It can be really tough to watch your beloved dog constantly scratch, lick their paws, or rub their face. If these behaviors are persistent and are affecting their quality of life, your pup might be dealing with atopic dermatitis. It’s one of the most common skin conditions affecting dogs today.
With the right treatment plan, atopic dermatitis can be managed successfully. Let's explore what the condition looks like in dogs, why it happens, and how you can help your furry friend find relief.
Key Points About Atopic Dermatitis in Dogs
- Atopic dermatitis is a chronic, itchy skin condition that affects around one in ten dogs, and is caused by an overactive immune response to environmental allergens.
- Gut health plays a crucial role in atopic dermatitis, as 70-80% of a dog’s immune cells live in their digestive tract.
- Interestingly, transferring beneficial bacteria from healthy dogs to dogs with atopic dermatitis is shaping up to be a promising treatment strategy.
- New research reveals a well-known probiotic strain may help to both relieve atopic symptoms and prevent the condition from developing in puppies.
- If successful, probiotic supplements and microbiota transplants could replace the current treatments for atopic dermatitis, which often come with a range of unwanted side effects.
What Do We Know About Canine Atopic Dermatitis?
Atopic dermatitis (often called AD for short) is a hypersensitivity disorder in which a dog's immune system overreacts to everyday substances like pollen, dust mites, or mold.
Dogs are primarily exposed to these usually-harmless allergens through their skin. For most dogs, allergen exposure has no immunological effect. But in atopic dogs, skin contact triggers an allergic reaction and an overproduction of IgE antibodies. This creates skin inflammation that leads to itchiness, redness, and other uncomfortable clinical signs.
Even though atopic dermatitis is relatively common, veterinarians still don't completely understand why it develops. It's a challenging condition to treat because it is a long-term condition that flares up unpredictably. In addition, every dog's skin reacts differently to different allergens.
When severe, atopic dermatitis can deeply impact a dog's comfort and daily life. Treatment can become a frustrating journey for dog parents, and finding the right combination of interventions often takes time and patience.
Interestingly, the connection between atopic dermatitis and the gut microbiome is now being considered as a potential tool to treat the condition. After all, atopic dermatitis is an allergic skin disease caused by a dysfunctional immune system, and 70-80% of immune cells live in the gut (more on this in a bit!).
Causes of Canine Dermatitis
Atopic dermatitis can be triggered by a wide variety of environmental allergens that vary by season and geographic location. Common culprits include:
Seasonal allergens:
- Mold spores
- Tree, grass, and weed pollens
- Seasonal changes in humidity
Year-round allergens:
- Storage mites
- House dust mites
- Environmental molds
- Human and animal dander (microscopic skin cells shed from the body)
A Note on Diet and Atopic Dermatitis
While environmental allergens are the primary triggers for atopic dermatitis, food allergies and sensitivities can also play a role in some dogs. Food-induced atopic reactions typically develop separately from environmental allergies, but they can complicate diagnosis and treatment. Read more about food allergies and intolerances in dogs here.
Diagnosing Canine Atopic Dermatitis
The most telltale dermatological sign of atopic dermatitis is persistent, excessive itchiness (pruritus). A formal diagnosis must be made by a veterinarian, but here are some things to watch out for:
- Scratching behind the elbows and in the armpit areas.
- Persistent paw licking and chewing.
- Face and ear rubbing against furniture or carpets.
- Excessive grooming or licking of the belly and groin area.
- Redness in affected areas.
- Hair loss (alopecia) from constant scratching and licking.
- Brown discoloration of fur from saliva staining.
- Inflamed, moist, or broken skin.
- Recurrent ear infetions (otitis).
Researchers from the College of Veterinary Medicine at North Carolina State University provide helpful pictures and diagrams of typical atopic dermatitis in their 2010 publication.
Commonly Affected Areas
Atopic dermatitis in dogs commonly occurs on the face, ears, and ear canals, as well as the paws, armpits, belly, and groin areas. These locations tend to have thinner skin and a denser concentration of hair follicles, making them more susceptible to allergen penetration.
Breeds at Higher Risk of Atopic Dermatitis
While any dog can develop atopic dermatitis, certain breeds have a genetic predisposition. These include Bulldogs, Golden Retrievers, Labrador Retrievers, German Shepherds, Boston Terriers, West Highland White Terriers, Shar Peis, and Boxers.
Atopic dogs typically start to show symptoms between 6 months and 3 years old. This early onset helps distinguish atopic dermatitis from other cutaneous (skin) conditions that might develop later in life.
Secondary Complications of Atopic Dermatitis in Dogs
One of the most challenging aspects of managing atopic dermatitis is dealing with the secondary infections that develop when the skin barrier is compromised. Let’s take a quick look at the two most common ones.
