Chronic Inflammation of the skin in Dogs
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Definition of
Chronic inflammation of the skin refers to a condition in which a dog’s skin is inflamed for several weeks or repeatedly. This can be permanent or occur in episodes: it gets better, then flares up again. Typical signs are redness, itching, scales, crusts, thinning patches, and a visible thickening and darkening of the skin. Chronic does not mean that it is always equally bad, but that the problem does not heal on its own and threatens to become the “new normal” if nothing is done.
Can Occur with the Following Diseases:
- Hypersensitivity, non-anaphylactic in dogs (Allergy)
- Allergic Inflammation of the skin in Dogs (Atopic Dermatitis)
- Chin and Lip Acne in Dogs (Canine Acne)
- Walking Dandruff Mite Infestation in Dogs (Cheyletiellosis)
- Inflammation of the skin, muscles, and blood vessels in dogs (Dermatomyositis)
- Ringworm in Dogs (Dermatophytosis)
- Skin Diseases Inflammation in Dogs (Dermatoses)
- Skin Rash in Dogs (Exanthem)
- Food Hypersensitivity Reaction in Dogs (Food Allergy)
- Hypersensitivity reaction of the skin to grass pollen in dogs (Grass Pollen Allergy)
- Allergic Skin Reaction to Contact Substances in Dogs (Contact Allergy)
Grundlagen und mögliche Ursachen
The skin is not just a shell, but an active organ. It keeps germs away, regulates moisture and temperature, and is part of the immune system. If this interaction is thrown out of balance, inflammation can develop and become established. Often, several factors work together: a slightly permeable skin barrier, a sensitive or overreacting immune system, an altered composition of skin germs, genetic predisposition, and environmental influences.
Often, a hypersensitivity is behind it. This includes environmental allergies (e.g., to house dust mites or pollen), reactions to food components, or flea saliva allergy. Sometimes it starts with a parasite infestation such as scabies mites or with a Demodex mite that multiplies in the hair follicles. Infections with bacteria or yeasts are also involved – rarely as the sole cause, much more often as a result of the damaged skin barrier. In some dogs, hormonal disorders such as hypothyroidism or Cushing’s syndrome worsen skin health because they change sebum production, hair growth, and defenses. More rarely, but important to consider, are autoimmune diseases, in which the immune system attacks structures of the skin, or tumors that can initially disguise themselves as a persistent inflammation. Finally, contact reactions to detergents, plastics, or plants can also play a role if contact persists.
It is essential to understand: Chronic skin inflammation runs like a cycle. Due to itching, the dog scratches, the skin is injured, germs penetrate more easily, the inflammation intensifies, the itching increases further – and so on. The treatment starts exactly at these points: strengthen the barrier, inhibit itching, control infections, and reduce triggers.
Typische Begleitsymptome
Most dogs initially stand out due to itching. Some scratch, others gnaw at their paws, rub their face on the carpet, or slide their hindquarters across the floor. Often, reddened areas with scratch marks appear. The hairs break off more easily or fall out; bald spots are therefore often not just “hair loss” but the result of rubbing and biting. As the inflammation gets older, the skin changes: it becomes thicker, more wrinkled, and darker, especially in the armpits, groin, and between the toes. Not infrequently, the skin smells sweetish-rancid, especially when yeasts are involved. Many dogs also have ear problems: dark secretion, shaking, head tilting. Inflamed paws and open, painful areas between the toes are also part of the picture. Deep, knotty inflammations can be painful and lead to fistulous tracts from which secretion escapes. Accompanying symptoms such as weight gain, apathy, or increased drinking are more indicative of a hormonal cause and are important for classification.
Wann zum Tierarzt?
At the latest, if the symptoms persist for more than three to four weeks, a dog should be presented – even if the symptoms subside somewhat in the meantime. Very severe itching, self-injury, bloody scratch marks, oozing or foul-smelling areas, and recurring ear infections are warning signs. Deep nodules, ulcers, and fistulas should be clarified promptly. If cortisone frequently has to “rescue”, but the symptoms quickly return, a thorough clarification is also useful. In very young animals with extensive changes or in older dogs in whom new and persistent skin problems occur, one should take a closer look in order not to overlook parasites, hormonal disorders, autoimmune diseases, or tumors.
Symptomerkennung für den Tierhalter und tierärztliches diagnostisches Vorgehen
For owners, it is helpful to observe patterns. Do the symptoms occur at certain times of the year? Are paws and ears particularly affected? Do the symptoms worsen after certain feedings or trips to certain environments? Photos over a few weeks are often more valuable than a snapshot in practice. Also, a simple scale on which you enter the daily itching from 0 to 10 helps to make the course objective.
