Name
#113 Integrative Medicine approaches to Bilateral facial Keloids Scars in a military veteran with history of Pseudo-folliculitis Barbae (PFB)
Speakers
Content Presented On Behalf Of:
Other entity not listed
Session Type
Poster
Date
Tuesday, March 3, 2026
Start Time
5:00 PM
End Time
7:00 PM
Location
Prince Georges Expo Hall E
Focus Areas/Topics
Clinical Care, Technology, Wellbeing, Policy/Management/Administrative, Trending/Hot Topics or Other not listed
Learning Outcomes
1. Define Pseudofolliculitis Barbae (PFB) and Keloid Scars, and explain their relationship: Participants will be able to describe PFB, its common presentations (especially in populations with curly hair), and how repeated irritation from shaving can lead to keloid scar formation, particularly in predisposed individuals.
2. Summarize risk factors for keloid formation, specifically in the context of PFB and military grooming standards: Participants will be able to list factors that increase the likelihood of keloid development, including ethnicity (specifically African Americans), history of PFB, repeated trauma to the skin (e.g., shaving), and genetic predisposition. They'll also understand how strict military grooming policies can exacerbate the risk in susceptible individuals.
3. Recognize the importance of early diagnosis and appropriate management of PFB to prevent keloid scarring: Participants will understand that timely recognition of PFB and providing shaving waivers or alternative hair removal methods can prevent progression to severe keloid formation and the associated morbidity.
4. Outline the differential diagnosis, treatment options, and prognosis for both PFB and keloid scars: Participants will be able to differentiate PFB and keloids from other skin conditions with similar presentations. They will also be able to describe various treatment modalities for PFB (e.g., topical treatments, alternative hair removal) and keloids (e.g., intralesional steroids, surgery, radiation), and understand the typical prognosis for each.
5. Illustrate the ethical considerations related to military grooming standards and the health needs of individual service members: Participants will be able to critically analyze the balance between adhering to military regulations and addressing the individual health needs of service members, especially when those regulations can contribute to preventable morbidity.
6. Interpret the potential benefits of incorporating complementary and integrative therapies in the treatment plans
7. Identify and describe at least three emerging alternative and complementary therapies for keloid scar management: Participants will be able to name and explain the principles behind modalities like:
Silicone sheeting/gel: Understanding its mechanism of hydration and pressure application.
Intralesional cryotherapy: Discussing how freezing damages keloid tissue.
Laser therapy (various types): Explaining the different types of lasers used (e.g., pulsed dye laser, fractional CO2 laser) and their mechanisms of action in reducing keloid size and appearance.
Microneedling: understanding the process of stimulating collagen production
Botanical extracts (e.g., onion extract, green tea extract): Understanding the potential anti-inflammatory or collagen-modulating properties.
8. Evaluate the evidence base for the efficacy of emerging alternative and complementary keloid treatments: Participants will be able to critically assess the available research (clinical trials, case studies) supporting the use of these therapies, including understanding the limitations of the existing evidence and the need for further rigorous studies. They will understand the levels of evidence supporting these treatments.
9. Discuss the potential benefits and risks associated with integrating alternative and complementary therapies into a comprehensive keloid treatment plan: Participants will be able to articulate the potential advantages of using these therapies in conjunction with conventional treatments (e.g., enhanced outcomes, reduced side effects), as well as the potential risks (e.g., lack of standardization, potential for adverse reactions, cost).
10. Explain the importance of patient-centered care in the selection of keloid treatments, including considering patient preferences and cultural beliefs: Participants will be able to emphasize the need to involve patients in the decision-making process, taking into account their individual goals, cultural backgrounds, and preferences for treatment approaches, particularly regarding alternative and complementary options.
11. Describe the role of future research in further exploring the efficacy and safety of alternative and complementary therapies for keloid scars: Participants will be able to identify key areas for future research, such as conducting well-designed clinical trials with standardized protocols, investigating the mechanisms of action of these therapies, and developing personalized treatment approaches based on individual patient characteristics. They will understand the need for more randomized controlled trials (RCTs) in this area.
