Sarcoptic Mange, Scabies, Red Mange


also see Mitaban Toxicity

Mange mites

Question: Dr. Mike: Our male black lab is 5 mths. old. When he was 3 months old we noticed he gnawed at his hind legs a lot and also his belly. Our vet strongly suspected demodex mites, but two series of scraps taken from several areas came up negative. She still suspects them but suggests we wait a while and see if his scratching gets worse or he loses hair in those areas. In the last 3 weeks he has lost a lot of hair around his right eye only. Although he has thin hair areas on his belly, it does not look like he has gotten any more sparse in that area. But he continues to bite his hind legs, rump area and belly. He even barks sometimes when he is doing this as if agitated. However, the area around his eye never seems to bother him although he has really lost hair there. My questions are: 1)at what point do you consider the immune system of a lab to be mature (at which point it can hopefully keep the mites in check) and 2)i s it a good idea to just let this condition continue untreated and hope it clears up, or should I take the initiative and suggest an amitraz dip or other treatment? (Also, a day or two after we got him he developed an infection in both eyes, with drainage. He was given an antibacterial cream to put in the eyes. Would this have given the mites in that area a chance to take over, although only one eye is losing hair and it is now 3 months later?) Thanks for your help - Mindy

Answer: Mindy-

It is usually fairly easy to find Demodex mites on a skin scraping. Not being able to find mites on three or more scapings would make this diagnosis fairly unlikely, but not impossible. On the other hand, sarcoptic mange mites are very hard to find on skin scrapings and are more likely to cause severe itchiness.

I would probably treat for the possibility of sarcoptic mange mites first, because they are easier to kill and eliminating them will provide pretty quick relief for the itchiness. Amitraz (Mitaban Rx) will kill sarcoptic mange mites but so will many other medications and most of them are less likely to cause serious side effects. My personal favorite, at the present time is ivermectin, but your vet may have another choice, such as lime-sulfur or organophosphate pour-on products.

If sarcoptic mange wasn't the problem, based on the results of treating for it, then food allergies, atopy and bacterial skin infections would be the next things I would think about. And I would recommend continuing to do skin scrapings on each visit in which hair loss was still present.

It is very unlikely that the antibacterial eye ointment would be playing any part in this problem.

Most puppies have reasonably competent immune systems by about twelve weeks of age but complete immune competency may not occur until a puppy is over a year of age.

If demodecosis is the problem, I am reluctant to treat a puppy that might be used for breeding, since it is important to know if a puppy has generalized demodecosis prior to deciding whether to breed or not. On the other hand, if the puppy is not to be used for breeding then it really doesn't matter when the demodecosis is treated and we will go ahead and try to treat for it earlier.

If you don't get a diagnosis as time goes on and if response to further treatment is unsuccessful, you might want to ask your vet for a referral to a veterinary dermatologist.

Good luck with this.

Mike Richards, DVM 8/16/2000

Sarcoptic Mange - itching

Q: Hi Dr. Mike:

My dog Remington, who is an 11 year old Shepherd/Beagle (more like a Shepherd)who was misdiagnosed 4 months ago with FAD, only to find out that he has Sarcoptic Mange! Yuk, and I have it a little too, but that's the least of my worries. He is on predisone, and the vet gave him a shot of Ivermectin on Saturday. He is really itching and I don't know what to do. He has a "halo" on to keep him from digging at himself, and a pair of socks on his back feet to keep the scratching from harming him. He feels hot and inflamed in the legs (mostly at night) has alopecia of the legs, and scabs on the ear margins and flaky scabs in the coat. He is losing some hair on flanks, but his upper coat is mostly okay. He also has a smell that's well, pretty doggy! I want to put something on it to make this go away. I would hesitate with any powdered insecticides, and we have waged war in the house and with all bedding and other pets.

