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,^[32]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.

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.

Medication

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Media Gallery

Inflammatory tinea barbae resulting from Trichophyton mentagrophytesvar granulosuminfection.
Wax model of kerionlike tinea barbae. Courtesy of the Museum of the Department of Dermatology, University of Medicine, Wroclaw, Poland.

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Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Coauthor(s)

Jacek C Szepietowski, MD, PhD Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Received consulting fee from Orfagen for consulting; Received consulting fee from Maruho for consulting; Received consulting fee from Astellas for consulting; Received consulting fee from Abbott for consulting; Received consulting fee from Leo Pharma for consulting; Received consulting fee from Biogenoma for consulting; Received honoraria from Janssen for speaking and teaching; Received honoraria from Medac for speaking and teaching; Received consulting fee from Dignity Sciences for consulting; .

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Franklin Flowers, MD Professor Emeritus, Department of Dermatology, Affiliate Associate Professor of Pathology, University of Florida College of Medicine

Franklin Flowers, MD is a member of the following medical societies: American College of Mohs Surgery

Disclosure: Nothing to disclose.

Tinea Barbae Treatment & Management

Medical Care

Prevention

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