Tinea barbae or beard scabies is a fungal infection in the beard area. Tinea barbae is also known as ‘mycotic sycosis barbae’ and ‘dermatomycosis barbae’. In fact, the name ‘bearded scabies’ is incorrect, as the inflammation is not caused by the scabies mite. Beard scabies is caused by both zoophilic and anthropophilic dermatophytes or fungi. Zoophilic dermatophytes are primarily pathogens of certain animal species and anthropophilic dermatophytes are natural pathogens of humans. In beard scabies, the hair follicles or the tissue surrounding the hair follicles in the beard area are affected. Treatment of beard scabies or tinea barbae is often with an oral antifungal agent, such as itraconazole for a period of 4 to 6 weeks. The prognosis is good; scarring is rarely seen.
- Tinea barbae is a fungal infection of the beard area
- Synonyms
- Cause of beard scabies
- Mold
- Immune disorders
- Risk factors
- Symptoms of beard scabies
- Examination and diagnosis
- Interview
- KOH preparation
- Differential diagnosis
- Treatment of tinea barbae
- Prognosis
- Prevention of beard fungus
Tinea barbae or beard scabies / Source: Public domain, Wikimedia Commons (PD)
Tinea barbae is a fungal infection of the beard area
Tinea barbae, also known as ‘mycotic sycosis barbae’, ‘dermatomycosis barbae’ or simply ‘beard scabies’, refers to a fairly rare fungal infection that is limited to the beard area, i.e. the part of the face where beard growth occurs in men . Beard scabies occurs almost exclusively in adolescent and adult males. Women and children cannot get beard scabies, but they can contract a mycosis or fungal infection of the face (tinea faciei). The clinical presentation of beard scabies includes pinkish-red, scaly patches of skin with loose hair stumps and pustules with sometimes stinging itching.
Synonyms
Tinea barbae is also known as:
- beard fungus
- beard scabies
- dermatomycosis barbae
- sycosis trichophytica barbae
Cause of beard scabies
Bearded scabies or tinea barbae is caused by both zoophilic and anthropophilic dermatophytes or fungi.
Mold
Beard scabies is caused by dermatophytes or fungi that can cause a skin infection. The main causative agents of tinea barbae or beard scabies are the Trichophyton species, including T. rubrum, a fungus known as the common cause of athlete’s foot and the so-called nail fungus. The risk of infection is increased by warm and humid conditions. In the past, the fungus could also be transmitted via improperly cleaned razors at the hairdresser’s. It was therefore also called barber’s itch . Nowadays it is mainly found among livestock farmers. This concerns zoophilic dermatophytes such as T. mentagrophytes and dermatophytes that can occur in humans and animals, such as T. verrucosum. Not only farm animals, pets can also carry fungi. Anthropophilic dermatophytes, which are natural pathogens of humans such as T. verrucosum and T. violaceum, generally cause a more superficial and milder inflammation than the zoophilic variants, which are primarily pathogens of certain animal species.
Immune disorders
Bearded scabies or tinea barbae is sometimes also seen in immune disorders such as HIV (Human Immunodeficiency Virus), Severe Combined Immune Deficiency Syndrome (SCID, also called ‘Boy in the Bubble Syndrome’), bone marrow depression or aplastic anemia and immunosuppressants.
Risk factors
People of all ethnic backgrounds can develop tinea barbae. However, it is almost exclusively seen in older teenagers and adult men. Tinea barbae is more common in warmer, more humid climates. It is mainly farmers and livestock keepers who get this fungal infection. People with a weakened immune system, such as patients with HIV, severe combined immunodeficiency (SCID) or bone marrow disease, are more likely to become infected. The use of immunosuppressants (medicines that suppress the immune system) also increases the risk of getting the infection. Hirsutism is also a risk factor. Hirsutism refers to excessive hair growth in a woman on the face, chest, back and lower abdomen.
Symptoms of beard scabies
Bearded scabies or tinea barbae is characterized by circumscribed, round, red, inflamed scaly skin changes, with pustules, crusts and thickening of the skin. Loose hair stubs are visible in the affected areas. These broken hairs and bald spots are sometimes permanent. In somewhat severe cases, the spots coalesce to form abscessing infiltrates. The skin changes may be accompanied by a stinging itch.
Examination and diagnosis
Interview
The GP asks questions about your complaints, lifestyle and professional activity. This information may already provide clues about the presence of the fungal infection. At the same time, the GP will examine the areas.
KOH preparation
The diagnosis of tinea barbae is made on a KOH (potassium hydroxide) preparation of a number of pulled out hairs. With KOH you can directly diagnose fungal infections of the skin. In potassium hydroxide, cell walls and horny material are dissolved, but hyphae are not. A positive KOH indicates a fungal infection. Some hairs and the contents of a pustule can be cultured so that it can be determined which fungus is the culprit and the therapy can be adjusted accordingly.
Acne vulgaris on the forehead / Source: Roshu Bangal, Wikimedia Commons (CC BY-SA-4.0)
Differential diagnosis
Bearded scabies or tinea barbae should not be confused with:
- acne vulgaris (pimples)
- allergic contact dermatitis
- candidiasis (fungal infection caused by the yeast Candida)
- eczema herpeticum
- folliculitis
- folliculitis barbae (a chronic skin condition caused by shaving)
- skin complications of actinomycosis (fungal infection caused by bacterium Actinomyces)
- irritating contact dermatitis
- carbuncle (boil with multiple pus heads)
- perioral dermatitis or clown dermatitis
- pseudofolliculitis barbae
- rosacea
- boil or furuncle
Treatment of tinea barbae
The therapy of beard scabies or tinea barbae should be systemic and long-term. The treatment must be systemic, as locally applied ointment or cream often does not penetrate sufficiently deeply to be effective. Itraconazole and terbinafine are antifungal agents that can be used both locally and in tablet form.
Prognosis
The prognosis of tinea barbae is usually good. After the infection has healed, no scars are usually left behind. The disease rarely comes back, as you usually become immune to the fungus after experiencing an initial infection. Sometimes permanent hair loss is caused by the fungal infection.
Always use a clean towel / Source: Mama_mia/Shutterstock.com
Prevention of beard fungus
Although rare today, tinea barbae may still be endemic in certain parts of the world. A few simple measures can help prevent beard fungus:
- Always use a clean razor to shave your beard area. Never share razors and make sure barbers use new clean blades when shaving the area.
- Be careful about sharing personal items such as towels with a person who has tinea barbae. The fungi can be spread, especially after shaving, when small cuts in the skin provide a portal of entry for fungi.
- Remove facial hair if you suffer from tinea barbae. Remember that the hair should only be removed with a clean razor. Hair removal with other methods less often leads to tinea barbae.
- Try not to touch your face after coming into contact with animals without first washing your hands thoroughly. People prone to tinea barbae should be more careful in this regard.
- Ensure that fungal infections elsewhere in the body, such as the scalp (head thrush), groin (groin thrush) or feet (athlete’s foot), are properly treated and eradicated to prevent cross-infection between these areas and the beard area.
- Use an antimicrobial application to disinfect the area after shaving. Also make sure that the skin remains well hydrated.
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