Skin fold disease is a common condition seen in many dogs, though some breeds are more predisposed. If your dog is prone to skin fold disease, today we are going to discuss why your dog might get it, how it is treated and how we can prevent it from occurring.
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What Is Skin Fold Disease?
Skin folds disease, also known as skin fold dermatitis or intertrigo, is inflammation and/or infection located between folds of skin pushed tightly together. Common sites of skin folding are the face (under the eyes above the nose, and the lips), the base of the tail, between the toes, and around the vulva.
Often skin fold disease begins as inflammation but can progress to infection. Infections are primarily either bacterial or yeast. Many of these organisms are commensals; microbes that live normally on a dog’s skin that become pathogenic. Close skin folds cause friction and trap heat that encourages microbial growth within the skin fold. The microbes produce toxins that lead to further inflammation of the skin and deeper infection. Substances running into folds, such as urine, saliva and tears, will encourage microbial growth further. All this irritation causes scratching and more skin damage that can make the problem worse.
Certain breeds with excessive skin are much more likely to get skin fold disease – these include pugs, French bulldogs, English bulldogs, and shar-peis. Overweight dogs are also more likely to get skin fold disease, as well as dogs with conditions causing looser skin. Predisposing factors for skin fold disease include deeper skin folds, dirty folds, allergies or hypersensitivities, irritation, heat and moisture in the area, dental or eye disease, and more. Skin fold disease is often a chronic condition that has acute flare-ups.
What Are the Symptoms?
Skin fold disease is uncomfortable and irritating for the dog. Inflammation causes redness, but there may be pus-like discharge if there is infection. Infections cause wet and smelly skin folds – often the smell is described as ‘yeasty’ if yeasts are present. The skin can also look brown and greasy. Extreme infections can spread to deeper parts of the skin or across other parts of the body. Rarely, if the dog is very old, young or immunocompromised, infection can become systemic and cause generalised symptoms, such as lethargy, loss of appetite, or a fever.
How Do Vets Investigate Skin Fold Disease?
When presented with a dog with skin fold disease, your vet will first take a thorough history – how long has it been going on for? Has it happened before? Do they have any known allergies? How often are the folds cleaned? And so on.
They will then perform a generalised examination to check your dog’s overall health, as well as identify any underlying factors for skin disease, such as a weakened immune system. Once this is complete, they can look in more depth at the skin fold disease itself. This is primarily visual (and occasionally smell!), but some vets may want to take samples from the folds to check what microbes are lurking in there. Treatment can often be started at this point.
In some cases, further investigation may be necessary.
This is especially true if the problem is recurrent or there are other symptoms. This may involve culturing the microbes swabbed from the skin fold and testing which antimicrobial drugs are effective against them. Scrapes of the skin can be performed to rule out certain parasites too. Screening blood tests are useful to check the overall health of your dog and identify underlying diseases. Some vets may also want to perform blood tests to identify allergies. Very severe and deep skin fold infections may require surgical investigation and biopsies.
How Is Skin Fold Disease Treated and Prevented?
Treatment varies depending on the location and severity of the disease. Mild skin fold inflammation and infection can be controlled with daily antiseptic wipes or washing, and ensuring the folds stay dry. Inflammation can also be controlled with topical or systemic anti-inflammatory drugs. Some infections may require topical antibiotic drugs. More severe infections may require systemic oral or injectable antibiotics, though culturing the bacteria first is advised if this is needed to prevent resistance.
It is difficult to ‘cure’ a dog that gets skin fold disease. Regular antiseptic cleaning and drying is critical to prevent recurrence. Some dogs benefit from occasional courses of anti-inflammatories as well. Regular antibiotic use should be discouraged as this can also cause resistance. Underlying factors, such as obesity or allergies, should be controlled. In some cases, surgery can be performed to reduce skin folds – this may involve removing excessive skin, amputation of the tail, or correcting the shape of the vulva via an episioplasty. Surgeries like this are not always simple, especially as many of the likely breeds are at a higher risk of anaesthetic and surgical complications.
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