grooming waiver for more than 1 year.11 These branch-specific changes appear to implement a broader DoD policy outlined in the August 2025 memorandum, which represents a tightening of medical shaving waivers across all branches by limiting them to no more than 1 year in duration before triggering a review for administrative separation.7 Additional implications also may include increased utilization of laser hair removal (LHR) for service members for whom conservative management has failed and who wish to pursue more definitive options. Given the potential career implications of PFB, LHR may become a more frequently considered intervention among military and civilian dermatologists. In the civilian sector, TRICARE covers LHR for active-duty service members when deemed medically necessary and unavailable at their military treatment facility.14 Consequently, civilian dermatologists may see an increase in referrals from military personnel seeking LHR to maintain compliance with grooming standards under the new policy framework.
Final Thoughts
Military personnel, their chain of command, and the military medical system are keenly aware of the DoD’s newly mandated policy changes regarding grooming standards. There are many circumstances in which military personnel (eg, active-duty service members, reservists, National Guard members) receive medical care from civilian providers, who may not be up to date on changes in the military’s approach toward grooming. Civilian dermatologists may be the first to diagnose or treat PFB in prospective recruits and should be aware that under current DoD policy, failure to meet grooming standards can lead to premature separation from military service. Civilian providers who are aware that the DoD’s policies on shaving and waivers have changed dramatically can discuss these implications when evaluating or counseling patients with a history of or risk for PFB. Previously published guidelines for service members seeking a shaving waiver for PFB are listed in eTable 1.10,16-23 The current changes, which remove various accommodations that previously had been introduced, are detailed in eTable 2.7-9,15,24
The grooming policy changes, particularly in the Army and Marines, require de novo waivers, which are likely to increase health care costs as measured in time and dollars. Each waiver cycle involves medical evaluation, documentation, and chain-of-command review. The cumulative work of these recurring requirements becomes considerable when scaled across the force.
As the military’s grooming policies evolve, ongoing evaluation of their effects on service members and unit readiness remains important. Continued data collection, transparent communication, and collaboration among military institutions and health care providers may help ensure that future policy updates maintain operational standards while also supporting the health and well-being of the force.
- Department of the Air Force. Air Force Instruction 1-1: Air Forcestandards. August 18, 2023. Accessed November 14, 2025. https://static.e-publishing.af.mil/production/1/af_cc/publication/afi1-1/afi1-1.pdf
- Department of the Air Force. Air Force Instruction 1-2: Commander’s responsibilities. May 8, 2014. Accessed November 14, 2025. https://www.af.mil/Portals/1/documents/csaf/afi1_2.pdf
- Tshudy MT, Cho S. Pseudofolliculitis barbae in the US military, a review. Mil Med. 2021;186:e52-e57. doi:10.1093/milmed/usaa243
- Uniform Code of Military Justice. 892. Article 92. Failure to obey order or regulation. Accessed November 14, 2025. https://ucmj.us/892-article-92-failure-to-obey-order-or-regulation/
- The White House. Restoring America’s fighting force. The White House Newsletter. January 27, 2025. Accessed November 14, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/restoring-americas-fighting-force/
