Overview of VA Skin Condition Ratings

Skin conditions affect the largest organ of the body and can range from minor irritations to severe, debilitating disorders. Military service can lead to skin conditions through environmental exposures, chemical contact, extreme weather conditions, infections, or as secondary effects of other service-connected conditions. This section explains how the VA rates skin conditions and provides detailed guidance for the most common conditions.

General Rating Principles for Skin Conditions

The VA rates most skin conditions based on several factors:

• Percentage of body affected: How much of your total body surface area (BSA) or exposed areas (face, neck, hands) are affected by the condition
• Required treatments: Medications, therapies, or other interventions needed, with particular attention to systemic therapy such as corticosteroids or immunosuppressive drugs
• Frequency and duration of flare-ups: How often symptoms occur and how long they last
• Impact on daily activities: How the condition affects your ability to work and perform daily tasks

Pseudofolliculitis Barbae (PFB)

Overview of Pseudofolliculitis Barbae

Pseudofolliculitis Barbae (PFB), commonly known as “razor bumps,” is a skin condition that occurs primarily in the beard area when curved hairs grow back into the skin after shaving, causing inflammation, bumps, and sometimes infection. It is particularly common among individuals with curly or coarse hair, including many African American men.

Symptoms of PFB include:

• Small, painful bumps on the face and neck
• Inflammation and irritation
• Hyperpigmentation (darkening of the skin)
• Scarring
• Ingrown hairs
• Pustules or papules

Military service often contributes to PFB due to strict grooming standards that require daily shaving, even for individuals whose skin and hair type make them more susceptible to this condition.

Service Connection for Pseudofolliculitis Barbae

To establish service connection for PFB, you generally need:

1. Current diagnosis of PFB or evidence of current symptoms
2. Evidence of PFB during service, such as profiles, shaving waivers, or treatment records
3. Medical nexus linking your current PFB to your military service

PFB is often well-documented in service treatment records because it directly interferes with military grooming standards, requiring medical profiles or shaving waivers.

VA Disability Ratings for Pseudofolliculitis Barbae

PFB does not have its own diagnostic code in the VA rating schedule. Instead, it is typically rated by analogy to dermatitis or eczema under Diagnostic Code 7806, based on the percentage of the body affected and the type of treatment required:

Rating	Criteria
60%	More than 40% of the entire body or more than 40% of exposed areas affected; or constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period
30%	20 to 40% of the entire body or 20 to 40% of exposed areas affected; or systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, during the past 12-month period
10%	At least 5%, but less than 20%, of the entire body, or at least 5%, but less than 20%, of exposed areas affected; or intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period
0%	Less than 5% of the entire body or less than 5% of exposed areas affected; and no more than topical therapy required during the past 12-month period

Alternatively, if PFB has caused permanent scarring, it may be rated under the diagnostic codes for scars (7800-7805), which could potentially result in a higher rating depending on the number, size, and characteristics of the scars.

Evidence Needed for Pseudofolliculitis Barbae Claims

To support your PFB claim, gather the following evidence:

Medical Evidence

• Diagnosis of PFB from a medical provider
• Treatment records showing medications or therapies prescribed
• Dermatology consultations or evaluations
• Photos of affected areas (if available)
• Medical opinions linking your PFB to military service

Service Records

• Service treatment records showing diagnosis or treatment of PFB
• Shaving profiles or waivers
• Documentation of any disciplinary actions related to failure to shave
• Sick call visits for skin irritation or infection in the beard area

Lay Evidence

• Personal statements describing when your PFB began and how it has affected you
• Statements from fellow service members who witnessed your skin condition
• Description of how PFB has affected your appearance, comfort, and daily activities
• Timeline of treatments you’ve tried and their effectiveness

Tips for Successful Pseudofolliculitis Barbae Claims

• Document Percentage of Affected Area: Ask your doctor to document what percentage of your face/neck (exposed areas) is affected by PFB, as this is crucial for rating purposes.
• List All Treatments: Keep a record of all medications and treatments you’ve used, including both prescription and over-the-counter products.
• Highlight Systemic Treatments: If you’ve been prescribed oral antibiotics, corticosteroids, or other systemic medications, ensure these are prominently documented in your claim.
• Address Scarring: If PFB has caused permanent scarring, make sure this is documented and consider seeking a separate rating for scars.
• Explain Racial Factors: If applicable, explain how your hair type and skin type make you more susceptible to PFB, and how military shaving requirements exacerbated this natural predisposition.

Dermatitis

Overview of Dermatitis

Dermatitis is a general term that describes inflammation of the skin. There are several types of dermatitis, including contact dermatitis, atopic dermatitis (eczema), seborrheic dermatitis, and others. Each type has different causes and may affect different parts of the body, but all involve inflammation and irritation of the skin.

