Skin : What to Expect at the Flight Physical
Item 40: FAA Policies on the Airman Medical Exam
Apr 2014
Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide pages 93-97, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).
I. Code of Federal Regulations
Legal References: 14 CFR 67.113(b)(c), 67.213(b)(c), 67.313(b)(c),
Legal Extract (Applies to All Classes):
-
(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds -
- Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
- May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
- (c) No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds -
- Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
- May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
II. Examination Techniques
A careful examination of the skin may reveal underlying systemic disorders of clinical importance. For example, thyroid disease may produce changes in the skin and fingernails. Cushing's disease may produce abdominal striae, and abnormal pigmentation of the skin occurs with Addison's disease.
Needle marks that suggest drug abuse should be noted and body marks and scars should be described and correlated with known history. Further history should be obtained as needed to explain findings.
The use of isotretinoin (Accutane) can be associated with vision and psychiatric side effects of aeromedical concern - specifically decreased night vision/night blindness and depression. These side-effects can occur even after the cessation of isotretinoin. See Aeromedical Decision Considerations.
III. Aerospace Medical Disposition
The following tables list the most common skin conditions of aeromedical significance, and course of action that should be taken by the examiner as defined by the protocol and disposition in the tables. Medical certificates must not be issued to an applicant with dermatologic conditions that require deferral, or for any skin condition not listed in the tables that may result in sudden or subtle incapacitation without consulting the AMCD or the RFS. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.
|
Cutaneous (Conditions Affecting Your Skin) | |||
|---|---|---|---|
|
DERMATOLOGIC DISEASE/CONDITION |
CLASS |
EVALUATION DATA |
DISPOSITION |
|
Dermatomyositis; |
All |
Submit all pertinent medical information and current status report |
Requires FAA Decision |
|
All |
Submit all pertinent medical information and current status report. See HIV Protocol |
Requires FAA Decision | |
|
Use of isotretinoin (Accutane) |
All |
For applicants using isotretinoin, there is a mandatory 2-week waiting period after starting isotretinoin prior to consideration. This medication can be associated with vision and psychiatric side effects of aeromedical concern - specifically decreased night vision/night blindness and depression. These side-effects can occur even after cessation of isotretinoin. A report must be provided with detailed, specific comment on presence or absence of psychiatric and vision side-effects. The AME must document these findings in Item 60 (Comments on History and Findings.) |
Any history of psychiatric side-effect requires FAA Decision. If there are no vision, psychiatric, or other aeromedically unacceptable side- effects |
*Note:
- Use of isotretinoin must be permanently discontinued for at least 2 weeks prior to consideration date (confirmed by the prescribing physician)
- An eye evaluation in accordance with specifications in 8500-7
- Airman must provide a statement of discontinuation
- Confirming the absence of any visual disturbances and psychiatric symptoms, and
- Acknowledging requirement to notify the FAA and obtain clearance prior to performing any aviation safety-related duties if use of isotretinoin is resumed
|
Malignant Melanoma (A type of pigmented skin cancer) | |||
|---|---|---|---|
|
DERMATOLOGIC DISEASE/CONDITION |
CLASS |
EVALUATION DATA |
DISPOSITION |
|
Melanoma Level >.75 mm with/ without any metastasis |
All |
Submit all pertinent medical records, operative/ pathology reports, and current oncological status report, and current MRI of the brain |
Initial Special Issuance |
|
Melanoma of Unknown Primary Origin |
All |
Submit all pertinent medical records, operative/ pathology reports, and current oncological status report, current MRI of the brain; PET scan if no primary |
Requires FAA Decision |
This page discussed the Skin section of the Fight Physical Examination required of pilots.
Reminder: use FlightPhysical.com to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now