- Nava V. Hegseth orders review of US military standards, including grooming, after they were loosened under Biden. New York Post. March 12, 2025. Accessed November 14, 2025. https://nypost.com/2025/03/12/us-news/hegseth-orders-review-of-us-military-standards-including-grooming/
- Secretary of Defense. Grooming standards for facial hair. Memorandum for senior Pentagon leadership, commanders of the combatant commands, defense agency and DoD field activity directors. August 20, 2025. Accessed November 14, 2025. https://media.defense.gov/2025/Sep/15/2003799859/-1/-1/1/GROOMING-STANDARDS-FOR-FACIAL-HAIR.PDF
- Driscoll D. Army Directive 2025-13 (Facial Hair Grooming Standards). Secretary of the Army. July 7, 2025. Accessed November 17, 2025. https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN44307-ARMY_DIR_2025-13-000-WEB-1.pdf
- US Marine Corps. MARADMIN 124/25: uniform and grooming standards for medical conditions. March 13, 2025. Accessed November 17, 2025. https://www.marines.mil/News/Messages/Messages-Display/Article/4119098/uniform-and-grooming-standards-for-medical-conditions/
- United States Navy uniform regulations NAVPERS 15665J. MyNavy HR. Accessed November 17, 2025. https://www.mynavyhr.navy.mil/References/US-Navy-Uniforms/Uniform-Regulations/
- Novelly T. Medical beard waivers nearly double in Air Force and Space Force in just 3 years. Military.com. April 8, 2024. Accessed November 17, 2025. https://www.military.com/daily-news/2024/04/08/medical-beard-waivers-nearly-double-air-force-and-space-force-just-3-years.html
- Slayton N. Medical shaving waivers could soon get you kicked out of the Army. Task & Purpose. June 28, 2025. Accessed November 17, 2025. https://taskandpurpose.com/military-life/army-medical-shaving-waivers-separation/
- Keller E. Razor bumps can now get you kicked out of the marines. Black men will likely suffer the most. The Independent. May 27, 2025. Accessed November 17, 2025. https://www.the-independent.com/news/world/americas/us-politics/marines-grooming-shaving-waiver-black-men-b2758653.html
- Defense Health Agency. 2.3.2.4.8. Laser therapy for pseudofolliculitis barbae (PFB) of the face and neck. In: TRICARE Operations Manual 6010-59.M. April 1, 2015. Revised May 15, 2024. Accessed November 17, 2025. https://manuals.health.mil/pages/DisplayManualHtmlFile/2024-06-10/AsOf/TO15/C17S3.html
- Degoes JJ. Medical guidance for shaving protocols. Department of the Air Force. Accessed November 17, 2025. https://www.af.mil/Portals/1/documents/2025SAF/Tab_4_Medical_Guidance_for_Shaving_Profiles.pdf
- Department of the Army. Army Regulation 670-1. Uniform and insignia: wear and appearance of Army uniforms and insignia.January 26, 2021. Accessed November 14, 2025. https://cdn.shopify.com/s/files/1/0468/8107/9449/files/ARN30302-AR_670-1-26-JAN-2021.pdf?v=1615263762
- Department of the Army. TB MED 287. Pseudofolliculitis of the beard and acne keloidalis nuchae. July 16, 2025. Accessed November 14, 2025. https://api.army.mil/e2/c/downloads/2025/09/29/89dfa985/tb-med-287-jul2025.pdf
- DeFilippi GR. Department of the Air Force guidance memorandum to DAFI 36-2903, dress and personal appearance of Department of the Air Force personnel. Department of the Air Force. July 11, 2025. Accessed November 17, 2025. https://static.e-publishing.af.mil/production/1/af_a1/publication/dafi36-2903/dafi36-2903.pdf
- Miller RI. Air Force guidance memorandum to AFI44-102, Medical Care Management. Office of the Surgeon General. September 5, 2023. Accessed November 17, 2025. https://milreg.com/File.aspx?id=3068
- Department of the Navy. BUPERS Instruction 1000.22C: management of Navy uniformed personnel diagnosed with pseudofolliculitis barbae (PFB) update. Published March 2022. Accessed November 17, 2025. https://www.mynavyhr.navy.mil/Portals/55/Messages/NAVADMIN/NAV2022/NAV22064txt?ver=bc2HUJnvp6q1y2E5vOSp-g%3D%3D
- Headquarters, US Marine Corps. Marine Corps uniform regulations. May 1, 2018. Accessed November 17, 2025. https://www.marines.mil/portals/1/Publications/MCO%201020.34H%20v2.pdf?ver=2018-06-26-094038-137
