This common condition is caused by an inflammation of the skin follicles. Here are some natural ways to ease the itch of folliculitis.
Have you ever seen a dog that could best be described as a “moth-eaten rug”? He may have been suffering from a common condition called folliculitis, an inflammation of the hair follicle. Follicles are tiny openings in the outer layer of the skin in which hair grows and sebaceous glands produce oils. Folliculitis is usually the result of some underlying problem.
What causes folliculitis?
Many things can cause inflammation of the skin and hair follicles, but there a few very common culprits.
- The ectoparasite that causes demodectic mange (Demodex canis) can cause folliculitis. This parasite is ubiquitous and normally lives on adult dogs in the hair follicle. It rarely causes any symptoms, however, because the mature adult immune system keeps the mites from proliferating. Puppies are particularly at risk for demodex, because their immune systems are immature and don’t keep the mites in check. While rare, some adult dogs can develop folliculitis from demodex infestation, but this is usually an indication of underlying immune system incompetence.
- Fungal agents can also cause folliculitis. Dermatophytosis, or ringworm, is a contagious condition caused by fungal organisms found in the environment. Again, this is more commonly a problem for puppies or kittens, but if there is a lot of exposure to the organism, even adult dogs can become infected.
- Bacteria are by far the most common factors associated with folliculitis. Bacterial pyoderma (bacterial skin infection) can cause a myriad of symptoms, including folliculitis. The most common underlying cause of pyoderma is allergies. Certain breeds, such as cocker spaniels and boxers, are prone to skin allergies, but any dog can develop them. If the inciting allergen can be identified and eliminated, recurrent problems with pyoderma and folliculitis will disappear.
Diagnosis is simple
Folliculitis is relatively easy to identify just by looking at the skin. The challenge is determining why it is there. Thankfully, there are several quick and easy tests that can be used to find the particular cause of the folliculitis.
- Skin scrape and hair plucking: Demodex can be identified via a skin scrape. A sample of the cells, hair and debris on the surface of the skin can be examined under the microscope to look for parasites. Hair can also be plucked to look for demodex mites clinging to the hair shafts.
- Fungal culture: A fungal culture can be performed to identify dermatophytes. Again, this is a relatively easy and inexpensive test, although it does take up to seven to ten days to get full results.
- Skin cytology: This is similar to a scrape but is done to determine the presence of bacterial infection. Unfortunately, this test does not specify what strain of bacteria is present.
- Bacterial culture: If the condition is chronic or unresponsive to previous treatment, a bacterial culture may be necessary. While this test can be expensive, it is often needed to ensure that the treatment chosen works properly.
Once the underlying cause of folliculitis is identified, treatment is usually straightforward.
If demodex is suspected, it is conventionally treated with sulfur lime dips or occasionally with oral milbemycin oxime (a commonly-used medication in heartworm preventatives).
Dermatophytosis can be treated with shampoos containing antifungals, or topical antifungal creams. Occasionally, oral antifungal medications are used, but this is generally avoided since these medications can have side effects.
Pyoderma is treated with oral antibiotics, generally for four to six weeks. Steroids can be used to decrease itchiness and inflammation but are rarely needed for mild cases. Topical antibacterial agents can be used for localized lesions. Shampoos that contain cholorhexadine, ketoconazole and benzoyl peroxide are particularly useful for flushing the follicles.
Many alternative options can both treat the symptoms of folliculitis and address some of the underlying causes.
- Omega-3 fatty acids (fish oil) have been proven to be an effective anti-inflammatory agent for skin disease.
- Probiotics can be helpful for a wide range of conditions. Many veterinarians theorize that allergies are related to poor gut health. Whether from antibiotic overuse, stress, poor diet or poor genetics, some dogs have an overgrowth of “bad” bacteria in their intestines. This not only leads to poor digestion, but potentially over-stimulation of the immune system, which manifests as an excessive immune response, or allergies.
- Nettles (Urtica dioica) have both anti-allergic and anti-inflammatory properties when taken orally.
- Chamomile can calm itchiness and may also be given orally.
- Tea (black or green) applied topically has both astringent and anti-itch properties, good for itchy infected skin.
- Witch hazel is also an effective astringent. When selecting witch hazel products, know that it is often prepared with alcohol, which can be extremely drying and painful if the skin is red and irritated.
- Aloe vera is a good option in cases of very irritated and infected skin. It is both anti-bacterial and soothing, which is why it’s frequently used for mild burns associated with excessive sun exposure.
- Coconut oil is another good topical option for irritated skin. It is anti-bacterial, anti-fungal and soothing, and due to its recent popularity, has become readily available at most grocery stores.
Folliculitis is a common condition, probably because there are a lot of things that can trigger it. The key to dealing with it, and avoiding that unsightly “moth-eaten” look, is to get to the root cause.
Prevention is simple as long as the underlying cause can be identified and eliminated or avoided.
- Demodex mites and fungi are ubiquitous in the environment, but are usually only a problem if the immune system is not working properly. In these cases, you can help boost your dog’s natural defenses with a good diet, daily exercise and minimal stress.
- If allergies are suspected, the allergens need to be identified and avoided. For example, a common type of folliculitis occurs on the chin, and is referred to as “chin acne”. It can result from contact with certain types of plastic, so switching out plastic food and water bowls to glass or ceramic eliminates the problem. Other options for addressing allergies include diet changes. Talk to your veterinarian if you suspect your dog’s folliculitis is related to allergies.
Veterinarian Dr. Erin Mayo graduated from the North Carolina State University College of Veterinary Medicine in 2002. She received her veterinary acupuncture and Chinese herbal certification from the International Veterinary Acupuncture Society, and provides holistic and TCVM services for companion animals in central New Jersey.