Malassezia Overgrowth
Malassezia pachydermatis is a yeast that naturally lives on a healthy dog’s skin in controlled numbers. However, in dogs with atopic dermatitis, Malassezia often becomes overabundant. These pups can then develop a distinctive odor that smells like rancid fat or bread yeast.
In addition to the unpleasant smell, Malassezia overgrowth triggers more inflammation, making a dog’s skin more susceptible to further yeast infections. This creates a frustrating (and uncomfortable) cycle.
Your veterinarian can easily check for yeast overgrowth by pressing clear tape against the affected skin areas to collect a sample. The tape is then examined under a microscope. Malassezia has a characteristic oval or peanut shape, enabling easy identification.
Bacterial Infections
Constant scratching and a damaged skin barrier make atopic dogs more prone to secondary skin infections, particularly by Staphylococcus bacteria. These infections can cause additional redness, pimples, and discomfort, all of which compound the original itching problem.
Treating Atopic Dermatitis in Dogs Requires a Multi-Pronged Approach
"When tackling a condition as complex as atopic dermatitis, it's crucial to take a multi-pronged approach,” says AnimalBiome’s Chief Science Officer, Dr. Holly Ganz. This means pet parents may need to combine several care options that work together for the most effective relief.
Ideally, a treatment strategy should be individualized to each dog. Current treatment options typically involve a combination of calming inflammation and limiting exposure to environmental allergens.
Before starting treatment, pet parents should try to minimize allergen exposure. Intradermal allergy testing can identify common culprits that cause allergic dermatitis, but it is also important to discuss flea control, mitigation of house dust mites, and other potential triggers with your vet.
Controlling Secondary Infections First
Until any secondary infections are under control, other atopic dermatitis treatments will not be as effective.
Your veterinarian might prescribe antibiotics such as cephalosporin for Staphylococcus skin infections, or antifungal medications like itraconazole for Malassezia problems. For localized skin infections with pus (called pyoderma), topical treatments applied directly to the affected area may be more effective than oral medications.
However, these treatments come with an important consideration, because while antibiotics and antifungals can clear up infections, they also affect the beneficial bacteria that normally live on your dog's skin and in their gut. This can sometimes lead to treatment-resistant infections down the road, which is why many veterinarians are favoring approaches that support the body's natural defenses rather than just indiscriminately eliminating large groups of bacteria.
Managing Itching and Inflammation
Once secondary infections have been treated, several medication options are available to help control itching and inflammation.
Topical Therapies
Specialized shampoos, conditioners, and spot-on treatments containing ceramides, essential fatty acids, and other skin-supporting ingredients can help strengthen the compromised skin barrier associated with atopic dermatitis. Regular bathing with appropriate medicated products can remove allergens from the skin surface, reduce bacterial and yeast populations, and provide soothing relief. Topical glucocorticoid creams and sprays can provide targeted anti-inflammatory relief for smaller, localized flare-ups.
Traditional Oral Medications
Antihistamines, corticosteroids such as prednisolone, and immunomodulating drugs like cyclosporine (Atopica) remain important tools in managing atopic dermatitis. However, long-term use of these requires careful monitoring, as the side effects of immunotherapy drugs can be problematic.
Kinase Inhibitors
Newer medications like oclacitinib (Apoquel) target specific pathways involved in itching and inflammation to help your dog find relief. These tend to work quickly and have fewer gastrointestinal side effects than the older, more traditional medications above.
However, because veterinarians don’t have much data on the long-term effects of oclacitinib, dogs may need careful, ongoing monitoring while they are taking the drug. It’s important to keep in mind that atopic dermatitis is a lifelong diagnosis, so there may come a time when the drawbacks of drugs like these will outweigh the benefits.
Newer Biological Therapies
Treatments such as lokivetmab (Cytopoint) use monoclonal antibodies to target specific inflammatory molecules, providing relief for many dogs with fewer systemic side effects. Cytopoint is an injectable medication that is administered by a veterinarian (DVM) every four weeks.
Allergy Testing and Allergen-Specific Immunotherapy
Allergen-specific immunotherapy can alter the immune response and help prevent atopic dermatitis from developing. It starts with intradermal testing (IDT) or a serum allergy test, then involves gradually desensitizing your dog's immune system to specific allergens through regular injections or oral medications. While allergen-specific immunotherapy can be effective, it is one of the most expensive options.
The Gut-Skin Connection: A Revolutionary Approach
There’s good news in the treatment of atopic dermatitis: We're learning about supportive options that work with your dog's natural immune system.