- US Marine Corps. Advance notification of change to MCO 6310.1C (pseudofolliculitis barbae), MCO 1900.16 CH2 (Marine Corps Retirement and Separation Manual), and MCO 1040.31 (Enlisted Retention and Career Development Program. January 21, 2022. Accessed November 17, 2025. https://www.marines.mil/News/Messages/Messages-Display/Article/2907104/advance-notification-of-change-to-mco-63101c-pseudofolliculitis-barbae-mco-1900/#:~:text=No%20Marine%20shall%20be%20processed,4
- Commandant of the Marine Corps. Marine Corps order 6310.1C. Pseudofolliculitis barbae. Department of the Navy. October 9, 2012. Accessed November 17, 2025. https://www.marines.mil/portals/1/Publications/MCO%206310.1C.pdf
- Headquarters, Department of the Army. TB MED 287. Pseudofolliculitis of the beard and acne keloidalis nuchae. July 16, 2025. Accessed November 17, 2025. https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN44381-TB_MED_287-000-WEB-1.pdf
- Department of the Air Force. Air Force Instruction 1-1: Air Forcestandards. August 18, 2023. Accessed November 14, 2025. https://static.e-publishing.af.mil/production/1/af_cc/publication/afi1-1/afi1-1.pdf
- Department of the Air Force. Air Force Instruction 1-2: Commander’s responsibilities. May 8, 2014. Accessed November 14, 2025. https://www.af.mil/Portals/1/documents/csaf/afi1_2.pdf
- Tshudy MT, Cho S. Pseudofolliculitis barbae in the US military, a review. Mil Med. 2021;186:e52-e57. doi:10.1093/milmed/usaa243
- Uniform Code of Military Justice. 892. Article 92. Failure to obey order or regulation. Accessed November 14, 2025. https://ucmj.us/892-article-92-failure-to-obey-order-or-regulation/
- The White House. Restoring America’s fighting force. The White House Newsletter. January 27, 2025. Accessed November 14, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/restoring-americas-fighting-force/
- Nava V. Hegseth orders review of US military standards, including grooming, after they were loosened under Biden. New York Post. March 12, 2025. Accessed November 14, 2025. https://nypost.com/2025/03/12/us-news/hegseth-orders-review-of-us-military-standards-including-grooming/
- Secretary of Defense. Grooming standards for facial hair. Memorandum for senior Pentagon leadership, commanders of the combatant commands, defense agency and DoD field activity directors. August 20, 2025. Accessed November 14, 2025. https://media.defense.gov/2025/Sep/15/2003799859/-1/-1/1/GROOMING-STANDARDS-FOR-FACIAL-HAIR.PDF
- Driscoll D. Army Directive 2025-13 (Facial Hair Grooming Standards). Secretary of the Army. July 7, 2025. Accessed November 17, 2025. https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN44307-ARMY_DIR_2025-13-000-WEB-1.pdf
- US Marine Corps. MARADMIN 124/25: uniform and grooming standards for medical conditions. March 13, 2025. Accessed November 17, 2025. https://www.marines.mil/News/Messages/Messages-Display/Article/4119098/uniform-and-grooming-standards-for-medical-conditions/
- United States Navy uniform regulations NAVPERS 15665J. MyNavy HR. Accessed November 17, 2025. https://www.mynavyhr.navy.mil/References/US-Navy-Uniforms/Uniform-Regulations/
- Novelly T. Medical beard waivers nearly double in Air Force and Space Force in just 3 years. Military.com. April 8, 2024. Accessed November 17, 2025. https://www.military.com/daily-news/2024/04/08/medical-beard-waivers-nearly-double-air-force-and-space-force-just-3-years.html
- Slayton N. Medical shaving waivers could soon get you kicked out of the Army. Task & Purpose. June 28, 2025. Accessed November 17, 2025. https://taskandpurpose.com/military-life/army-medical-shaving-waivers-separation/
- Keller E. Razor bumps can now get you kicked out of the marines. Black men will likely suffer the most. The Independent. May 27, 2025. Accessed November 17, 2025. https://www.the-independent.com/news/world/americas/us-politics/marines-grooming-shaving-waiver-black-men-b2758653.html
