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SynopsisTinea barbae is also known as barber's itch. It is a localized inflammatory reaction to a dermatophyte occurring in the beard area of the face and neck. Species of Trichophyton are the most common causative organisms.
The lesions may be deep, kerion-like plaques or superficial patches resembling tinea corporis. The deeper, more inflammatory variants are due to infection with zoophilic species of dermatophyte, such as Trichophyton verrucosum or Microsporum canis acquired from animals such as cattle, horses, dogs, and cats. The more superficial forms are caused by anthropophilic species like Trichophyton rubrum. Involved hairs are often loose and easily removed with tweezers. Regional lymphadenopathy can occur if the infection has been long-standing or is superinfected.
Tinea barbae is more common in warm and humid climates. It has decreased in incidence since the advent of disposable razors. Permanent scarring and alopecia are possible sequelae.
B35.0 – Tinea barbae and tinea capitis
399329002 – Tinea barbae
Differential Diagnosis & Pitfalls
Patient Information for Tinea barbae
OverviewTinea infections are commonly called ringworm because some may form a ring-like pattern on affected areas of the body. Beard ringworm (tinea barbae), also known as tinea sycosis or barber's itch, is a fungal infection of the skin, hair, and hair follicles of the beard and mustache area. Beard ringworm may be passed to other people by direct contact with infected people or animals, with contaminated objects, or from the soil.
Although beard ringworm is most common in men, it may also affect women who have dark, coarse hair on their faces and necks.
Who’s At RiskBeard ringworm may occur in people of all races. However, it is seen almost exclusively in older teens and adult males.
Beard ringworm is more commonly seen in warmer, more humid climates. It is most frequently passed to humans from animals, so agricultural workers are the most commonly infected people with beard ringworm.
Signs & SymptomsThe most common locations for beard ringworm infection include the following:
- Upper lip
Beard ringworm is usually itchy. Deeper forms of beard ringworm may be accompanied by fever and swollen lymph glands.
Self-Care GuidelinesIt is extremely difficult to totally get rid of beard ringworm with only topical medications; oral antifungal medications are usually required. However, if the infection has just started, you might try one of the following over-the-counter antifungal creams or lotions:
Stop shaving the affected area until you start treatment. If you must shave, use a new disposable razor each time you shave.
Since people often have tinea infections on more than one body part, examine yourself for other ringworm infections, such as in the groin (tinea cruris), on the feet (tinea pedis, athlete's foot), and anywhere else on the body (tinea corporis).
Have any household pets or farm animals evaluated by a veterinarian to make sure they do not have a fungal (ie, dermatophyte) infection. If the veterinarian discovers an infection, be sure to have the animal treated.
When to Seek Medical CareIf the lesions do not improve after 1 or 2 weeks of applying over-the-counter antifungal creams, see your doctor for an evaluation. If the affected areas are deep and tender or if you have a fever or swollen lymph glands, see your doctor as soon as possible.
TreatmentsTo confirm the diagnosis of beard ringworm, your physician might scrape some surface skin material (scales) or pluck an affected hair and place it onto a glass slide for examination under a microscope. This procedure, called a KOH (potassium hydroxide) preparation, allows the doctor to look for tell-tale signs of fungal infection.
If you have many pus-filled lesions or if deeper lumps are present, your physician may wish to perform a procedure to grow out the fungus (fungal culture) in order to discover the particular organism that may be causing the infection. The procedure involves:
- Penetrating the pus-filled lesion with a needle, scalpel, or lancet.
- Rubbing a sterile cotton-tipped applicator across the skin to collect the pus.
- Sending the specimen away to a laboratory.
Since beard ringworm usually requires oral antifungal pills in order to get rid of the infection completely, your physician will likely recommend one of the following oral medications:
Bolognia, Jean L., ed. Dermatology, pp.1174-1185. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.1861, 1996-1997. New York: McGraw-Hill, 2003.