How to Treat and Cure Dog Mange

Updated on August 30, 2017
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Alex is a marine biologist, aquarist, lover of animals, and an experienced veterinary assistant.

What is mange?

First things first, mange is a nasty disease. That being said there are some graphic pictures in this article. There are two kinds of mange that affect dogs: sarcoptic and demodectic. Both forms of mange are caused by mites living around the skin of the dog. With sarcoptic mange the mites live just under the surface of the dog's skin. While the mites associated with demodex live in the hair follicles themselves. Of the two demodex is more commonly seen.

On a healthy dog with a fully functioning immune system a few demodex mites will not cause any problems. However, if a dog has a compromised immune system or an immune system that is immature it will be susceptible to the mites. Interestingly enough most puppies get the mites from their mother in their first days of life. Demodectic mange is not contagious to other dogs or people.

The good news is there is a cure for demodectic mange. The bad news is that the treatment process is long and can get rather expensive.

A Boston terrier puppy with generalized demodex mange.
A Boston terrier puppy with generalized demodex mange.

Localized and Generalized Demodectic Mange

Demodectic mange can be further broken down into two categories: localized and generalized. Localized demodex typically occurs in puppies, or dogs under a year of age. The hallmarks of localized demodex are: thinning fur around the mouth and eyes and small patches of hair loss. It is important to note that if more than five patches are present at one time it is possible that the disease is progressing to the generalized form. It is not unheard of for localized mange to clear up on its own, reappear in a few weeks, and then clear up again.

Generalized mange is more widespread than localized mange. Dogs with generalized mange typically start with patches of hair loss that progresses to large areas of hair loss. The fur is not able to grow back as the follicles are completely filled with mites and and dead skin. The skin of the dog is extremely delicate and often covered in crust. It is even possible that there may be open sores on the skin and pockets of infection under the skin. There have been some cases there young dogs, one year or younger, have developed generalized demodectic mange and it cleared up on its own. However, this should not be expected with all cases.

Thankfully there are treatments available for both forms of demodectic mange.


So, how exactly is demodectic mange diagnosed? As an average run-of-the-mill pet owner chances are pretty good that you will not be able to tell the difference between sarcoptic and demodectic mange. All you are going to see is that your dog is losing fur, covered in scaly skin, and has open sores. Your veterinarian will do a skin scraping to determine the exact cause of fur loss. Essentially your vet is going to gently scrap the dog's skin at different locations throughout the body. They will then create a slide and check for mites under a microscope. In the case of demodectic mange typically a large number of mites are present on the slide. The skin scraping will then be completed several times throughout the treatment process to insure that the treatment is working.

There is one other method used to determine if mange is effecting the dog. The pedal-pinnal reflex is tested by the examiner lightly touching the ear of the dog. If the dog has mites in its skin or ears the dog will move its foot in a scratching motion. However, this test doesn't definitely test for mange as it also will be positive for ear mites, and it cannot determine which type of mite is causing the mange.

That same Boston terrier puppy after several weeks of treatment.
That same Boston terrier puppy after several weeks of treatment.
Notice how the fur is starting to grow back in thin patches and all the crusty skin and open sores are gone.
Notice how the fur is starting to grow back in thin patches and all the crusty skin and open sores are gone.

If your vet recommended it would you use ivermectin to treat your dog for demodex mange?

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Veterinary medicine has come a long way in the last few years. Just a few decades ago dogs with generalized demodectic mange were considered untreatable. While it is true that some dogs have spontaneously healed from both localized and generalized mange it should not be expected. The best thing that can be done for a dog with either form of demodex is for them to be seen by a veterinarian and for the veterinarian to set up a treatment plan for the dog.

Localized demodectic mange can be treated with topical medications. Most often the same cleaning solution used on ear mites or a get containing benzol peroxide is used. Often the veterinarian prescribes these drugs and instructs them to be rubbed into affected areas at least once every day until the condition clears. Both of these drugs help to shorten the life of the mites. It is possible that the skin might look worse for a few days after starting treatment, but this is alright. The immune system of the dog is fighting as hard as it can against the mites and trying to heal the damage to the skin.

Generalized demodectic mange is much more difficult to treat. The veterinarian will prescribe shampoos and dips to help remove the scaly skin and kill the mites. Sometimes removing what is left of the dog's fur is necessary to have access to all infected areas. The shampoos and dips contain a strong insecticide called amitraz to kill the mites, currently this is the only miticide approved by the FDA for topical use on dogs.

