Folliculitis refers to inflammation of hair follicles. Inflammation occurs when the body responds to injury or infection. When hair follicles are infected by bacteria, it sends inflammatory cells that attack the bacteria and repair the damaged tissue. Inflamed hair follicles may be caused by ectoparasites (a fungus), an underlying hormonal disorder or trauma from itching and hypersensitivity (allergy). This condition is also known as superficial pyoderma. It refers to the hair and epidermis, while pyo and derma are both words for pus.
Folliculitis can happen anywhere on a dog’s bodies, but it is most common in warm, moist places such as the lips, nose, neck, vulva and base of the tail. Folliculitis can also be developed in the axillary (or armpits, as they are known on human bodies), groin and spaces between your toes.
Although this is a mild case, the presence of an epidermal collarette can indicate an infected folliculcle. To determine the source of the irritation to the skin, it’s a good idea for your dog to visit the vet. Jennifer Bailey, DVM.
Macules are small, flat red spots on the skin of your dog that indicate bacterial folliculitis. The macules will become papules as the condition progresses. Papules can become enlarged and filled with pus. This creates a small white spot in the center of the raised red circle. A pustule is a pustule in dogs that fills with pus. In humans, this would be a pimple.
Folliculitis can be itchy (itchy), and your dog may scratch or lick at the lesions. Scratching and licking papules or pustules can cause them to burst and release fluid from the papules. The crust forms on the pustules and papules when the clear fluid and pus dry. These crusty red circles will grow larger if your dog keeps licking them. These are epidermal collarettes.
Pyoderma
There are three types: surface, shallow, and deep pyoderma.
Surface pyoderma refers to an infection of the skin’s surface. Surface pyoderma refers to an infection on the skin’s surface. Folliculitis refers to an infection of the hair and skin follicles. Deep pyoderma, on the other hand, is an infection of deep layers of the skin.
Folliculitis: General Treatment
A medicated shampoo may be used to treat folliculitis. This will reduce the amount of bacteria on the skin, as well as relieve the discomfort and pruritus. An oral antibiotic will likely be used as well. Typically, a dog will need an oral antibiotic for one week until his symptoms improve. It may take up to two weeks, but it usually takes four to six weeks.
Folliculitis Treatments
The bacterial infection of the hair follicles and skin is almost always secondary. Folliculitis can only be treated if the original cause is known. These are the most common precipitating factors.
Demodicosis
Demodex mites, also known as hair follicles or sebaceous glands in your dog’s skin, are responsible for this condition. Demodex mites are considered a companion mite. They live in the hair follicles and sebaceous glands of your dog’s skin, but they do not cause any harm to your dog. Demodex mites can make a dog itchy if their numbers suddenly rise. If the balance between Demodex mites in the skin microenvironment and the population of mites explodes, the mites are considered parasites rather than commensals.
Because puppies are young, the Demodex mite is more likely to cause pruritus in them. Demodicosis can also occur in adult dogs, but it is possible to have an immunocompromising condition that allows for the Demodex mite’s proliferation. Demodex mites do not transmit disease to dogs.
To check for Demodex mites, your veterinarian might recommend a skin scrape test. There are many treatments for demodicosis. Amitraz, a dip treatment for demodicosis (brand name Mitaban) is the only FDA-approved medicine. Amitraz can cause side effects and make the dip smell very noxious. While not FDA approved for this purpose, there are other treatments that can be used to treat demodicosis. These include milbemycin (an oral medication), ivermectin, moxidectin and fluralaner. They are all found in many oral flea/tick prevention products. Talk to your veterinarian about which treatment is best for you, your dog, and your pet.
Ectoparasites (skin parasites)
Lice and mites are skin parasites that can infest your dog’s skin. These parasites include:
Sarcoptic mange is caused by the Sarcoptesscabiei mite, also known as scabies. The mite burrows under your dog’s skin, laying eggs in the tunnels that they make. Dogs have an allergic reaction to the poop that mites leave behind in the skin tunnels, causing the dog to become extremely itchy.Cheyletiellayasguri (the cause of cheyletiellosis) is a white mite that lives on the surface of a dog’s skin. Cheyletiella can cause dandruff in dogs that appears to be moving. This infection is often called “walking dandruff.”Trombiculidae, better known as “chiggers,” are tiny, orange-red mites that attach to a dog’s skin to feed for a few days before detaching.
All three mites can be treated with similar methods. These include lime-sulfur topical drops, amitraz and limesulfur oral medications, ivermectin an oral medication, moxidectin & selamectin topical preventatives, and fluralaner a class of drugs (found within several oral flea/tick preventions). FDA approved for treating sarcoptes menge, but they have been shown to be effective in treating walking dandruff or chiggers. Although fluralaner is not FDA approved for these mites, it has been shown to be effective. All three mites can be transmitted from one animal to another.