Since atopic dermatitis involves an overactive immune response, and the vast majority of immune cells live in the digestive tract, researchers have found that supporting gut health can have profound effects on atopic dermatitis — without the problematic side effects of many traditional therapies.
The Gut-Skin Axis and Atopic Dermatitis
Scientists are still determining exactly how the gut and skin communicate, but there's plenty of proof that they're connected. For example, human studies show that giving Lactobacillus probiotics to young children can help prevent them from developing atopic dermatitis later in life. Many other studies have also found links between unhealthy gut bacteria and atopic disorders in both humans and dogs.
Researchers have many theories on how gut health affects atopic dermatitis. After all, it is an allergic skin disease caused by a dysfunctional immune system, and 70-80% of immune cells live in the gut. It’s believed that:
- Imbalanced (dysbiotic) gut bacteria cause inflammation, which can trigger immune system overreactions throughout your dog's entire body, including their skin.
- A dysbiotic gut can contribute to improper immune function and increased intestinal permeability (a factor associated with food allergies), which can manifest as atopic dermatitis.
So, we now know that building healthy gut bacteria is a critical step in both preventing and treating atopic dermatitis.
Innovative Gut-Based Treatments
This research has led to exciting new treatments, which are crucial because many conventional treatments may actually worsen the bacterial imbalances associated with atopic dermatitis.
In contrast, promoting balanced bacterial communities offers a long-term strategy that can positively impact multiple aspects of your dog's health. These over-the-counter treatment options include:
🦠 Targeted Probiotic Support
Just like in humans, Lactobacillus probiotics may help to alleviate atopic dermatitis symptoms in dogs. The gentle probiotic can be used as part of a care program for all dogs with atopy.
Lactobacillus may also help prevent atopy from developing in the first place — so if you have a puppy that’s genetically predisposed to atopy, it’s an especially good idea to start them on this probiotic early.
💩 Fecal Microbiota Transplants (FMTs)
A growing body of scientific evidence suggests that FMTs can be a successful treatment option for many diseases, including atopic dermatitis. Oral FMT capsules allow you to transfer bacteria from a healthy dog to an atopic dog, quickly introducing a complete community of beneficial bacteria to their gut.
For an example of how impactful FMT capsules can be in the treatment of atopy, read Zuki the rescue dog’s story here. And, this link will take you to FMT capsules for dogs.
🔬 Gut Microbiome Testing
You don’t have to wonder if your atopic dog’s gut health needs help — now, you can test it! A simple, at-home microbiome test can identify bacterial imbalances that might be contributing to immune dysfunction and skin problems. A deeper understanding of your dog’s microbiome can help guide more targeted interventions. Learn more about the microbiome tests here.
Living with Atopic Dermatitis: Quality of Life Considerations
If your dog struggles with atopic dermatitis, it’s important to set realistic expectations. It is a lifelong condition, and even the best treatment isn’t likely to eliminate all symptoms. But, it is possible to keep itching and inflammation at manageable levels that don't interfere with your dog's well-being.
With a combination of new medications, limited allergen exposure, and supported gut health, most atopic dogs can live comfortable, happy lives.
FAQs
What foods cause atopic dermatitis in dogs? Atopic dermatitis is primarily triggered by environmental allergens rather than food. However, some dogs may have concurrent food sensitivities that can worsen symptoms. The most common culprits of food sensitivities in dogs include chicken, beef, dairy, wheat, and eggs. If food sensitivities are suspected, your veterinarian can guide you through an elimination diet trial to identify specific triggers.
Does Zyrtec help with atopic dermatitis in dogs? Antihistamines like cetirizine (Zyrtec) may provide mild relief for some dogs with atopic dermatitis, but they're generally not as effective in dogs as they are in humans. Most dogs with atopic dermatitis require more targeted treatments like gut health support, immunotherapy, kinase inhibitors, or biological therapies for significant relief. Always consult your veterinarian before giving any human medications to your dog.
What is the new treatment for atopic dermatitis in dogs? Recent advances include biological therapies like Cytopoint, which uses antibodies to target specific inflammatory molecules, and improved kinase inhibitors that more precisely target itch pathways. Additionally, there's growing interest in microbiome-based therapies, including probiotic treatments and fecal microbiota transplants, which address the gut-skin connection that underlies immune dysfunction.
Can I use coconut oil on my dog for atopic dermatitis? While coconut oil has some antimicrobial properties, it's not an effective treatment for this pruritic condition and may actually clog pores or cause additional skin irritation in some dogs. Specialized veterinary skin barrier repair products containing ceramides and essential fatty acids are more effective for supporting compromised skin. Always consult your veterinarian before applying any topical treatments to your dog's skin.