There is also an oral medication that can be used to treat dogs with generalized demodectic mange. However, it is important to note that the FDA has not officially approved of its use in this form so any use of the medication is strictly off-label. Most often the drug of choice is ivermectin. This should sound familiar if you are a dog owner. This is because ivermectin is used in heartworm medications. The use of this drug for treating demodectic mange must be strictly monitored by a veterinarian because of the risks involved with using such high levels of the drug. Typically the dosage starts off low and gradually increases until it reaches a therapeutic level. Once it reaches a therapeutic level it is maintained until the dog has two negative skin scrapings for demodex mites.

It is extremely important to note that if ivermectin is not used properly it could result in the death of the dog. For this reason ivermectin therapy and heartworm medications cannot be used at the same time. It is recommend that a month long detox is needed before the dog can be safely put back onto a heartworm regimen. Interestingly enough most herding dogs, particularly collies (including boarder collies, shelties, Australian shepherds, and old English sheep dogs) are very susceptible to the side effects of large doses of ivermectin and should never be placed on an ivermectin treatment for demodex mange.

Secondary Problems

Infections in the skin should be treated as recommended by a veterinarian by antibiotics. It is important to note that some antibiotics and anti-itching medication will not be used since they run the risk of lowering the dog's immune system. Since demodex mange is only a problem because of a weak immune system these medications would be counter productive.

It is also recommend that dogs that do recover from demodectic mange should not reproduce. This is because they could pass on their weaker immune system to their offspring, thusly making their offspring more susceptible to demodectic mange.


With all the advances in veterinary technology the prognosis for demodectic mange is good. In fact most vets agree that a dog that has completely overcome the disease should never have a relapse, provided that the dog remains healthy. It is advised that the dog get regular skin scrapings as recommended by your veterinarian to insure that the mage does not come back.

With proper care your dog should be able to live a full and healthy life. Most, if not all, of the fur should grow back as well. Scar tissue doesn't often develop fur, but the rest of the dog's body should be covered in fur by the time the dog has been fully treated.

Financial Costs

If you have ever had a sick dog before it should come as no surprise that treatments can be expensive. Demodectic mange is no different, in fact it is going to be a long and expensive road to recovery. While localized mange can be cleared up fairly quickly with a little miticide shampoo and dips generalized mange is not so lucky. The treatment for generalized mange is going to last several months and coast several hundred dollars.

Click thumbnail to view full-size
The same Boston terrier nearly finished with treatment.Notice that nearly all of the fur has grown back, with the exception of the scar tissue.
The same Boston terrier nearly finished with treatment.
The same Boston terrier nearly finished with treatment.
Notice that nearly all of the fur has grown back, with the exception of the scar tissue.
Notice that nearly all of the fur has grown back, with the exception of the scar tissue.

In Conclusion

The main thing to keep in mind about the differences between demodectic mange and sarcoptic mange is that demodectic mange is an autoimmune disorder that does not affect dogs with healthy immune systems. Demodectic mange is a nasty disease that can effect dogs at any age, though it is more commonly seen in younger dogs. Thankfully, with all the advances in veterinary medicine it is possible that a dog can make a full recovery.

Further Reading:


VCA Animal Hospitals

WebMD for pets


This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

Questions & Answers


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      • isharkbait profile imageAUTHOR


        5 years ago from Virginia Beach, VA

        I did not know that ivermectin was used to treat horses. It makes sense though, its strong stuff. If you look at how much is in heartworm medication and how much is used to treat demodex it is crazy how much more is in demodex treatment.

        I know there are still shelters out there that will euthanize dogs that come in with bad cases of demodex. They just can't afford the treatment and can't put the time into treating the dog.

      • Ann1Az2 profile image


        5 years ago from Orange, Texas

        I'm so glad they found a successful treatment for the bad kind of mange - about 5 or so years ago, I actually saw a couple of dogs die eventually because of it and it's a miserable skin disease. I believe had they been my dogs, I would have had them euthanized rather than see them suffer. But as you say, the disease came and went, so there were periods where their hair and skin didn't look too bad, so I guess the owners figured they were getting better. I think they also might have thought it was a flea problem, but hey, after so many treatments for fleas, and the skin problem still exists, you would thing some people would get a clue!

        Also, you might find it interesting, in case you didn't know, that Ivermectin is a common treatment for worms in horses (in much bigger doses, of course!). It is one of the wormers that kills bots in horses also so when you worm them, it gets rids of several different kinds of worms, as well as bots. Many of the horse wormers do not kill bots so you have to give them two separate medicines.


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