🧫 Vet Guide 2025: Demodicosis (Red Mange) in Dogs – Mite Infestation, Symptoms & Treatment 🐶

By Dr Duncan Houston, BVSc

Demodicosis—also known as red mange or demodectic mange—is a skin condition caused by microscopic Demodex mites that live deep in the hair follicles of dogs. While a small mite population is normal for most dogs, certain individuals experience an overgrowth that leads to hair loss, skin infections, and sometimes systemic illness. In this 2025 vet guide, we’ll walk through symptoms, diagnosis, and modern treatments to get your dog back to happy and healthy. 🐾

🔍 What Is Demodicosis?

Demodicosis is caused by tiny Demodex mites that naturally live in your dog’s skin. Under normal circumstances, they go unnoticed. But when a dog’s immune system is weakened—due to age, stress, genetics, or illness—the mites can multiply uncontrollably. 🧬

📌 Common Signs:

• 🦴 Hair loss (especially around the face, paws, or body)
• 🔴 Red, irritated, or crusty skin
• 📈 Itching in some cases (especially when infection is present)
• 💥 Swelling and secondary skin infections
• 🌡️ Fever in severe or generalized cases

The disease ranges from mild, localized forms to widespread, severe cases. Early diagnosis and management are essential. 🩺

🔬 Diagnosis: How Is It Confirmed?

Demodicosis can mimic many other skin conditions, so testing is critical. Your veterinarian will typically perform:

• 🔬 Deep skin scraping: Scraping cells from affected areas to view under a microscope
• 📦 Hair plucks: Especially in paw lesions (demodectic pododermatitis)
• 🧪 Additional tests: For generalized cases, your vet may recommend screening for immune-suppressive diseases (e.g., cancer, hormonal imbalance)

📊 Types of Demodicosis

1️⃣ Localized Demodicosis

Usually affects puppies and presents as a few small, round bald patches, especially on the face. 🐶

• 🟢 Prognosis: Very good—90% of cases resolve without treatment
• 🩺 Monitoring: Watch for signs of spreading or worsening
• ⚠️ No more than 4 spots or 2 body regions affected

2️⃣ Generalized Demodicosis

This involves large body areas or the entire dog. Skin may be scaly, inflamed, and infected. 🩸

• 🧒 Juvenile-onset: Genetic immune issue common in young dogs
• 🧓 Adult-onset: Usually secondary to serious health problems
• 📉 May need long-term treatment or management

3️⃣ Demodectic Pododermatitis

Demodicosis localized to the paws. Commonly severe and difficult to treat. Often affects breeds like Shar-Peis and Old English Sheepdogs. 🐾

💊 Treatment Options

💠 Isoxazoline Products (Preferred Treatment)

These oral flea/tick medications are now frontline therapies for demodicosis:

• 🧪 Simparica® (sarolaner)
• 🧪 Bravecto® (fluralaner)
• 🧪 Nexgard® (afoxalaner)
• 🧪 Credelio® (lotilaner)

Typically given every 2–4 weeks. Most dogs respond quickly and completely. ✅

⚠️ Alternatives for Non-responders:

• 💊 Ivermectin (oral liquid – NOT safe for herding breeds)
• 💊 Milbemycin oxime (Interceptor®)
• 🧴 Moxidectin (Advantage Multi® – topical)
• 🛁 Amitraz dips (Mitaban® – rarely used today)

❌ Avoid: Oclacitinib (Apoquel®)

This drug suppresses the immune system and may worsen or reactivate demodicosis, even years later. Use only with extreme caution and under veterinary guidance. 🚫

📈 Monitoring Progress

Continue treatment until:

• 🔬 Two consecutive negative skin scrapings
• 📅 Lesions have fully resolved
• 💥 No signs of recurrence after a few months

Relapse can occur if treatment is stopped too soon. Re-checks every 2–4 weeks are standard. 🧠

🔁 Prognosis & Relapse

• 🟢 Puppies: Excellent prognosis, especially with early treatment
• 🟡 Adults: Variable – depends on underlying health status
• 🔴 Chronic or relapsing cases may require lifelong management

Maintaining a strong immune system is key: provide a healthy diet, reduce stress, and maintain regular deworming and heartworm prevention. 🥦💤

🐾 Breeding Considerations

Dogs with juvenile-onset generalized demodicosis should not be bred. The condition likely has a genetic basis, and breeding can pass susceptibility to puppies. Spaying or neutering is typically recommended once the condition is under control. 🧬

📲 Ask A Vet for Skin Help

If you’re unsure about a skin issue or need help managing demodicosis, use AskAVet.com for real-time vet advice 24/7. 🐕

The Ask A Vet App lets you:

• 📸 Upload photos of your dog’s lesions
• 💬 Chat with licensed vets for treatment guidance
• 📅 Track progress and medication reminders
• 🧠 Get advice on choosing safe flea/tick products

Better answers start with better access. 📱🐾

📝 Final Thoughts

Demodicosis may look scary, but with today’s treatments, it’s usually very manageable—and often curable. Early diagnosis, consistent treatment, and ongoing monitoring are your best tools. 🛠️

When in doubt, contact your vet or the team at Ask A Vet. Don’t let the mites win—help your pup reclaim their healthy skin and confidence! 🐶💚