In practice, diagnostics begin with a detailed discussion and a thorough skin and ear examination. Then follow simple, painless tests directly on the animal: Skin cells and germs are assessed under the microscope with adhesive strips or impression preparations. Skin scrapings – superficial and deep – look for mites. A look at hairs (trichogram) shows whether they are broken off and whether parasites adhere. If skin fungi are suspected, a Wood’s lamp and a culture or PCR can be used; here it takes some patience because cultures take time. If the bacterial or yeast-heavy infections recur or do not respond to treatment, a targeted germ culture with antibiogram is useful.
Often, therapy trials are part of the diagnosis. Consistent flea prophylaxis for all animals in the household is almost always a first step for itching. If skin scrapings do not show scabies mites, a treatment sample against mites can still be useful because they are not always found. If a food reaction is suspected, an elimination diet is carried out over six to eight weeks – strictly and without exceptions. If the symptoms improve, a food provocation follows to secure the diagnosis.
If the findings indicate it, blood tests are added, which, for example, check the thyroid or adrenal function. Unusual, serious, or therapy-resistant changes are clarified with skin biopsies. Small tissue samples provide the pathology with important information, such as on autoimmune processes, deep inflammations, or tumors. Allergy tests for environmental allergens have a place as soon as it is clear that it is actually an atopic disease; they then serve to plan a possible hyposensitization. However, they are not suitable for the initial diagnosis “allergy yes or no?”.
Was kann der Tierhalter tun und professionelle Therapieoptionen
At home, many building blocks can be implemented that significantly influence the success of the treatment. Consistent flea control throughout the year is the most important. Depending on the situation, measures against other ectoparasites are also part of it. If food involvement is suspected, a carefully planned and strictly adhered to diet has the greatest effect. Skin and coat care is more than “bathing”: Antiseptic shampoos or wipes can lower germs on the skin, and refatting products stabilize the barrier. The frequency depends on the phase of the disease; in the beginning, more often is often better, later it is extended. Ears and paws benefit from regular, gentle care. A quiet, low-irritant environment for the skin is important: dry, clean berths, mild household cleaners without fragrances, and well-dried interdigital areas after walks.
The veterinary practice contributes the targeted building blocks. Infections are – if possible – preferably treated topically, i.e. with shampoos, gels, sprays, or ear preparations. This allows the active ingredient to get where it is needed, and the rest of the body is spared. For deep or extensive infections, time-limited systemic antibiotics or antifungals are necessary, ideally after culture. Various tools are available for itching and inflammation. Cortisone works quickly and reliably, but is only suitable in the long term in the lowest possible dose and as a bridging aid. Modern active ingredients that intervene more specifically in the signaling pathway of itching can improve long-term control and reduce side effects. Which option fits depends on diagnosis, comorbidities, and living conditions.
In the case of confirmed environmental allergy, allergen-specific immunotherapy is an important option. It does not work overnight, but can reduce sensitivity in the long term and reduce the need for other medications. Another, often underestimated pillar is the barrier therapy of the skin. Products with ceramides and essential fatty acids support the natural protective layer. In dogs with wrinkles or tight, moist skin between the toes and in skin pockets, a combination of drying, friction reduction and – in severe cases – even a small surgical procedure helps to permanently defuse the problem area. Hormonal disorders are treated in parallel; without their control, infections and inflammations usually return quickly.
Decisive for success is the planning. A written treatment plan with clear steps, control appointments, and “early warning signs” ensures that everyone pulls together. Photos of the course and an itching scale make progress visible. Realistic goals are important: In many cases, one does not strive for “healing” but for stability with as few and mild episodes as possible.
Ausblick auf aktuelle Forschung
The dermatology of the dog is developing rapidly. Researchers are trying not only to consider allergies as “one” disease, but to divide them into subgroups that have different signaling substances and reaction patterns. The goal is to find more precisely fitting therapies for the individual dog, in particular further biologics that specifically block certain inflammatory messengers. JAK inhibitors are also being further developed to improve efficacy and safety. A major focus is on the skin barrier: If you strengthen it in a targeted manner, allergens and germs will have a harder time getting through, and the vicious circle will be broken. The microbiome of the skin – i.e. the entirety of the useful and harmful germs – is also moving into focus. Strategies are being tested to displace problematic germs without harming the useful ones, for example through clever combinations of antiseptics, probiotic approaches, or even bacteriophages. Finally, digital tools allow better progress control: Apps that recognize scratching behavior or standardized photo sequences help to make therapy decisions based on reliable data. All this aims to dampen less “from the outside” and to intervene more disease-modifying.