Symptoms of dermatitis can include:

• Redness and inflammation
• Itching
• Dry, cracked, or scaly skin
• Blisters or oozing
• Swelling
• Pain or tenderness
• Thickened or leathery skin (in chronic cases)

Military service can contribute to dermatitis through various factors:

• Environmental exposures: Chemicals, irritants, allergens, extreme weather conditions
• Equipment and uniforms: Friction from gear, allergic reactions to materials, trapped moisture
• Living conditions: Shared facilities, exposure to new allergens, limited access to proper skin care
• Stress: High-stress environments can trigger or worsen dermatitis

Service Connection for Dermatitis

To establish service connection for dermatitis, you generally need:

1. Current diagnosis of dermatitis or evidence of current symptoms
2. Evidence of an in-service event that could have caused or aggravated your dermatitis
3. Medical nexus linking your current dermatitis to your military service

VA Disability Ratings for Dermatitis

Dermatitis is rated under Diagnostic Code 7806 based on the percentage of the body affected and the type of treatment required:

Rating	Criteria
60%	More than 40% of the entire body or more than 40% of exposed areas affected; or constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period
30%	20 to 40% of the entire body or 20 to 40% of exposed areas affected; or systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, during the past 12-month period
10%	At least 5%, but less than 20%, of the entire body, or at least 5%, but less than 20%, of exposed areas affected; or intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period
0%	Less than 5% of the entire body or less than 5% of exposed areas affected; and no more than topical therapy required during the past 12-month period

Evidence Needed for Dermatitis Claims

To support your dermatitis claim, gather the following evidence:

Medical Evidence

• Diagnosis of dermatitis from a medical provider
• Treatment records showing medications or therapies prescribed
• Dermatology consultations or evaluations
• Photos of affected areas (if available)
• Documentation of the percentage of body affected
• Medical opinions linking your dermatitis to military service

Service Records

• Service treatment records showing diagnosis or treatment of skin conditions
• Documentation of exposure to chemicals, irritants, or allergens
• Records of environmental conditions during deployment
• Sick call visits for skin issues

Lay Evidence

• Personal statements describing when your dermatitis began and how it has affected you
• Statements from fellow service members who witnessed your skin condition
• Description of how dermatitis affects your daily activities and ability to work
• Timeline of treatments you’ve tried and their effectiveness
• Log of flare-ups, including frequency, duration, and severity

Tips for Successful Dermatitis Claims

• Document During Flare-ups: Try to get medical documentation and photos during flare-ups, as dermatitis can be cyclical with periods of improvement and worsening.
• Track Medication Usage: Keep a detailed log of all medications used, including frequency, duration, and whether they are topical or systemic.
• Get Professional Assessment: Ask your dermatologist to document what percentage of your body is affected by dermatitis, as this is crucial for rating purposes.
• Address Occupational Impact: Explain how dermatitis affects your ability to work, including any limitations on the types of environments or activities you can tolerate.
• Consider Secondary Connection: If you have service-connected PTSD or other conditions that could cause or aggravate dermatitis, pursue secondary service connection.

Eczema

Overview of Eczema

Eczema, also known as atopic dermatitis, is a chronic skin condition characterized by dry, itchy, inflamed skin. It typically appears in patches and can occur anywhere on the body, though it’s most common on the hands, feet, arms, legs, and face. Eczema often follows a pattern of flare-ups and remissions.

Symptoms of eczema can include:

• Dry, sensitive skin
• Intense itching
• Red, inflamed skin
• Rough, leathery, or scaly patches
• Oozing or crusting
• Areas of swelling
• Dark colored patches
• Raw, sensitive areas from scratching

Military service can trigger or worsen eczema through various factors:

• Environmental conditions: Extreme temperatures, low humidity, dust, sand
• Chemical exposures: Cleaning agents, solvents, fuels, oils
• Equipment and uniforms: Friction from gear, synthetic materials, wool, frequent washing with harsh detergents
• Stress: High-stress environments can trigger or worsen eczema flare-ups
• Limited access to proper skin care: Especially during deployment or field exercises

Service Connection for Eczema

To establish service connection for eczema, you generally need:

1. Current diagnosis of eczema or evidence of current symptoms
2. Evidence of an in-service event that could have caused or aggravated your eczema
3. Medical nexus linking your current eczema to your military service

VA Disability Ratings for Eczema

Eczema is rated under Diagnostic Code 7806 based on the percentage of the body affected and the type of treatment required:

Rating	Criteria
60%	More than 40% of the entire body or more than 40% of exposed areas affected; or constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period
30%	20 to 40% of the entire body or 20 to 40% of exposed areas affected; or systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, during the past 12-month period
10%	At least 5%, but less than 20%, of the entire body, or at least 5%, but less than 20%, of exposed areas affected; or intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period
0%	Less than 5% of the entire body or less than 5% of exposed areas affected; and no more than topical therapy required during the past 12-month period

