Beard lichen, also called tinea barbae or beard mycosis, is a male skin disease caused by fungi. It is manifested by large reddish patches that can become pustules as the disease progresses and occur mainly on the facial hair.
What is a beard lichen?
The beard lichen, whose medical term is Tinea barbae, belongs to the so-called dermatophytoses. This includes skin diseases caused by one of the 38 species of deratophytes, a type of filamentous fungus. One of the most common forms of this disease is beard lichen, which occurs only in men. In addition, there are similar skin rashes caused by these fungi that can affect all mammals, such as head lichen or facial lichen. Beard lichen usually affects older men, boys and young men are rarely affected. However, the presence and length of the beard do not play a role in disease development and progression. Typical symptoms of beard lichen are round, scaly, reddish patches that very quickly attach to the hair follicles at the hairline, where they form so-called furuncles or pustules. Sparkles are deep, very painful inflammations of hair follicles and the tissue surrounding them, which fill with pus and leave scars when they heal.
Causes
Beard lichen is caused by infections with specific filamentous fungi called deratophytes. The exact causative agents are called Trichophyton mentagrophytes, which is found in rodents, or Trichophyton verrucosum, whose primary word is cattle. Less frequently, fungal sprouts or bacterial infections, these mostly with staphylococci, can be identified as the cause. The transmission of the pathogens and thus the infection occurs through contact with the mentioned animal species. The problem is that the fungal spores are not only highly contagious, but also remain infectious for more than four years and are resistant to any environmental influences. In order to infect humans, the fungi must overcome the natural skin flora and their specific immune system in order to penetrate the nails, horny layer or hair. The following processes are very complex, but lead to the symptoms described.
Symptoms, complaints and signs
A beard lichen is associated with a characteristic appearance. Typically, the facial skin is red and painful or itchy. An initial sign is circular red patches in the region of the beard, where weeping scales may form. In the later stages, the disease resembles a severe form of acne: the inflamed foci fill with pus and cause intense itching. If the pustules do not empty themselves, large boils form. Accompanying fever, chills and circulatory problems may occur. A beard lichen also manifests itself by an unpleasant odor. Especially with the progression of the disease, there is a slightly foul odor in the area of the rash. Furthermore, abscesses, scarring of the skin and bleeding may occur. In a severe course, the beard hair falls out in the affected area, resulting in the characteristic light patches. If the beard lichen is based on a serious infectious disease, the inflammation can spread to other parts of the body. Then, in the course of the disease, redness and inflammation occur on the neck, nape of the neck and finally on the upper body and arms. If not treated, serious cardiovascular problems and other complications can develop.
Diagnosis and course
If a man notices noticeable spots on himself, he should get an appointment with a dermatologist. It is important to describe the rash as precisely as possible when making the appointment in order to get an appointment as soon as possible. For the dermatologist, the shape, appearance and location of the rash are already a typical indication of beard lichen and he can initiate a general treatment on suspicion. However, the exact diagnosis and thus the cause-related treatment may only be made when the causative agent has been perfectly identified after a smear test and laboratory analysis of the skin. Differentially, lupus erythematosus, an autoimmune disease, other fungal skin diseases, psoriasis and eczema must be excluded. If the reddish spots are not treated or are inadequately treated, they develop into pus-filled boils and, if treatment continues to be lacking, into large abscesses.These may be accompanied by lymph node swelling and fever. Chronicity of beard lichen is also a possible complication of the untreated course.
Complications
Beard itch, which is usually caused by the filamentous fungus Trichophyton mentagrophytes or Trichophyton verrucosum, can lead to significant complications if left untreated. After the initial stage of fungal infection, pustules typically form on the facial skin in areas with beard growth and fill with pus. If the pustules do not rupture and are not mechanically opened, deep, painful boils develop. Multiple boils may coalesce into carbuncles and ultimately cause abscesses, which may also be accompanied by fever. If basic hygiene is not observed, boils, carbuncles and abscesses provide the gateway for infections with other germs. Therefore, as a further complication, a kind of superinfection may develop, which can be caused by a wide variety of germs. If the disease is not treated further, there is a risk that the inflammations will become chronic and difficult to treat. If no superinfection develops, the beard lichen usually heals on its own after several months. However, healed boils, carbuncles and abscesses leave scars that can be a cosmetic problem. If the causative agent of the incipient beard infection can be diagnosed correctly, broad-spectrum and, in some cases, pathogen-specific antifungal agents are available for external use. The complications described above remain largely absent with a professional and targeted treatment. The beard length itself has no influence on the manifestations of beard lichen.
When should you go to the doctor?
