👂 Vet’s 2025 Guide to Equine Aural Plaques

By Dr Duncan Houston BVSc

1. What Are Aural Plaques?

Aural plaques—also called ear papillomas or papillary acanthomas—are grey-white, crusty, wart-like lesions that develop on the inner surface of a horse’s ear. These benign skin growths are caused by infection with Equus caballus papillomavirus (EcPV), and may coalesce into patches over time :contentReference[oaicite:3]{index=3}.

2. Who Gets Them?

• Seen in horses of all ages, breeds, or sex; often in adults over 1 year :contentReference[oaicite:4]{index=4}.
• Transmission is likely via biting insects—especially black flies—or direct contact :contentReference[oaicite:5]{index=5}.
• Most horses remain asymptomatic; a few develop head-shaking or ear sensitivity :contentReference[oaicite:6]{index=6}.

3. Recognizing the Signs

• Small 1–2 mm white nodules that may merge into larger rough patches :contentReference[oaicite:7]{index=7}.
• Pink inflamed skin beneath crusts; occasional hair loss in patches.
• Behavioural signs: mild ear sensitivity, head-shaking, ear-shyness when lesions are irritated :contentReference[oaicite:8]{index=8}.

4. Diagnosis

• Clinical diagnosis: visual exam of inner ear plaques :contentReference[oaicite:9]{index=9}.
• Optional biopsy: confirms papillomavirus infection via histopathology/PCR :contentReference[oaicite:10]{index=10}.

5. Treatment Options

5.1 Benign neglect

When plaques are not bothersome, no treatment is needed; some may even regress spontaneously over months :contentReference[oaicite:11]{index=11}. Ear protection from flies may help resolution.

5.2 Topical therapy (Imiquimod)

• 5% imiquimod cream stimulates a local immune response to clear lesions :contentReference[oaicite:12]{index=12}.
• Requires debridement under sedation and careful monitoring—can cause irritation or worsening head sensitivity :contentReference[oaicite:13]{index=13}.
• Treatment can take weeks to months and should be overseen by your vet.

5.3 Surgical removal

• Cryosurgery or careful excision under sedation may be considered for thick or persistent plaques :contentReference[oaicite:14]{index=14}.
• Some competition venues require removal for aesthetics—discuss with your vet.

6. Prognosis

Aural plaques are benign and do not affect overall health. Lesions may recur, especially with ongoing viral presence. Rarely, chronic plaques may progress to squamous cell carcinoma, so monitoring is advised :contentReference[oaicite:15]{index=15}.

7. Prevention Strategies

• Fly control is essential: fly masks with ear covers, repellents, stable screens :contentReference[oaicite:16]{index=16}.
• Insect-proof pastures and reduce biting insect habitat.
• Hygiene: avoid sharing tack/grooming tools without disinfecting with povidone-iodine :contentReference[oaicite:17]{index=17}.
• Experimental wart vaccines may reduce new cases, though widespread efficacy is not established :contentReference[oaicite:18]{index=18}.

8. Managing Ear Sensitivity

• Protect ears; avoid harsh handling and abrasive grooming.
• Stop treatment if sensitivity or head-shaking worsens—plaques may be better managed conservatively.

9. Ask A Vet Support 🩺

With Ask A Vet, owners can:

• Upload high-resolution photos for lesion evaluation.
• Get tailored fly-control plans and topical protocols.
• Receive follow-up on head-shaking, sensitivity, treatment side effects.
• Review show or competition readiness concerns.

Download the Ask A Vet app today for attentive guidance on ear‑health and comfort into 2025! ❤️

10. Quick Reference Table

11. Final Thoughts

Aural plaques are common, benign, and largely cosmetic—but can lead to head-shaking or ear sensitivity if irritated. With attentive fly control, selective treatment, and protective care, most horses stay comfortable and show-ready. Ask A Vet offers expert support, step-by-step protocols, and reassurance for ear-health into 2025 and beyond. ❤️