Author TB Thompson DVM has been a licensed, practicing veterinarian since 2000.

So, you just found out about demodectic mange and now you’re having nightmares about bugs crawling all over your sweet pup? I get it, it’s a lot to take in! As a veterinarian who’s diagnosed and treated hundreds of dogs with demodicosis (red mange), I’m here to help you understand this condition.

Demodectic mange is a common skin issue in dogs that can get serious if left untreated. But don’t worry, with the right care, your dog can recover and get back to being their happy self. 

In this article, I’ll explain what demodectic mange is, how dogs get it, its symptoms, and how it’s diagnosed. I’ll also cover treatment options, tips for home care, and ways to prevent it from coming back. Let’s get started on helping your pup feel better!

What is Demodectic Mange and How Did My Dog Get It?

A Demodex mite is a cigar-shaped parasite that lives in a dog’s hair follicles. These mites are about 0.3 millimeters long and can’t be seen without a microscope. Experts believe the mites are transmitted from a mother dog to her puppies during nursing. 

Most dogs’ immune systems are able to control the mite infection well enough that they never cause any problems.

However, some dogs have an inherited immune system defect that allows the mites to multiply and cause skin symptoms. The tendency is lifelong in affected dogs, with outbreaks occurring during times of stress, immune-suppression and illness.

Demodex mites are not contagious to humans, other dogs or other animals. 

2 pit bulls sleeping, one has hair loss from mange
Classic patchy hair loss seen with Demodex.

Prevalence and Risk Factors

Demodectic mange is the most common type of mange affecting owned dogs in the U.S. One study of over a million dogs found 0.58% of dogs were affected by juvenile-onset generalized demodicosis.

This type of mange is often diagnosed in dogs under two years old but can occur at any age. 

Certain breeds including Staffordshire Terriers, Chinese Shar-Peis, Pit Bulls, Pugs, Boston Terriers, and English Bulldogs are more prone to developing demodectic mange.

Generalized demodicosis is more likely to occur in dogs with poor diets, inadequate shelter, intestinal parasites or other health issues. 

Symptoms and Diagnosis

The symptoms of localized demodectic mange in dogs are patchy hair loss, redness, and scabs. Unlike other types of mange, Demodex mites don’t typically make a dog itchy. 

Dogs with localized (early-stage) mange usually have one or two patches of hair loss 1-3 inches in diameter. These lesions often occur on the head and face. 

In more severe cases (generalized), it can affect a dog’s entire body. Symptoms of generalized demodicosis include

  • Widespread hair loss
  • Foul skin odor
  • Secondary bacterial and fungal skin infections
  • Enlarged lymph nodes
  • Lethargy and poor appetite

Testing by a veterinarian is needed to make a diagnosis of demodicosis. In most cases, a simple skin scraping sample is examined under a microscope to identify the mites. 

This quick and straightforward test can confirm if your dog has demodectic mange and help determine the best course of treatment.

black and white puppy with hair loss on top of head from mange
Typical early stage mange lesion on the top of a puppy’s head.

Treatment and Recovery for Demodectic Mange

Managing demodectic mange involves a combination of treatments to clear up the mites and support your dog’s recovery. Here’s a breakdown of the common treatments and what you can expect…

Topical Treatments

Topical treatments may be recommended for dogs with very mild lesions. They may also be used in addition to the prescription medications listed later.

  • Benzoyl Peroxide: This compound helps flush out hair follicles where Demodex mites live. For localized mange, 5% benzoyl peroxide gel may be applied to affected areas a couple of times a day. For generalized cases, your vet may recommend bathing with benzoyl peroxide shampoo.
  • Goodwinol Ointment: Contains rotenone, an insecticide that can help treat early-stage mange. 
  • Neem Oil: Derived from an evergreen tree, neem oil is mild and can be used for spot treatment or added to a medicated shampoo.
  • Medicated Shampoo: bathing with antibacterial/antifungal shampoo can help dogs that have secondary skin infections.

Prescription Medications

Oral medications are widely used to treat dogs with more than one or two Demodex lesions. Most dogs do very well with these drugs but you should always monitor for side effects and contact your vet if any arise.

