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Tinea barbae, or beard ringworm, is a fungal infection that affects the bearded areas of the neck and face, caused by keratinophilic dermatophytes. Treatment involves antifungal drugs, and shaving or waxing is recommended. The disease is almost exclusive to men and is common in hot and humid countries. If left untreated, scarring and permanent baldness can occur.
Tinea barbae is a fungal infection that occurs in the bearded areas of the neck and face, particularly affecting the hair follicles. This infection, also called beard ringworm, mostly affects adults and adolescent males. It is also known as barber’s itch because in the past, the unsanitary razors used by barbers often served as a mode of transmission for the infection. Tinea barbae appears as inflammatory plaques or noninflammatory patches that resemble skin conditions such as tinea corporis or folliculitis. Treatment involves the topical application or oral intake of antifungal drugs.
This fungal infection is caused by dermatophytes, which are keratinophilic or keratin-loving fungi. Examples of keratinophilic dermatophytes include Trichophyton rubrum, Trichophyton violaceum, Trichophyton mentagrophytes and Trichophyton verrucosum. Members of the genus Trichophyton are the most common organisms isolated, thus tinea barbae is also called trichophytosis barbae. To invade the skin and hair, these dermatophytes release enzymes such as keratinases, which break down keratin. Once these organisms have invaded the hair and hair follicles, the body reacts by inducing the inflammatory cascade.
Anthropophilic dermatophytes, which undergo human-to-human transmission, cause the superficial non-inflammatory form of tinea barbae. This form resembles tinea corporis, or ringworm of the body, and can appear as reddish patches with blisters and crusts. The most profoundly inflammatory form of this skin condition, caused by zoophilic dermatophytes, is called a kerion. Typically, it looks like a reddish lump with pustules that eventually lead to pus-filled masses that drain and crust over. Associated symptoms including swollen lymph nodes in the neck, body aches and fever often occur with kerion.
The incidence of tinea barbae has decreased due to sanitation. However, it is still common in hot and humid countries. Additionally, rural dwellers and agricultural workers are prone to this infection because dermatophytes are commonly acquired through animal-to-human transmission. The bearded areas of the neck and face are involved, so this disease is almost exclusive to men. When similar areas are affected in women and children, the disease is called tinea faciei.
Shaving or waxing is recommended because hair is affected by tinea barbae. Applying a warm compress helps remove scabs and debris. Although antifungals can be applied topically, the best modality of medical treatment is the oral intake of these drugs. Examples of antifungals used for tinea barbae are griseofulvin, terbinafine, itraconazole and fluconazole. If tinea barbae is not treated, scarring and permanent baldness can occur.
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