Ear mites. Otodectes Cynotis is a species that lives in the dog’s ears. Ear mites can sometimes crawl out from the ear and live in the skin around it, the neck and face. This causes itching. Ear mites can be transmitted by close contact with other animals that have ear mites. Ear mites can be treated with topical medications that include milbemycin or flea preventatives that contain selamectin. Ear mites are transmitted between animals, such as dogs, cats and ferrets, but they do not usually infect humans. The sucking louse attaches to the skin of dogs and is one type. Other species include chewing lice, which eat skin flakes, fur and secretions. These little white or clear eggs, also known as nits, are glued to the fur shafts by lice. Lice are species-specific and prefer their host. Effective treatments for lice in dogs include topical flea preventatives that contain selamectin, imidacloprid, or fipronil.Dermatophytosis
Ringworm is the most common name for this fungal infection. Ringworm isn’t a worm. However, the skin lesions can sometimes look like a raised, squiggly ring under the skin. Dermatophytosis can be contracted by dogs from soil contamination or infected animals or humans.
A Wood’s lamp is a special type of light that can be used to treat skin lesions in dogs. A Wood’s lamp can often make a fungus glow the same color as a green apple. A fungal culture may be required to confirm diagnosis. To collect a sample, your veterinarian will use a toothbrush that has been previously opened to brush the skin. The fungal growth is monitored for 14-21 days after the sample has been added to fungal culture medium.
Dermatophytosis can be treated using a combination of topical medication, shampoo, and ointment. This is a zoonotic disease, which means that it can be transmitted from one animal to another. For safe handling and cleaning of the home, consult your veterinarian.
Endocrine disorders
Two endocrine conditions that can trigger bacterial folliculitis are hypothyroidism or hyperadrenocorticism.
Hypothyroidism results from a decrease in thyroid hormone production by the thyroid gland. Thyroid hormone plays an important role in many systems of the body, including the skin. Hypothyroidism can lead to dry and flaky skin in dogs. Also, hypothyroidism can cause slow fur growth. Hypothyroidism can cause fur to fall out naturally over time. However, hypothyroidism can lead to alopecia in certain areas of the dog’s body. Dry, flaky skin can lead to bacterial folliculitis. Your veterinarian might order a complete thyroid panel to check for hypothyroidism if your dog shows signs such as lethargy or weight gain, even though they are not eating as much. This disorder is treated with a daily medication called levothyroxine to replace missing thyroid hormone.Hyperadrenocorticism (also known as Cushing’s disease) is caused by an increased production of cortisol by the adrenal glands. Cortisol, a steroid hormone, plays an important role in many of the body’s systems. Cortisol excess can lead to skin changes in dogs that can lead to chronic and recurrent bacteria folliculitis. Cushing’s disease can also be seen in dogs who drink more water than usual, urinate more frequently, have a greater appetite, panting unrelated to reason, and are more potty-bellied. Your veterinarian may order a screening test and then one of two diagnostic tests for hyperadrenocorticism. Trilostane is a daily medication that reduces the amount of cortisol produced by the adrenal glands.
Canine atopic dermatology (CAD) is another cause of bacterial follicullitis. This is an exclusion diagnosis. Before a dog is diagnosed with atopic dermatitis, other causes must be investigated, treated or ruled out. Hypersensitivity to food, inhaled and contact allergens is the cause.
There are many treatment options available for CAD. Apoquel, Cytopoint and Cytopoint are two of the many treatment options for CAD. They target the process known as the itch cascade. An allergen can trigger a chain of reactions in dogs. The dog will feel itchy, licking and scratching at the allergen. The dog doesn’t feel itchy if the itching cascade is stopped.
Prednisone (modified cyclosporine), and Atopica (modified ciclosporine) are two options for treating CAD. Both of these medications can cause side effects. Prednisone and cyclosporine may require periodic monitoring and baseline blood work.
It may be helpful to have a prescription diet for sensitive skin or food sensitivities. A diet that promotes healthy skin and flora may be beneficial for dogs who don’t have food hypersensitivities. This diet can be ordered by your veterinarian and is available from Royal Canin as well as Hills.
A novel protein, limited-ingredient diet may be beneficial for dogs with food hypersensitivity. Hills, Royal Canin and Purina all offer diets that meet these requirements. These diets, unlike limited ingredient diets, are not available for purchase without a prescription. They are made separately from other diets to avoid cross-contamination with proteins that could cause allergic reactions.
Flea allergies are more common in dogs with CAD. Flea allergy dermatitis is the name of this condition. Flea allergy dermatitis causes itching in dogs. Fleas can be minimized by using a high-quality flea prevention product as directed.
Another treatment option is immunotherapy for CAD. To retrain the dog’s immune system to react to allergens, it is necessary to expose them to very low amounts of allergens. To determine the allergens that a dog is allergic and their reaction to them, testing is done. A blood test can be used to test for allergies, or an intradermal test can be done. A custom-made immunotherapy serum is made for each dog. It can be administered by injection every other week or by oral administration daily. To achieve a positive result, immunotherapy must be continued at least for one year. Sometimes it can last longer.
Proper diagnosis necessary
Folliculitis, regardless of the cause, can be serious if it isn’t treated. To determine the cause of your dog’s folliculitis and to provide appropriate treatment, make an appointment with your veterinarian.
Folliculitis in Dogs Whole Dog Journal.