Ringworm of the bearded area or Tinea Barbae is commonly referred to as ‘Barber’s Itch’. It is caused by skin fungus and not by a worm, as is the common misconception owing to its name. Compared to other forms of dermatophytic skin infections, Tinea Barbae is relatively uncommon and is limited to the bearded areas of the face in men.
What causes ringworm of the bearded area? How is it diagnosed?
Two kinds of fungi, namely zoophilic and antropophilic dermatophytes, are responsible for Tinea Barbae. These pathogens are found all around the world but are more common in tropical countries. This infection mainly occurs in adult men and teenage boys.
The problem with diagnosing ringworm of the beard is that its symptoms are similar to those of many other skin conditions (including bacterial folliculitis, atopic, seborrheic or contact dermatitis etc) as a result of which it is often misdiagnosed.
Typical signs and symptoms of Tinea Barbae include:
- Severe pustular eruptions on chin, cheeks and bearded parts of the neck
- Deep inflammatory or non inflammatory plaques
- Hair appears loose or broken, and can be pulled out easily
- Patches exudates pus and appear crusty or scaly and may be itchy
- Fever and malaise may be seen in some patients
Antropophilic dermatophytes cause non inflammatory patches under the beard that appear flat with a raised border. The hair follicles in the affected area may be plugged and can gradually increase in size, if left untreated. Hair loss is a common symptom of tinea barbae.
In new born children as well as immune-compromised patients, other fungi like yeasts and mold can also form similar lesions. Hence, diagnosis of tinea barbae must be based on mycological investigation. The dermatologist might take a sample of the skin lesion and examine it under the microscope in potassium hydroxide solution or perform a skin culture.
Treating Tinea Barbae
Treatment of Tinea Barbae consists of topical application of anti fungal agents. These include creams, lotions and ointments. Application of these should be continued even after symptoms have disappeared so as to prevent recurrence. In case the infection is extreme or widespread, doctors might prescribe systemic anti fugal medicines. In general, patients have seen good results with:
- Topical application of Terbinafine 250mg applied once a day for a period of 4 to 6 weeks
- Griseofulvin in the dosage of 20mg/kg per day for 8 weeks or
- 100mg/kg of Itraconazole for not less than 4 to 6 weeks
Patients suffering from ringworm of the bearded area must follow certain safety precautions in order to prevent recurrence of infection:
- Get treatment for pets having skin infections and try and avoid contact with them as far as possible.
- Trim hair and beard neatly preferably using an electric shaver rather than a razor or blade.
- Keep the skin clean and dry at all times. If the skin is inflamed, apply a warm compress of water and salt (1tsp salt to every pint of water).
- Carefully wash the clothes, towels, pillow covers and other bed linen etc in hot water.
- Avoid sharing towels, razors or combs with friends and family members.
- Avoid chronic moisture, chaffing and crowded conditions as these encourage fungal growth on skin.
There is no special diet or restriction of activities when suffering from Tinea barbae. However, it is important to seek prompt medical help if the lesions become painful, redder or start oozing pus. Likewise, notify your doctor immediately if the condition does not improve within 3-4 weeks of starting treatment or if new symptoms arise or if you have an allergic reaction to the drugs used for treating ringworm of the bearded area.