What is Acne?
Canine acne (chin acne) is also referred to as canine muzzle folliculitis and furunculosis. Folliculitis is an inflammation of the hair follicle. Furunculosis refers to an impacted, pus-filled, infected follicle that ruptures. Canine acne causes multiple comedones (blackheads) on the chin and lips of the muzzle where short, coarse hairs grow. The area can also be swollen, inflamed, crusty or bleeding. Canine acne can be painful and/or itchy. All dogs can develop canine acne. However, a large majority of patients are short-coated breeds. Canine acne could also be classified as a type of pyoderma.The technical terminology for canine acne is folliculitis and furunculosis. Inflammation of the hair follicle is folliculitis, and when the hair follicle is infected or impacted, it is known as furunculosis. Chronic acne is possible if the underlying causation is left unidentified, and if left untreated, can result in a serious medical issue.
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Symptoms of Acne in Dogs
Initial symptoms of canine acne are quite mild and may be first seen in any age range. Breakouts are typically concentrated in the chin and lip area of the muzzle. Affected dogs may be seen scratching the area more frequently due to itchiness or reacting to scratching the area due to pain. Left untreated, the symptoms can worsen.
Initial symptom may include:
- Redness (erythema)
- Hairless papules
- Cellulitis with plaques
- Itchy (pruritus)
Progressive or later symptoms can include:
- Suppurative (pus discharge) folliculitis and/or furunculosis
- Large papules
- Ulcerated lesions with or without discharge
- Extremely red/irritated
Causes of Acne in Dogs
Unfortunately, there are numerous possible causes for a dog to form canine acne initially.
- Contact dermatitis
- Autoimmune disease
- Eosinophilic foliculitis and furunculosis
- Malassezia dermatitis
- Metabolic disease
- Secondary bacterial infection - Usually Staphylococcus pseudointermedius
- Previously thought to be hormonal but now thought to be a genetically inherited condition among primarily short-coated dogs mainly due to abnormal follicular keratinization.
- Breed Predisposition - Short-haired breeds almost exclusively affected such as Boxers, Doberman Pinschers, English Bulldogs, Great Danes, Weimaraners, Mastiffs, German Short-Haired Pointers, Rottweilers
Diagnosis of Acne in Dogs
Owners may note certain things that cause the condition to worsen such as exposure to specific materials, foods or chemicals. Owners should make sure the reaction is only located around the muzzle and not spreading. They should also monitor the dog’s reaction (if any) to the acne and any other unusual symptoms such as lack of or change in appetite, diarrhea, vomiting, etc.
Veterinarians may perform one or several of these tests to determine the underlying causes of the acne because of the high probability of complicating infections.
- Skin Scraping - An instrument is scraped across the affected region of skin to collect large amounts of cell that can then be viewed under a microscope and also used for cultures. This is done to look for skin parasites, evidence of specific types of infection or causes for the outbreak.
- Hair Pluck - A few strands of hair from the affected area(s) may be pulled to look at under a microscope to check for parasites such as demodex mites. Hair strands are also a good way to test for fungal infections.
- Bacterial Culture and Sensitivity - Skin scraping can be used, as well as needle aspirate to check for bacterial infection and evaluate specific antibacterial efficacy.
- Biopsy - Typically a later resort test where a small but deep section of skin is taken under light anesthesia or sedation and analgesia. This can give more information about tissue disease than a surface or less invasive test.
- Fungal Culture - Fungal cultures are done similarly to bacterial except that hair samples may also be used in the test. A fungal infection can be a common complication with open and infected wounds or could be the cause.
- Needle aspirate - A needle aspirate can be performed on any fluids contained beneath the skin to better determine the infective elements or causes for the reaction. Fluid can also be observed under a microscope to give a better picture of the condition. In this test, a small needle is used to puncture a fluid-filled area and suck out a sample.
- Blood Test - This may not be warranted as a test immediately but only after lack of response to initial treatment. Blood tests can be used to rule out or in some diseases that will affect the skin such as autoimmune diseases or neoplasia.
- Allergy Testing - Allergy testing may be required if there isn’t a good response to medication. Skin and blood tests are both forms of allergy tests performed. It can be extremely helpful in targeting the factors in such a broad issue.
Treatment of Acne in Dogs
Treatment tends to be quite simple, especially once any infections are diagnosed, and the initial cause is determined.
- E-Collar – E-collars are used to prevent further trauma to the area by the dog. This tends to be temporary while infections clear and breakouts resolve.
- Topical – Topical treatments are most commonly used and are the initial treatment for most cases of canine acne, especially those with only a bacterial component. Shampoos, cleansers, creams, and wipes may all be prescribed. Topical treatments might need to be used for the dog’s lifetime to prevent more breakouts. Benzoyl peroxide can bleach fabrics. Topical retinoids can be drying and cause irritation to the skin. Topical steroids should only be used as a short-term solution as they can cause adrenal suppression. Some other creams can just be greasy or messy but with no ill-effects.
- Oral – Oral medications might be used in combination with topical treatment for certain causes or in more difficult cases. Antibiotics or antifungals are the most commonly needed. Oral medications are usually taken between 2-3 weeks in duration. Oral antibiotics can cause some G.I. upset, like diarrhea.
Recovery of Acne in Dogs
Follow-up appointments are extremely important in treatment and recovery of canine acne due to the large number of possible causes. Initial tests and treatments will tend to be basic, and follow-up appointments help veterinarians and owners determine any other necessary tests or treatments based on results. The veterinarian will most likely have your dog come back within two weeks to make sure any oral antibiotics/antifungals have been effective, and the topical medications are working without negative effects.
Management is key to treatment of canine acne because it has a high tendency to reoccur once it has developed. It also continues to worsen without proper treatment. Preventative care such as topical cleansers, medicated wipes, and shampoos can regularly be used. 2% benzoyl peroxide cream can help for mild outbreaks. Removing or avoiding the cause is ideal for treatment. Diet change, switching plastic to metal food bowls or grooming changes are commonly necessary. If a cause can be determined, and the infection is minor, full recovery is expected in less than a month.Relapse Risk
The risk of relapse depends on the cause and whether a specific cause can be determined. In most cases of canine acne, once the condition has presented the likelihood of recurrence is moderate to high. Long-term or lifelong treatment may be necessary to prevent relapse.
Acne Questions and Advice from Veterinary Professionals
Is there anything else I can do to help my dog with his acne located on his chin?
He is a Dalmatian and the acne is at the point of bleeding, when visiting the vets they said it had got infected due to him rubbing his chin on furniture.
He was given synulox 500mg 1 tablet twice a day,) for initially 2 weeks then after a check up he was given another 2 weeks worth and it hasn’t healed. We have also cleaned the area with hibiscrub to remove the bacteria.
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My 1 year old Great Dane has pimples on his lips and chin...he has had a dose of antibiotics that cleared it up. It has been several weeks now and the pimples have return
A simple question is whether Oakley has a plastic food or water bowl as small scratches in the plastic can irritate the lips and chin (especially when eating) which may lead to these pimples; switching to a stainless steel bowl may help. Also, when a dog is smelling the ground, it is also possible for them to get small scratches on their chins and lips which again may become infected leading to pimples. Regular bathing of the area with dilute chlorhexidine may help, but you may need another course of antibiotics. Regards Dr Callum Turner DVM
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