The vet just said to wait and see, but isn't there something soothing or something to bathe him with? I am using a soothing shampoo from Lambriar Vet called Epi-Soothe. That has colloidal oatmeal in it. Seems to help, but I want to keep Advantage on him, so I don't want to bathe that off of him too much. Would a cup of white vinegar in a foot of bathwater be bad for him? Salt water? I feel so helpless, and I don't want him to keep taking predisone!! But he really is suffering. Can you suggest anything? We have changed his diet completely to California Naturals Lamb and Rice, very little wet food and increased his "fatty acids" enzymes and minerals. We are also slathering him with 100% aloe vera gel,which seems to help temporarily. Hope you can help.

Thank you!

Kate C

A: Kate-

You might try using the Aveeno oatmeal rinse made for people. I don't think it has soap in it, so it would be less likely to wash off the Advantage. I don't think that it would hurt to try the vinegar in water but I don't know if it would help.

An antibiotic might be helpful, too. If your vet did not prescribe an antibiotic you might want to call and ask about getting one. Control of secondary bacterial infections can be very helpful in some cases. Especially when the itching continues for more than a few days after the ivermectin treatment.

Good luck with this.

Mike Richards, DVM

Mange treatment

Question: Whatever happened to just plain ole sulfur and oil applications for tx of mange. All the recommended txs I see on all the web sites call for vet visits and expensive drugs. $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$. Seems the most logical and common sense approach is to try least expensive FIRST, then go the big bucks route. B. D

Answer: B.-

I think that you can tell from reading our web site that we will recommend inexpensive treatments when they are likely to be helpful.

Motor oil is not safe to use on pets. Since that is usually the oil recommended by home remedy enthusiasts in my area, I am assuming it is the one you are referring to, too. It is better now than it was when cars burned leaded gas but it still can cause gastrointestinal problems.

Lime-sulfur dips will kill Sarcoptes mites but not Demodex mites. Other sulfer containing products do not appear to work for mange based on a fairly large number of cases I see in which they have already been tried. They do sometimes help with skin conditions that aren't actually caused by mange mites but which get called "mange" because people are not aware that this is a description of a specific disease rather than a description of the symptoms of hairloss and itchiness associated with the mites.

Demodectic mange will often clear up without any treatment at all, making almost any treatment appear successful at times. This is why we recommend not treating this form of mange at all unless it becomes generalized (affects more than five or six spots on the body). If it does become generalized, there is no effective home remedy that I am aware of.

Sarcoptic mange is easier to kill, does not require many visits to treat and there are safe and effective medications available for treatment. In this case, a questionable home remedy doesn't make economic sense. It is cheaper to use an effective medication before secondary complications from the mange sets in. Michael Richards DVM 12/2/99

Sarcoptic mange and people

Q: Dear Dr. Richards,

Here is my problem: I stayed overnight at my daughter's home about four weeks ago on a Wednesday night. I slept downstairs on the sofa, and as my daughter's puppy is confined to the downstairs area of her home, he slept on the sofa with me. The dog was about three months old. He kept me up most of the night because he kept jumping off and on the sofa to scratch violently. The next morning, I mentioned this to my daughter and told her he had fleas. She replied that she had already checked him for fleas and that he had none.

The following Sunday morning (4 days after my overnight stay), I awoke to a horrible, itchy rash. There were hundreds of "bites." It was primarily on my ankles & shins, my torso, my stomach, and my inner thighs. I had a couple of "bites" on my breasts, my back, and my upper arms. I had no idea what it was. It continued to get worse over the next couple of days so I went to my doctor. She thought it was an allergic reaction to soap or laundry detergent and did nothing. I hadn't changed any products. I even mentioned scabies to her but she said that the appearance and location of my rash was not consistent with scabies. She said that scabies usually produce "burrows" and are usually seen inside the elbows, on the inner wrist area, and between fingers. (I had no rash in any of those areas.) I then remembered the scratching dog, and so I contacted my daughter. She said that she, too, had had this rash shortly after acquiring the puppy, but that neither her husband nor the children had broken out. She said that her rash eventually just went away. She said that she only applied Benadryl cream to her inner thighs for the itching.

I went back to my doctor with this new information and she prescribed a medication called Elimite. I used this about ten days ago and it does not seem to be effective. Some of the original sites (of the hundreds on my body) appear to have dried up and flattened. However, I am still itching violently and it appears that I have new sites. I am frustrated, and very scared by all of this.