2. Summarize risk factors for keloid formation, specifically in the context of PFB and military grooming standards: Participants will be able to list factors that increase the likelihood of keloid development, including ethnicity (specifically African Americans), history of PFB, repeated trauma to the skin (e.g., shaving), and genetic predisposition. They'll also understand how strict military grooming policies can exacerbate the risk in susceptible individuals.
3. Recognize the importance of early diagnosis and appropriate management of PFB to prevent keloid scarring: Participants will understand that timely recognition of PFB and providing shaving waivers or alternative hair removal methods can prevent progression to severe keloid formation and the associated morbidity.
4. Outline the differential diagnosis, treatment options, and prognosis for both PFB and keloid scars: Participants will be able to differentiate PFB and keloids from other skin conditions with similar presentations. They will also be able to describe various treatment modalities for PFB (e.g., topical treatments, alternative hair removal) and keloids (e.g., intralesional steroids, surgery, radiation), and understand the typical prognosis for each.
5. Illustrate the ethical considerations related to military grooming standards and the health needs of individual service members: Participants will be able to critically analyze the balance between adhering to military regulations and addressing the individual health needs of service members, especially when those regulations can contribute to preventable morbidity.
6. Interpret the potential benefits of incorporating complementary and integrative therapies in the treatment plans
7. Identify and describe at least three emerging alternative and complementary therapies for keloid scar management: Participants will be able to name and explain the principles behind modalities like:
Silicone sheeting/gel: Understanding its mechanism of hydration and pressure application.
Intralesional cryotherapy: Discussing how freezing damages keloid tissue.
Laser therapy (various types): Explaining the different types of lasers used (e.g., pulsed dye laser, fractional CO2 laser) and their mechanisms of action in reducing keloid size and appearance.
Microneedling: understanding the process of stimulating collagen production
Botanical extracts (e.g., onion extract, green tea extract): Understanding the potential anti-inflammatory or collagen-modulating properties.
8. Evaluate the evidence base for the efficacy of emerging alternative and complementary keloid treatments: Participants will be able to critically assess the available research (clinical trials, case studies) supporting the use of these therapies, including understanding the limitations of the existing evidence and the need for further rigorous studies. They will understand the levels of evidence supporting these treatments.
9. Discuss the potential benefits and risks associated with integrating alternative and complementary therapies into a comprehensive keloid treatment plan: Participants will be able to articulate the potential advantages of using these therapies in conjunction with conventional treatments (e.g., enhanced outcomes, reduced side effects), as well as the potential risks (e.g., lack of standardization, potential for adverse reactions, cost).
10. Explain the importance of patient-centered care in the selection of keloid treatments, including considering patient preferences and cultural beliefs: Participants will be able to emphasize the need to involve patients in the decision-making process, taking into account their individual goals, cultural backgrounds, and preferences for treatment approaches, particularly regarding alternative and complementary options.
11. Describe the role of future research in further exploring the efficacy and safety of alternative and complementary therapies for keloid scars: Participants will be able to identify key areas for future research, such as conducting well-designed clinical trials with standardized protocols, investigating the mechanisms of action of these therapies, and developing personalized treatment approaches based on individual patient characteristics. They will understand the need for more randomized controlled trials (RCTs) in this area.
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Description
A finding of scar growth beyond the original wound boundary is known as a Keloid scar. These scars can be caused by excessive stretching of the skin during the re-granulation wound healing process or from scar formation in pre-disposed populations. African American military personnel with a history of underlying PFB may be at increased risk of disfiguring facial Keloid formation. This case represents a challenge to military physicians who do not quickly recognize this potential avoidable morbidity. Military grooming standards often require continuous close facial hair removal; without an active shaving waiver, at risk populations can suffer unnecessarily. This case highlights and Air Force veteran who was asked repeatedly to shave despite worsening of PFB during basic training. Severe bilateral pre-auricular keloids developed. We report a rare case of preventable keloid scarring that arose directly from a patient that was directed to repeatedly shave, despite history of PFB. This care report explores the pathology of Pseudofolliculitis Barbae as well as keloid development, their respective differential diagnoses, treatments and prognosis and emerging complimentary integrative therapies.