Tinea Barbae Treatment & Management

Updated: Apr 25, 2019
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

Since hairs are infected in tinea barbae, the therapeutic procedure is similar to that of tinea capitis. Shaving or hair depilation is recommended with warm compresses to remove crusts and debris. Topical formulations with antifungal compounds (eg, shampoo, lotion, cream) can be applied, but tinea barbae requires oral antifungal therapy. Details of therapeutic modalities for tinea barbae are found in Medication.

Griseofulvin remains in wide use. Newer antifungals, especially terbinafine, [29] also can be used. At the author's institution, experience with terbinafine in tinea barbae has been excellent, with all cures achieved within 4 weeks of initiating therapy. Itraconazole can be recommended as one-pulse therapy at a dosage of 400 mg/d divided into 2 doses for 1 week. Some prefer to use a second pulse after 3 weeks. Itraconazole also may be used continuously for 4 weeks at a dose of 200 mg/d. Fluconazole treatment is not well documented, but data from tinea capitis studies indicate that a dose of 150 mg once per week for up to 6 weeks also may be effective. All of these new antifungal drugs generally are well tolerated.

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Prevention

Eliminating the source of tinea barbae infection is of great importance. If farm workers become infected, examine all animals for the presence of fungal skin lesions. Treatment of other fungal skin infections, such as tinea pedis or onychomycosis, may prevent the infection's spread by autoinoculation.

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