Evidence Needed for Eczema Claims

To support your eczema claim, gather the following evidence:

Medical Evidence

• Diagnosis of eczema or atopic dermatitis from a medical provider
• Treatment records showing medications or therapies prescribed
• Dermatology consultations or evaluations
• Photos of affected areas during flare-ups (if available)
• Documentation of the percentage of body affected
• Medical opinions linking your eczema to military service

Service Records

• Service treatment records showing diagnosis or treatment of skin conditions
• Documentation of exposure to chemicals, irritants, or allergens
• Records of environmental conditions during deployment
• Sick call visits for skin issues

Lay Evidence

• Personal statements describing when your eczema began and how it has affected you
• Statements from fellow service members who witnessed your skin condition
• Description of how eczema affects your daily activities and ability to work
• Timeline of treatments you’ve tried and their effectiveness
• Log of flare-ups, including frequency, duration, and severity

Tips for Successful Eczema Claims

• Document Flare-ups: Keep a detailed log of eczema flare-ups, including triggers, duration, and treatments used.
• Address Childhood History: If you had childhood eczema that resolved and then returned during or after service, emphasize how military service triggered the recurrence.
• Emphasize Systemic Treatments: If you’ve required oral medications or other systemic treatments, ensure these are prominently documented in your claim.
• Consider Occupational Impact: Explain how eczema affects your ability to work, especially if your job involves exposure to irritants or requires frequent hand washing.
• Address Sleep Disruption: If itching from eczema disrupts your sleep, document this as it can support a higher rating or additional conditions like sleep disorders.

Psoriasis

Overview of Psoriasis

Psoriasis is a chronic autoimmune condition that causes rapid buildup of skin cells, resulting in scaling on the skin’s surface. The inflammation and redness around the scales is fairly common. Typical psoriatic scales are whitish-silver and develop in thick, red patches. Sometimes, these patches will crack and bleed.

Symptoms of psoriasis can include:

• Red patches of skin covered with thick, silvery scales
• Small scaling spots (commonly seen in children)
• Dry, cracked skin that may bleed
• Itching, burning, or soreness
• Thickened, pitted, or ridged nails
• Swollen and stiff joints

Military service can trigger or worsen psoriasis through various factors:

• Stress: High-stress environments are a major trigger for psoriasis flare-ups
• Injuries: The Koebner phenomenon can cause psoriasis to develop at sites of skin injury
• Infections: Strep throat and other infections can trigger psoriasis
• Medications: Certain military-related medications can trigger or worsen psoriasis
• Weather extremes: Cold, dry weather or sunburn can trigger flare-ups

Service Connection for Psoriasis

To establish service connection for psoriasis, you generally need:

1. Current diagnosis of psoriasis or evidence of current symptoms
2. Evidence of an in-service event that could have caused or aggravated your psoriasis
3. Medical nexus linking your current psoriasis to your military service

VA Disability Ratings for Psoriasis

Psoriasis is rated under Diagnostic Code 7816 based on the percentage of the body affected and the type of treatment required:

Rating	Criteria
60%	More than 40% of the entire body or more than 40% of exposed areas affected; or constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period
30%	20 to 40% of the entire body or 20 to 40% of exposed areas affected; or systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, during the past 12-month period
10%	At least 5%, but less than 20%, of the entire body, or at least 5%, but less than 20%, of exposed areas affected; or intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period
0%	Less than 5% of the entire body or less than 5% of exposed areas affected; and no more than topical therapy required during the past 12-month period

Evidence Needed for Psoriasis Claims

To support your psoriasis claim, gather the following evidence:

Medical Evidence

• Diagnosis of psoriasis from a medical provider or dermatologist
• Treatment records showing medications or therapies prescribed
• Dermatology consultations or evaluations
• Photos of affected areas during flare-ups (if available)
• Documentation of the percentage of body affected
• Medical opinions linking your psoriasis to military service

Service Records

• Service treatment records showing diagnosis or treatment of skin conditions
• Documentation of stressful events or high-stress deployments
• Records of injuries that may have triggered psoriasis (Koebner phenomenon)
• Sick call visits for skin issues

Lay Evidence

• Personal statements describing when your psoriasis began and how it has affected you
• Statements from fellow service members who witnessed your skin condition
• Description of how psoriasis affects your daily activities and ability to work
• Timeline of treatments you’ve tried and their effectiveness
• Log of flare-ups, including frequency, duration, and severity

Tips for Successful Psoriasis Claims

• Emphasize Stress Connection: If your psoriasis flares up during times of stress, document this connection as it supports service connection for stress-related conditions.
• Document Percentage Affected: Ask your dermatologist to document what percentage of your body is affected by psoriasis, as this is crucial for rating purposes.
• Track Systemic Treatments: Keep detailed records of any systemic treatments, including duration and effectiveness.
• Address Joint Involvement: If you have joint pain or stiffness, get evaluated for psoriatic arthritis which may warrant a separate rating.
• Consider Occupational Impact: Explain how psoriasis affects your ability to work, especially if your job involves public interaction or physical demands.

