The disease is most common in men between the ages of 30 and 40, but it is less common in adolescents, although it can also develop. The disease begins with flushing and mild swelling of the skin at the site of beard growth, with burning and itching. This is followed by the appearance of an inflammatory rash and pustules on the erythema consistent with hair follicles. The pustules are surrounded by a red halo, and a central pustule penetrates a beard hair, which is easily removed. After the pustule breaks, it dries and crusts, and after 10 days or so the scab falls off and heals, but a new rash occurs constantly. This damage can be scattered in the beard area or can occur in groups. If the lesion is superficial, the shed hairs can be regenerated, but if the invasion site is deeper and the hair follicles have been destroyed to form scars, it is called lupus-like whiskers. Lupus-like whiskers also start out as follicular inflammatory papules and small pustules, with localized skin flushing and swelling, oozing, and crusting off to form a dark red atrophic scar at the center. Surrounding the area are still active follicles consistent with small pustules and margins of granuloma-like inflammatory lesions. It often begins on the cheek or whiskers in front of the ear and may extend peripherally. The scalp may also be invaded, destroying hair follicles and creating scarring baldness. Beard sores usually occur on the upper lip, cheek in front of the ear, lower lip and chin, and other areas of beard growth. However, it can also occur on the eyebrows, lid margin, axillae, pubic hair, and scalp. The course of the disease is chronic and recurrent, and it is not easy to cure. In lupus-like beard sores, the sebaceous glands and hair follicles can be destroyed and scar tissue can be formed.