DrugDescription
Isoxazoline (oral)Found in products like Bravecto® and NexGard®. Standard dosages are often effective to treat demodicosis. May cause seizures or neurological symptoms in some dogs.
Ivermectin (oral or injectable)Found in heartworm preventives such as Heartgard® but used at a higher dose for mange. Can cause neurological side effects in some dogs.
Milbemycin (oral)A drug used in heartworm preventives such as Interceptor® but used in higher doses to treat demodectic mange. Can cause neurological side effects in some dogs.

How Long Does It Take to Treat Dog Mange?

Dogs with mild to moderate demodicosis are often lesion-free after a few months of appropriate treatment. However, the recovery duration can vary based on the severity of the mange and your dog’s overall health.

Can Demodectic Mange Go Away Without Treatment?

Many dogs with one or two small Demodex lesions can recover without treatment. Consult your veterinarian about taking a “wait and see” approach.

What Is the Best Home Remedy for Dog Mange?

You might find suggestions to use apple cider vinegar, mayonnaise, coconut oil or even kerosene to treat mange. But the fact is, none of these home remedies are effective treatments for generalized Demodex mange. It’s a serious problem that needs treatment and veterinary supervision. 

However, you can use the following home care interventions to help your dog recover more quickly and avoid a relapse of mange.

Preventing Recurrence and Keeping Your Dog Healthy

Demodectic mange can recur, especially if underlying health issues or immune deficiencies are present. To prevent recurrence, maintain a healthy immune system and monitor your dog’s condition closely.

Here are some ways to support your dog’s general health

  • Preventive Veterinary Care: keep current on physical exams, vaccination, deworming and heartworm preventives.
  • Spay and Neuter: Since the tendency for demodicosis is inherited, it’s best not to breed dogs with the condition. 
  • Nutrition: Feed your dog high-quality food that meets AAFCO standards. Brands like Purina®, Iams®, and Royal Canin® are widely recommended by veterinarians for their nutritional balance and safety.
  • Minimize Stress: Common sources of stress include chronic exposure to extreme weather, parasites (fleas, ticks and intestinal parasites), and even boarding in kennels. 
  • Caution with Immunosuppressive Drugs: Immunosuppressive drugs such as steroids can bring about a recurrence of demodicosis in vulnerable dogs. Discuss options with your veterinarian.

Long-term Health and When to Seek Further Help

While most dogs recover well, some may experience long-term skin issues or recurring mange. Continued health management is key to preventing these problems.

Regular vet check-ups are essential to monitor your dog’s condition and adjust treatment as needed. Keep up with recommended vaccinations and preventive care.

If your dog’s condition doesn’t improve with treatment, or if new symptoms develop, contact your vet. They may need to reassess the diagnosis or adjust the treatment plan.

By following these guidelines, you can help your dog recover from demodectic mange and maintain their overall health.

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Photo credits CC BY 2.0:  Megan Ann and Anneheathen

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  1. Ferrer, L., Ravera, I., & Silbermayr, K. (2014). Immunology and pathogenesis of canine demodicosis. Veterinary Dermatology, 25(5), 427-e65.
  2. Mueller, R. S. (2012). An update on the therapy of canine demodicosis. Compendium (Yardley, PA), 34(4), E1-4.
  3. Six, R. H., Becskei, C., Mazaleski, M. M., Fourie, J. J., Mahabir, S. P., Myers, M. R., & Slootmans, N. (2016). Efficacy of sarolaner, a novel oral isoxazoline, against two common mite infestations in dogs: Demodex spp. and Otodectes cynotis. Veterinary Parasitology, 222, 62-66.
  4. Zhou, X., Hohman, A., & Hsu, W. H. (2020). Review of extra label use of isoxazolines for treatment of demodicosis in dogs and cats. Journal of the American Veterinary Medical Association, 256(12), 1342-1346.
  5. Plant, J. D., Lund, E. M., & Yang, M. (2011). A case–control study of the risk factors for canine juvenile‐onset generalized demodicosis in the USA. Veterinary dermatology, 22(1), 95-99.