When the appearance of beard tartar, a doctor should be consulted in any case. The symptoms can also spread to other regions of the body and lead to various complaints there as well. In this regard, a doctor should be consulted in case of permanent redness of the skin or the appearance of pustules in the region of the beard. Also in case of swelling of the lymph nodes or high fever, the complaints may indicate beard lichen, so that an examination by a doctor is advisable. Furthermore, it is not uncommon for other skin diseases or psoriasis to occur. As a rule, a dermatologist can be consulted directly in the case of beard lichen. In acute emergencies or in case of severe itching or pain, the hospital can also be visited. As a rule, the treatment is carried out with the help of medication and does not lead to further complications. The discomfort is relatively well contained. Above all, direct shaving of the beard can quickly remove and eliminate the beard tartar. The life expectancy of the affected person is not limited by this complaint.
Treatment and therapy
Although the beard tartar often heals itself after several months, but since this does not happen without abscess formation, pain and large scars are associated with this. For this reason, those affected are advised to seek specialist treatment. In addition, chronicity should be prevented. An important first step in treatment is thorough shaving of the affected area. Further therapy depends on the pathogens identified and the severity of the disease. Beard fungal lichen is treated externally with antifungals or disinfectant creams; taking medication is rare and only necessary in very severe cases of disease.
Outlook and prognosis
Beard tartar allows different prognoses, depending on the affected person, his hygiene and the type of treatment. For example, a beard lichen detected early and not yet in the stage of abscess and boil formation can be treated well with medication. Complete healing is to be expected and no secondary damage is to be expected if detected early. If left untreated, tinea barbae will also heal. However, for the affected person this also means that pustules form first, followed later by boils and abscesses. Due to the enormous damage to the skin, this can allow secondary infections with other pathogens, making a dangerous superinfection possible. The series of subsequent complications is long and includes, among other things, permanent disfigurement of the face due to tissue damage. In addition, hair roots – and thus beard growth – are often lost in affected areas if the fungus is not treated with medication.In addition, progression of fungal infections can lead to swollen lymph nodes and fever. The treatment of a beard infection is the more successful, the more conscientiously it is carried out. It is recommended to shave off existing beard for better accessibility of the fungus and for better skin regeneration. The better the face is cared for during the treatment, the better the skin can regenerate. A one-time infestation of beard mycosis does not lead to resistance in the affected person. The skin type, various diseases and life circumstances are significantly involved in the likelihood of re-infestation.
Prevention
Antimyotics are a very effective medication against fungi, provided they are used correctly and targeted to the pathogen. They are applied as a cream or ointment. There are no safe preventive measures due to the longevity of the pathogens unless contact with diseased animals can be ruled out. However, ill persons should observe strict hygiene measures to avoid recurrent infection. Used razors should be disinfected after each use, and towels and compartment rags must be hot washed or ideally boiled regularly.
Aftercare
Follow-up treatments or follow-up examinations are not necessary for a beard tartar that has been completely cured or has healed on its own. If beard lichen has healed on its own, it can be assumed that there is no longer any recurrence. Even in the case of tinea barbae treated with anitmycotics, it is assumed that a treatment lasting several weeks will eliminate even the last traces of the fungus. The only exception is particularly serious fungal infestations, in which it cannot be ruled out that the spores also reside outside the neck and beard region. Here, even if the symptoms have completely subsided, the use of systemic antifungal drugs is usually recommended. This is usually continued for several weeks and should be combined with blood tests due to the stress on the liver. The scars that may develop, which are caused by the fungus, do not require follow-up care. They are merely a cosmetic problem. In addition, people who have intensive contact with fur-bearing animals (i.e. farmers, for example) should have their animals examined for fungal infestation. This is because hairy animals in particular often transmit the fungus. Accordingly, part of follow-up care (and also prophylaxis against further infection) is to check the herd and treat it if necessary.
What you can do yourself
Beard lichen can be treated independently in consultation with a doctor. Usually it is sufficient to apply fungicidal ointments, lotions and creams to the affected area several times a day. Until the inflammation has subsided, wet shaving should also be avoided. It is advisable to use dry razors and generally ensure adequate hygiene. To prevent a recurrence of inflammation, dietary and lifestyle habits should also be questioned and, if necessary, changed. Before this, however, the cause of the beard tartar must be determined. In most cases, the cause is a weakened immune system, which can be treated by a healthy diet and sufficient physical exercise, as well as by intestinal cleansing or autologous blood therapy. Medicinal herbs such as taiga root also have a positive effect on the body’s immune system. Calendula ointment or tincture from the pharmacy helps against the actual inflammation. Alternatively, teas or compresses made from horsetail can be used. From homeopathy, for example, the Schüssler salts No. 1 “Calcum fluoratum”, No. 11 “Silicea” and No. 12 “Calcium sulfuricum” are suitable. Inexpensive household alternatives include vinegar and tea tree oil.