Scars

Overview of Scars

Scars are fibrous tissue that replaces normal skin after an injury. Service members can develop scars from various causes during military service, including combat injuries, accidents, surgeries, burns, or other traumatic events. The VA recognizes that scars can have both functional and cosmetic impacts on veterans.

Types of scars include:

• Linear scars: Straight-line scars from surgical incisions or lacerations
• Wide scars: Scars that have spread beyond the original wound
• Superficial scars: Scars that affect only the surface of the skin
• Deep scars: Scars that extend into deeper tissue layers
• Unstable scars: Scars prone to breaking down or ulcerating
• Painful scars: Scars that cause ongoing pain or discomfort
• Keloid scars: Thick, raised scars that extend beyond the original injury
• Contracture scars: Scars that restrict movement by pulling on surrounding tissue

Service Connection for Scars

To establish service connection for scars, you generally need:

1. Current evidence of scarring
2. Evidence of an in-service injury that caused the scarring
3. Medical nexus linking your current scars to the in-service injury

Scars are often easy to establish service connection for because they are visible evidence of an injury and typically don’t heal completely over time.

VA Disability Ratings for Scars

Scars are rated under different diagnostic codes depending on their location and characteristics:

Head, Face, or Neck Scars (Diagnostic Code 7800)

Rating	Criteria
80%	Disfiguring or painful scars covering the majority of the face and head
50%	Disfiguring or painful scars covering one-half or more of the face and head, but not the majority
30%	Disfiguring or painful scars covering less than one-half of the face and head, or disfiguring scars of the neck
10%	Superficial scars not subject to ulceration covering less than half of the face and head, or other scars of the head, face, or neck not covered above

Other Body Areas (Diagnostic Codes 7801-7805)

Rating	Criteria
40%	Five or more unstable or painful scars
30%	Three or four unstable or painful scars
20%	One or two unstable or painful scars
10%	Superficial scars that are not painful or unstable

Evidence Needed for Scar Claims

To support your scar claim, gather the following evidence:

Medical Evidence

• Medical examination documenting the location, size, and characteristics of scars
• Photos of scars (both recent and historical if available)
• Treatment records for the original injury and any scar treatment
• Documentation of any functional limitations caused by scars
• Medical opinions on the stability and pain level of scars

Service Records

• Service treatment records documenting the original injury
• Medical records from the time of injury
• Documentation of surgeries or other treatments
• Line of duty determinations

Lay Evidence

• Personal statements describing how scars were acquired
• Statements from fellow service members who witnessed the injury
• Description of how scars affect your daily activities and self-esteem
• Timeline of scar healing and any complications

Tips for Successful Scar Claims

• Document All Characteristics: Ensure your medical examination documents the size, depth, texture, color, and any functional limitations of your scars.
• Take Quality Photos: Good photographs showing the scars clearly can be valuable evidence, especially for facial scars.
• Address Pain and Instability: If your scars are painful or prone to breaking down, make sure this is well-documented as it can significantly increase your rating.
• Consider Functional Impact: If scars limit range of motion or cause other functional problems, these may warrant separate ratings under musculoskeletal codes.
• Don’t Forget Psychological Impact: Disfiguring scars can contribute to depression, anxiety, or PTSD, which may warrant separate mental health ratings.

Other Skin Conditions

Acne

Acne can be service-connected if it was caused or aggravated by military service conditions such as stress, equipment use, or environmental factors. Acne is rated under Diagnostic Code 7828:

• 30%: Deep scarring or persistent activity with deep inflamed nodules
• 10%: Superficial scarring or intermittent activity with inflamed papules
• 0%: Superficial scars, non-inflamed lesions, or completely resolved acne

Chloracne

Chloracne is a severe form of acne caused by exposure to certain chemicals, particularly relevant for veterans exposed to Agent Orange or other herbicides. It is rated under Diagnostic Code 7829 using the same criteria as regular acne. Vietnam veterans and others with documented herbicide exposure may be eligible for presumptive service connection.

Vitiligo

Vitiligo is a condition that causes loss of skin pigmentation. It is rated under Diagnostic Code 7823 based on the percentage of exposed areas affected:

• 20%: More than 20% of exposed areas affected
• 10%: 5 to 20% of exposed areas affected
• 0%: Less than 5% of exposed areas affected

If you have a skin condition not specifically covered in this guide, consult with a Veterans Service Officer (VSO) or accredited representative for assistance with your claim.