I have widely searched the Internet and the public libraries in my area for more information on this sarcoptic (scabies?) mite and I can't find anything which tells me (a) what is the lifespan of this mite?, (b) is there a prevention for humans?, (c) what is the treatment?, and (d) is the condition transmissible from human-to-human and/or from their clothing? (I intend to stay miles away from the dog.) I ask about "prevention" because my daughter thinks there is no problem since her own rash went away untreated. However, the family visited me this past Sunday and I noticed the children scratching. I tried not to be obvious, but I found myself afraid to hug my own grandchildren. And now...I feel that my home is reinfested after I waged an all-out war when I treated myself. I have washed tons of laundry, I have scrubbed down furniture and floors. Dr. Richards, I am tired of dealing with this. I am already under enormous stress from unrelated problems, and under the care of a therapist for grief-related emotional problems due to the loss of my husband.

Please Dr. Richards, can you give me any advice at all? I have talked to dog owners and dog breeders. Some say it cannot be passed from person to person, some say it can. Some say these mites cannot survive in human skin, some say they can and do survive and spread very well. Some say scabies disappears without treatment, some say "No way." Some people have even told me that it can only be passed from one human to another through contact as intimate as sexual relations. (I was very skeptical about this last one, because I thought of how scabies epidemics sweep through elementary schools.) Please help me.

Thank you so very much. I apologize for the length of my letter.

Sincerely, Brenda

A: Brenda-

I think that the problem with the information you are receiving is that there is a species of sarcoptic mange that infects primarily dogs and there is a species of sarcoptic mange that infects primarily people.

The dog species of sarcoptic mange can TEMPORARILY infect humans. Usually the itchiness from this lasts about three weeks, or less. The mite can't live in humans, so it dies. If the dog remains in the household and remains infected it can continue to give its owners new mites, though -- so the itching can last longer because there is a constant new supply of mites. Cortisones are sometimes used to reduce the inflammation and itchiness. It is not necessary to kill the mites because the are going to die, anyway.

The human species of sarcoptic mange is contagious between people and is a problem in settings like nursing homes where it can spread pretty rapidly through the resident population in some cases. It is often referred to as scabies.

Many dogs that are being bitten by fleas do not have fleas that can be found on an examination. This is especially true of dogs that are allergic to fleas. Why? Because the dogs are very very good at finding the flea and ingesting it. They know they are being bitten and they know where they are being bitten when they are sensitive to the bites. This is even more true in the case of cats, who are also equipped with a barbed tongue and extraordinarily flexible bodies to help in capturing the fleas. So I wouldn't rule out flea bites just because you can't find fleas. Many client also say "If my house had fleas, I would know it" but they are wrong. Fleas like to live on pets if possible. They attack humans when their favorite targets are unavailable.

It wouldn't be possible to tell you whether sarcoptic mange, flea bites, or another problem is leading to the symptoms you are seeing but it would be a really good idea for your daughter to use Frontline (TM) to kill fleas (and possibly even sarcoptic mange mites) that MIGHT be infesting her dog. People seem to have a hard time believing that their pet might have fleas even if they can't find them but it is true.

If you continue to have problems with the rash it would be a good idea to get your doctor to recheck you, too. (which I'm sure you have probably already done!)

Mike Richards, DVM

Mange Mites

Q: Dr. Richards,

We have a labrador retriever who is 1 year old. She was recently diagonosed with mites. She was given antibotics and the situation appeared to be cleared up and "regrowing" the fur that she had lost. We recently saw the same bald spots on her paws and are wondering if the situtation has come back. Is this possible that we didn't get rid of it all the first time? The images of these diseases helps identify what may be happening to our dogs. As you know, vet bills can be expensive and having this great tool helps. Thanks. This website is priceless!!!!


A: Sharon-

Unfortunately, it is not unusual for demodecosis to persist or to appear to recur. Sometimes sarcoptic mange will do this, too, especially if there is a source of the mite (like a neighboring dog) that is still there after the dog is treated the first time. So the best thing to do is have skin scrapings done of the new areas of hairloss and then make a treatment plan based on the results of the skin scrapings.

