Summary about Disease
Black piedra is a superficial fungal infection of the hair shaft. It is characterized by the formation of hard, dark nodules that firmly adhere to the hair. It primarily affects hairs on the scalp but can occasionally affect beard, mustache, and eyebrow hairs. It's generally considered a cosmetic issue rather than a serious health concern.
Symptoms
Presence of hard, black or dark brown nodules firmly attached to the hair shaft.
Nodules are gritty to the touch.
Hair may feel rough or brittle.
Hair breakage may occur at the site of the nodules, but it is not typical.
Usually asymptomatic (no itching or discomfort).
Causes
Black piedra is caused by the fungus Piedraia hortae. The exact mode of transmission is not fully understood, but contributing factors include:
Poor hygiene.
Contact with contaminated soil or water.
Use of shared combs or hair accessories.
Living in tropical or subtropical climates with high humidity.
Possibly, close contact with infected individuals.
Medicine Used
Treatment typically involves topical or oral antifungal medications. Common options include:
Topical:
Selenium sulfide shampoo.
Ketoconazole shampoo.
Clotrimazole cream.
Other topical antifungals.
Oral:
Itraconazole.
Terbinafine.
Fluconazole (less commonly used).
Griseofulvin (an older medication, less commonly used now). Shaving or cutting the hair
Is Communicable
The disease is potentially communicable through direct contact with infected hair or shared items like combs, brushes, or headwear. However, it is not considered highly contagious.
Precautions
Maintain good personal hygiene, especially washing hair regularly.
Avoid sharing combs, brushes, hair accessories, and headwear.
Avoid prolonged contact with potentially contaminated water or soil.
If infected, seek treatment promptly to prevent further spread.
Clean combs and brushes regularly.
Dry hair thoroughly after washing.
How long does an outbreak last?
Without treatment, the infection can persist indefinitely. With appropriate antifungal treatment, the infection typically resolves within a few weeks to months. Relapses can occur if treatment is not thorough or if predisposing factors are not addressed.
How is it diagnosed?
Visual Examination: Diagnosis is often made based on the characteristic appearance of the nodules on the hair shaft.
Microscopic Examination: A microscopic examination of the affected hair confirms the diagnosis. The nodules are examined to identify the fungal elements.
Fungal Culture: A fungal culture of the hair shaft can identify Piedraia hortae, but this is not always necessary for diagnosis.
Timeline of Symptoms
Initial Infection: The fungus begins to colonize the hair shaft.
Nodule Formation: Over time, small, hard nodules begin to form on the hair. This process can take weeks to months.
Progression: The nodules gradually increase in size and number.
Advanced Infection: Hair may become rough, brittle, and in rare cases, breakage may occur.
Important Considerations
Differential Diagnosis: It's important to differentiate black piedra from other hair shaft conditions like white piedra, hair casts, or nits (lice eggs).
Compliance with Treatment: Completing the full course of antifungal medication is crucial to prevent recurrence.
Underlying Conditions: Consider underlying conditions or lifestyle factors that may contribute to the infection, such as excessive sweating or poor hygiene.
Environmental Factors: In areas with high humidity, preventive measures are especially important.