Itchy Skin in Dogs: Dr Doug's Approach

Itchy skin in dogs: Dr Doug's approach

I've been treating dogs with skin problems since 1974, and itchy skin, often labelled "atopic dermatitis" or "allergies", is one of the most common and frustrating problems owners face.

Skin and blood tests often show reactions to dozens of things — grasses, foods, dust. My view is that in many of these dogs the underlying problem is an unhealthy skin barrier. Thin skin with poor-quality keratin lets yeast (such as Malassezia) and bacteria (such as staphylococci) take hold, and lets allergens reach the immune system. So the allergy is often a secondary effect, not the starting point.

That means the focus should be on restoring healthy skin, not just stopping the itch. Every dog is different, so please work through this with your own vet.

The principles I follow

  1. Get a proper diagnosis first. Your vet should rule out other causes of itchy or hairless skin, such as mites (including demodex), hypothyroidism, autoimmune skin disease and, in older dogs, skin cancers.
  2. Keep the skin clean. Regular baths with a medicated shampoo recommended by your vet, massaged well into the skin, help control yeast and bacteria. Bathe more often at first, then space baths out according to when the itch returns. Dry thoroughly afterwards.
  3. Support the skin barrier. Ask your vet about a leave-on conditioner or barrier-repair spray after bathing.
  4. Feed for skin health. A good-quality diet with a healthy balance of omega-3 to omega-6 fats supports the skin. Many owners also add a small amount of coconut oil, or turmeric as Golden Paste or Turmeric Dog Bites, as part of a wholefood diet. See how to feed turmeric to dogs.
  5. Treat infection properly. Where infection has set in, your vet may prescribe a course of antibiotics. These often need to run for several weeks. Follow your vet's directions and finish the course.
  6. Use itch medications wisely. Your vet may discuss options such as oclacitinib (Apoquel), lokivetmab (Cytopoint), cyclosporin (Atopica), antihistamines or a short course of cortisone for immediate relief. I prefer to avoid long-term cortisone because of its side effects and its effect on skin immunity, but each has a place, and your vet will weigh them up for your dog.
  7. Be patient. Skin turns over slowly. It can take weeks to see the full effect of changes, and many dogs need ongoing maintenance.

If your dog licks or chews its feet, see also my notes on yeasty paws.

This page is general information and isn't a substitute for a consultation with your vet.

By Dr Doug English BVSc