Mike Richards, DVM

Treatment for Sarcoptic Mange

Q: I have a chow mix that from what I have read on the internet may have sarcoptic mange. My vet initially thought it was an allergic reaction, but it has since spread to the other dogs in our household. I have my vet if he would treat him for sarcoptic mange, since it won't hurt anything, but he isn't sure what dosage to use. I know that I need to treat all the dogs, so I need to know the dosage for large dogs (about 80 pounds) and a small dog (about 20 pounds).

A: j- When itchiness spreads from one pet to another sarcoptic mange is pretty likely. The dosage of medication for this depends on the medication used. Organophosphate dips such as Paramite Rx are used according to the label directions, as is Lime-Sulfur dip. Ivermectin has been used by many veterinarians to kill sarcoptic mange but usually after approved medications fail to work due to a small chance of toxicity. Recently there have been several reports of good success using Frontline spray to kill sarcoptic mange, used according to the directions for fleas. Since it is approved for use in dogs for flea control you'd at least be doing the dogs some good even if the reports are wrong! One dose is reported to be effective.

Mike Richards, DVM

Sarcoptic Mange is contagious

Q: Hi, my dog has mange, and my question is which kind of mange will affect humans, and if it does, how much will it affect them? I'm treating my dog, but I'm afraid I'll get mange myself, is this posible?? Answers are greatly appreciated.

A: Fidel- Sarcoptic mange is contagious to humans. It causes a rash, usally around the waistband area, wrists and ankles (areas of tight skin or close skin/clothes contact). Usually this is a self-limiting infection as long as reinfection isn't constantly recurring. The mites can't reproduce or live well in human skin so they die in a few days to a few weeks and the rash and itching stop. While I would try to avoid getting infected by washing my hands after playing with the dog and by treating the dog with effective medications I wouldn't be overly concerned about contracting this mite infestation.

Mike Richards, DVM

Sarcoptic mange - young puppy

Q: We just brought home a 7week old Golden and just found out he has sarcoptic mange, unfortunatly our vet won't treat him till he is at least 10 weeks of age!! Is this normal? I know this is contagious and am concerned for our 3 year old doxie and the rest of our family as well. Isn't there something we can do to stop this? Once the mange has been cured can it ever come back, is he a mange man for life? the vet has him on Benadryl 3 times a day right now and I just can't see how that is going to help this problem. Any info you can give will be helpful. Tannis

A: Tannis- I usually treat young puppies with sarcoptic mange. We use 2% lime sulfur dip (I think the brand name is LymDip but I can't remember for sure) on young puppies to avoid the problems that organophosphate dips or ivermectin may cause in young puppies at the dosages necessary to kill the mites. I think I would be comfortable using either of these treatments when necessary for a seven week old puppy but I can understand being cautious since they are more toxic.

Sarcoptic mange can affect your family and it definitely could be a problem for your Dachshund. I do not think that I could advocate delaying treatment. I really think you need to discuss this with your vet again or possibly get a second opinion.

Mike Richards, DVM


Q: Dear Dr Mike - Hope you can help. My 4½mths old male Shih Tzu was diagnosed with scabies. He scratchs alot and has been 'biting' on his left hind leg lately which seems very sore. Part of the scabies spots? He has been given a jab (2 more to go) as treatment. Are there any side effects? Should I bath him with any special shampoo? Hope to hear from you soon. Thanks.

A: I am assuming that your shih tzu was injected with ivermectin. This is a pretty effective method of treating scabies infection. Most dogs have no reaction at all to the injections (except local pain when injected) and usually show a response to treatment within a day or two. Lyme-sulfur dip and organophosphate dips such as Paramite (Rx) can also be used to treat sarcoptic mange but it is not usually necessary to combine treatments.

A few dogs do react to ivermectin adversely. The symptoms of sensitivity or toxicity from ivermectin can include apparent blindness, staggering gait or coma. It is important to let your vet know if any side effects do occur -- but they are very unlikely.

Mike Richards, DVM

Photo Gallery - Sarcoptic Mange


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...