- Defense Health Agency. 2.3.2.4.8. Laser therapy for pseudofolliculitis barbae (PFB) of the face and neck. In: TRICARE Operations Manual 6010-59.M. April 1, 2015. Revised May 15, 2024. Accessed November 17, 2025. https://manuals.health.mil/pages/DisplayManualHtmlFile/2024-06-10/AsOf/TO15/C17S3.html
- Degoes JJ. Medical guidance for shaving protocols. Department of the Air Force. Accessed November 17, 2025. https://www.af.mil/Portals/1/documents/2025SAF/Tab_4_Medical_Guidance_for_Shaving_Profiles.pdf
- Department of the Army. Army Regulation 670-1. Uniform and insignia: wear and appearance of Army uniforms and insignia.January 26, 2021. Accessed November 14, 2025. https://cdn.shopify.com/s/files/1/0468/8107/9449/files/ARN30302-AR_670-1-26-JAN-2021.pdf?v=1615263762
- Department of the Army. TB MED 287. Pseudofolliculitis of the beard and acne keloidalis nuchae. July 16, 2025. Accessed November 14, 2025. https://api.army.mil/e2/c/downloads/2025/09/29/89dfa985/tb-med-287-jul2025.pdf
- DeFilippi GR. Department of the Air Force guidance memorandum to DAFI 36-2903, dress and personal appearance of Department of the Air Force personnel. Department of the Air Force. July 11, 2025. Accessed November 17, 2025. https://static.e-publishing.af.mil/production/1/af_a1/publication/dafi36-2903/dafi36-2903.pdf
- Miller RI. Air Force guidance memorandum to AFI44-102, Medical Care Management. Office of the Surgeon General. September 5, 2023. Accessed November 17, 2025. https://milreg.com/File.aspx?id=3068
- Department of the Navy. BUPERS Instruction 1000.22C: management of Navy uniformed personnel diagnosed with pseudofolliculitis barbae (PFB) update. Published March 2022. Accessed November 17, 2025. https://www.mynavyhr.navy.mil/Portals/55/Messages/NAVADMIN/NAV2022/NAV22064txt?ver=bc2HUJnvp6q1y2E5vOSp-g%3D%3D
- Headquarters, US Marine Corps. Marine Corps uniform regulations. May 1, 2018. Accessed November 17, 2025. https://www.marines.mil/portals/1/Publications/MCO%201020.34H%20v2.pdf?ver=2018-06-26-094038-137
- US Marine Corps. Advance notification of change to MCO 6310.1C (pseudofolliculitis barbae), MCO 1900.16 CH2 (Marine Corps Retirement and Separation Manual), and MCO 1040.31 (Enlisted Retention and Career Development Program. January 21, 2022. Accessed November 17, 2025. https://www.marines.mil/News/Messages/Messages-Display/Article/2907104/advance-notification-of-change-to-mco-63101c-pseudofolliculitis-barbae-mco-1900/#:~:text=No%20Marine%20shall%20be%20processed,4
- Commandant of the Marine Corps. Marine Corps order 6310.1C. Pseudofolliculitis barbae. Department of the Navy. October 9, 2012. Accessed November 17, 2025. https://www.marines.mil/portals/1/Publications/MCO%206310.1C.pdf
- Headquarters, Department of the Army. TB MED 287. Pseudofolliculitis of the beard and acne keloidalis nuchae. July 16, 2025. Accessed November 17, 2025. https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN44381-TB_MED_287-000-WEB-1.pdf
Military Grooming Policy Changes Affecting Service Members With Pseudofolliculitis Barbae
Military Grooming Policy Changes Affecting Service Members With Pseudofolliculitis Barbae
Practice Points
- Revised US Department of Defense grooming policies eliminate permanent shaving waivers and limit medical waivers for pseudofolliculitis barbae (PFB) to no more than 1 year, after which administrative separation may be initiated if grooming standards cannot be met.
- These changes impose increased administrative and clinical demands on service members, military medical personnel, and commanders, requiring recurrent evaluation, documentation, and approvals for temporary shaving waivers.
- Civilian dermatologists should be aware of these policy changes and their potential career implications to appropriately counsel active-duty personnel and prospective military recruits.
- Laser hair removal may see increased utilization as a treatment option for service members for whom conservative management fails.
