🐴 Vet Guide 2025: Treating Pastern and Heel Dermatitis in Horses for Faster Recovery 🌧️🩹

Author: Dr Duncan Houston, BVSc

Pastern and heel dermatitis—commonly known as "scratches"—is a frustrating and painful condition frequently affecting horses. Often caused by prolonged exposure to wet and muddy environments, this skin inflammation targets the heel and pastern just above the hoof. With the right care and veterinary guidance, even the toughest cases can be successfully treated and managed. Let's explore the 2025 guide to healing this stubborn equine skin issue. 🐎💧

🔍 What Is Pastern and Heel Dermatitis?

This condition involves inflammation of the skin at the heel and pastern region of horses. It's also known by other names such as:

• 🐾 Scratches
• 🌿 Greasy heel
• 🧬 Mud fever

It typically develops when the skin in these areas becomes excessively moist or muddy, leading to softening and breakdown of the skin barrier. Horses with long feathers (longer hair) are particularly at risk, as the area retains moisture more easily. 💦

🌧️ Causes and Contributing Factors

The root causes can vary but often include:

• 💦 Prolonged wet or muddy pastures
• 🦠 Bacterial or fungal infections
• 🕷️ Parasites, such as mites
• 🌿 Irritants in plants or chemical exposure
• 🧬 Autoimmune or allergic reactions

It's not always a simple diagnosis—this condition can involve multiple pathogens or external irritants, making thorough veterinary evaluation essential. 🧪

🧪 Diagnostic Steps by Your Veterinarian

Effective treatment starts with accurate diagnosis. A veterinarian will usually perform:

1. 🔬 Skin cultures to detect bacterial or fungal presence.
2. 🕵️‍♂️ Skin scraping to rule out mites or parasitic causes.
3. 📋 Physical exam to assess severity and extent.

This step is vital before starting treatment, as using the wrong medication may worsen the issue. 🧬🧴

🧼 Step-by-Step Treatment Guide

1️⃣ Clip and Clean

All hair in the affected area must be carefully removed. This prevents moisture retention and allows better contact with medications.

Tip: If scabs are thick or painful, sedation may be necessary for safe cleaning. 🐎💤

2️⃣ Soak and Remove Scabs

Soak the skin with a veterinary-approved antibacterial scrub (such as chlorhexidine or povidone-iodine) for several minutes.

• 🧼 Gently soften the scabs.
• 🧤 Remove carefully to avoid pain or bleeding.

3️⃣ Apply Medication

After scab removal, apply a topical antibiotic-cortisone cream. This helps to:

• 💊 Reduce inflammation
• 🛡️ Kill bacteria
• 💧 Promote healing

Common ingredients: Neomycin, bacitracin, or hydrocortisone. Always use under veterinary advice. 🧴

4️⃣ Wrap the Area (Initially)

Wrapping helps the medication stay in place and protects the wound, but should only be done in the early phase:

• 🩹 Use non-stick dressings
• 🔁 Change daily or every 2–3 days

Once swelling and infection subside, discontinue wrapping to avoid moisture buildup. 🌬️

5️⃣ Oral Antibiotics (If Needed)

For moderate to severe infections, oral antibiotics may be prescribed to control deeper tissue involvement. 💊

🚫 What to Avoid

• ❌ Leaving scabs in place—they harbor bacteria and block healing.
• ❌ Continuing wraps too long—they trap moisture and worsen the issue.
• ❌ Applying random creams without diagnosis—can cause resistance or irritation.

🌿 Preventing Recurrence

To reduce the risk of future flare-ups, consider these steps:

• ☀️ Keep pastures dry and well-drained
• 🧼 Clean legs after muddy rides
• ✂️ Trim long pastern hair regularly
• 🐾 Use protective boots in wet grass (if appropriate)

📆 Long-Term Management

Pastern and heel dermatitis can become chronic if left untreated or improperly managed. Horses with recurring issues may need:

• 🔁 Rotational turnout to avoid muddy paddocks
• 🧴 Preventative barrier creams in wet seasons
• 🔍 Regular checks during grooming

🧠 Equine Health Tip from Dr Duncan Houston

“Always treat pastern and heel dermatitis early. Don't assume it's just ‘mud.’ Proper cleaning, diagnosis, and consistent care will save your horse from unnecessary pain and prolonged healing.” 🐴🩺

🔚 Final Thoughts: Empowering Horse Owners in 2025

Pastern and heel dermatitis may seem minor, but it's a condition that demands serious care. With 2025 veterinary advancements and proper at-home practices, you can protect your horse from painful flare-ups and long-term complications. 💡

Need expert help fast? Visit AskAVet.com or download the Ask A Vet app for instant advice from trusted professionals. Your horse deserves it! 📲🐎