Beard lichen (Tinea barbae): Information & beard lichen specialists

Beard lichen, medically known as tinea barbae, is a fungal infection of the hairy facial skin in men. It manifests itself with sometimes large, nodular and inflammatory swollen skin changes in the beard area. The fungus also causes itching and can lead to pain. Men from rural areas are particularly affected by beard lichen, as the pathogens are often transmitted to humans from livestock. Beard lichen often heals on its own - but if you don't want to be left with scars, you should visit a dermatologist first.

You can find further information and selected beard lichen specialists here.

Definition: What is beard lichen?

Beard lichen, medically known as tinea barbae, is a fungal infection of the skin in the area of the beard hair. It is a dermatophytosis, i.e. a fungal disease caused by dermatophytes.

Dermatophytes are a form of filamentous fungi. They only infect the skin of humans and animals. This makes them "classic" pathogens of skin fungus. Dermatophytes are also referred to by the generic term tinea. In addition to tinea barbae, there are also, for example

• Tinea pedis(athlete's foot),
• Tinea ungium(nail fungus)
• Tinea corporis(body fungus) or
• Tinea capitis(head fungus).

Causative pathogens of beard lichen

Diseases caused by fungal infections are generally referred to as mycoses. They often affect the lungs or the mucous membranes of the gastrointestinal or urogenital tract.

In the case of dermatophytes, they only affect the skin. Dermatophytes feed on keratin, the main component of the cornea. Dermatophytes therefore only occur

• in the skin and its appendages,
• in hair follicles and
• in fingernails and toenails.

Dermatophytes multiply particularly well in warm, moist environments. Therefore, frequent transmission sites are moist, warm places such as

• saunas,
• public showers,
• swimming pools,
• sports mats or
• gyms.

The fungal pathogen gets onto the skin through direct contact.

Direct transmission from person to person is also common. Possible opportunities are, for example, wrestling matches or during sexual intercourse.

Animals can also be affected by skin fungi. Some fungal pathogens can affect both animals and humans. These pathogens are called zoophilic species. Therefore, transmission from animal to human is also possible.

Zoophilic fungal pathogens usually cause deeper and more persistent infections (tinea profunda) than purely geophilic (from the soil) or antropophilic (dermatophytes that only live in humans) dermatophytes.

This also applies to the pathogens of Tinea barbae. Beard lichen occurs mainly in rural areas where those affected have close contact with cattle or other infected animals. Simply touching the animal with the hand and then scratching the chin with the hand can be sufficient.

Handling livestock is a common cause of beard lichen infection © littlewolf1989 | AdobeStock

If the affected person also suffers from a weakened immune system, the risk of infection increases. Weak immune systems are particularly common in people with

• diabetes,
• circulatory disorders,
• an illness that requires the use of immunosuppressive medication or
• an immunodeficiency disease

are affected.

The dermatophytes that trigger the disease are mainly

• Trichophyton mentagrophytes (main host rodents) and
• Trichophyton verrucosum (main host cattle),
• but also other Trichophyton and Microsporum species.

Symptoms of Tinea barbae: What beard lichen looks like

Beard lichen appears as round, reddened foci that form scales around the edges and can also weep. This is always accompanied by severe itching, which causes those affected to scratch.

Beard lichen is usually a deeper infection. The fungi are mainly located in the hair follicles. There they cause an inflammation that resembles severe acne: Boil-like nodules and pustules form, some of which can swell up very thickly. At some point they break open, draining pus. The entire area then crusts over. The affected whiskers can usually be plucked out very easily.

If the inflamed areas are large enough or several such furunculous formations join together, abscess formation can even occur: A pus-filled cavity encapsulates itself under the skin and no longer allows the outside world and the immune system access.

In severe cases of beard lichen, there may also be an enlargement of the regional lymph nodes

• behind the ear,
• on the side of the neck or
• under the lower jaw

may also occur. Fever is also possible.

Which doctor is responsible for beard lichen?

Beard lichen can also heal on its own. However, this leaves a scar on which no more beard hair will grow. The infection can also last for quite a long time. In addition to the pain and itching, this also means a cosmetic and social problem for the person affected.

You should therefore consult your family doctor in good time if you have the symptoms described. They will diagnose the underlying disease and initiate treatment. A referral to adermatologist may also follow.

Diagnosis of tinea barbae

Dermatologists can usually recognize beard lichen at a glance. If the relevant medical history (animal contact) matches the clinical appearance (new furuncle-like inflammation of the beard hair), this is usually sufficient.

If the disease or its pathogen remains unclear, pathogen detection by means of a tissue sample is necessary. To do this, the doctor takes a swab from the scaly edge of the inflamed area of skin. The corresponding filamentous fungi are then visible under the microscope and the diagnosis of beard lichen is confirmed.

It may be necessary to identify the exact species of fungus by means of a fungal culture.

This involves growing the fungus from the sample material on a suitable culture medium. This can take between one and over four weeks. Once sufficient growth has taken place, the exact pathogen can be identified. It is then also possible to draw conclusions about the effectiveness of the antifungal medication used. This is particularly interesting in the event of treatment failure.

Fungal detection is also important with regard to possible differential diagnoses. Various diseases have a similar appearance to beard lichen:

• Severe acne,
• furunculosis or
• carbuncles with bacteria

are among the possible suspects here. Immunodeficiency diseases such as AIDS could also be possible.

Antifungal therapy for tinea barbae

Beard lichen is treated with local and systemic antimycotics. These are active substances that prevent fungi from multiplying and kill them.

Applied locally, they help with many fungal skin infections in just a few days. However, they must be applied regularly over a longer period (a few weeks). Only then will the active ingredients achieve a reliable long-term effect.

Beard lichen is a difficult and deep fungal infection. Systemic therapy is therefore often unavoidable. "Systemic" means that the medication can then develop its effect throughout the entire "system" of the body. The patient takes tablets for this purpose.

Unfortunately, this can also lead to side effects. These include stomach problems and possibly liver damage. Most antimycotics attack the liver. The prerequisites for systemic beard lichen therapy are therefore

• healthy liver function and
• possibly a blood sample to monitor the liver values.

In addition, systemic therapy is safe and well tolerated by most people.

Possible active substances are azole antifungals or terbinafine. Thorough, hygienic and complete shaving is recommended.