Equine skin disease

A complementary medical approach for 5 common skin conditions in horses.

Veterinary clients and conventional practitioners often think of the horse’s skin as easy to heal since it’s on the outside of the body. However, skin is often the hardest organ to heal, and reflects internal as well as external health. In fact, most equine skin diseases need to be approached from a deep level of healing, and may take a long time to completely resolve. In this article, we’ll look at five common skin conditions in horses, and how a complementary medical approach can tackle them successfully.

Summer usually brings equine skin diseases to the surface, though some conditions are actually present year-round. Horses living in climates with warm humid summers often present with the most difficult skin diseases; these can continue through the winter months among many equines living in southern regions. In contrast, those living in more northern climates often have skin diseases related to the cold and damp conditions of winter.

Treatment can be frustrating from a conventional perspective, as drug selection is limited, but complementary medicine offers the practitioner many options. However, some cases can be very refractory to treatment, regardless of approach.

1. Sarcoids

Sarcoids are generally benign tumors that appear on the skin, sometimes at the site of a previous injury. They may have a bovine papilloma virus origin. Only locally invasive as a rule, they often will not spread or cause problems. In some cases, however, due to location or excessive growth, sarcoids need to be treated. Horse owners may find them unsightly or worry about them getting worse, and many sarcoids do progressively enlarge. Aggressive sarcoids can be bloody, have an odor, and behave like a cancerous tumor, although they seldom metastasize. Those in areas where tack can rub against them require treatment, as do those that are encroaching on the eyelids.

Conventional treatment includes surgical removal or cryosurgery, but both of these techniques often lead to recurrence, which can often be more aggressive than the original tumor. Several chemotherapeutic agents are used, again with variable results.

Complementary treatments include homeopathic medicine, herbal formulas, and topical applications of herbal preparations – see sidebar below. Some sarcoids appear to be aggravated in the first few weeks after vaccination, so it is helpful to reduce vaccinations and check titers so that only critical vaccines are given.

2. Hives

Hives are common in the equine world. Horses lie on the ground in places where plants with strong oils may grow, causing an allergic reaction in the skin. Many individuals — especially, but not limited to, light-colored chestnut or white-skinned horses — are sensitive to a range of potential allergens in the environment, and react by producing hives. Chronic hives are infrequent but can be difficult to treat conventionally.

Treatment for hives is often similar to that for pruritic skin conditions. Essential fatty acids, immune system support (but not stimulation), and appropriate herbal formulas will generally work well.

Homeopathic medicines are also effective for acute and chronic hives. An important key to arriving at a remedy is to ascertain the horse’s preference for either warm or cold compresses. For simple acute hives, if warm compresses ameliorate, Rhus toxicodendron can often be helpful; horses that prefer cool or cold water do well with Apis mellifica. Chronic cases require a complete history in order to be treated well with constitutional homeopathy.

3. Pruritic skin reactions

The most common equine skin cases that present to the veterinarian during the summer are allergic pruritic horses. Allergic reactions can be mild to severe, and range from itching without eruptions, to raw bloody eruptions.

Many factors can be involved, including pollens, foods, Culicoides mites, topical reactions to weeds, reactions to shampoos and detergents in saddle pads, as well as dust, molds and more. Allergy testing can be done, using skin tests for inhalant allergens, saliva tests for food allergens, and blood tests for both. However, with equine patients, it is impossible to remove many airborne allergens from their environments. It is much easier to change the terrain (i.e. the horse’s immune system) than to change the environment. A good history, with information about the onset of symptoms, can help determine the basic class of allergen (examples include tree pollens in the early spring, and ragweed in late summer).

Complementary medicine offers many possible solutions to treating allergic skin disease – see sidebar below. Simple cases may respond quickly to a single modality, but refractory or longstanding cases may require the treating veterinarian to have extensive training in homeopathy or herbal medicine.

Most allergic skin cases will benefit significantly from high levels of Omega 3 fatty acids, in the form of flax, hemp or chia seeds, either as oil or in seed form. Omega 3 fatty acids support and regulate the immune system. Flax and hemp oil or chia seeds can be supplemented at a rate of 2oz to 4oz per day, or whole seeds fed at 4oz twice per day. Naturally-stabilized ground seeds can be used; if the seeds are not stabilized, they will oxidize as soon as they are ground.

Additionally, most equine skin cases will respond best if prebiotics and probiotics are used to restore the microbiome, since the skin and gut are actually continuous structures that have a significant influence on one another. The horse’s history may reveal that he was on a course of antibiotics in the few years before the skin disease became a concern.

4. Rain rot

Rain rot (dermatophilosis), mud rash, and many other regional names are given to lesions on the back and lower legs. These are often seen in wet conditions, and frequently in colder climates and seasons.

Conventional treatment usually requires baths in an antimicrobial shampoo, and picking off the scabs that form. This can be problematic in cold wet conditions, as horses do not dry well and may become chilled. It also can be very painful to keep picking the scabs. More severe cases are usually treated with antibiotics, which affect the beneficial bacteria in the gut.

Homeopathics offer a simple solution that does not require bathing. For lesions on the back, oral remedies such as Tellurium, Sepia, Thuja, and occasionally Sulphur usually stop the infection in a week or so, then the scabs become dry and naturally fall off during grooming. For lesions on the legs, the more common remedies are Antimonium crudum, Graphites and Sulphur.

For horses, homeopathic remedies are dosed at about six to eight pellets of a 30C or 200C potency (strength), given once a day for three to seven days.  In many cases, three days at a time is enough for the response to begin; if there are still signs of tenderness at the lesions in two weeks, a second round of three days can be administered.

Topically, salves can help lessen soreness and promote tissue healing, but they are usually not the primary factor in curing the condition. Gentle topical essential oils in a water-based solution can also be soothing and help keep inflammation down, as well as treat secondary infections.

5. Scratches

Scratches are chronic lesions on the lower legs of horses. They’re most commonly seen in the winter, but different versions occur all year around and in different parts of the country. Scratches is known by local names such as greasy heel or mud fever. If the legs are white, the lesions may be from photosensitization, so be careful not to use herbs such as St. John’s Wort (Hypericum perforatum), which may aggravate the problem. Topical ointments of many different herbs are routinely used, but the most effective treatment strategy is to use an internal herbal formula to support immune function, along with high levels of Omega 3 fatty acids (flax, hemp, chia seeds) or homeopathic medicines.

It is best not to wash the lesions with soap every day, and pick the scabs off, as most clients are instructed to do. The skin needs to be allowed to heal, and scrubbing the it does not allow that. Water-based gels and creams or honey are better than lanolin or petroleum-based ointments because they allow the skin to breathe better. Ointments may help keep some moisture off horses turned out on damp pastures. A dilute solution of apple cider vinegar can be used to lower the pH, limiting the growth of bacterial or fungal infections secondary to the inflammation.

Effective ingredients for topicals include chaparral (Larrea tridentata), calendula, Pau d’arco (Tabebuia avellanedae), aloe vera, vitamin E (a natural source is best), comfrey (Symphytum officinale), lavender (Lavandula angustifolia), yarrow (Achillea millefolium), diluted tea tree oil (Melaleuca linariifolia), Echinacea, noni (Morinda citrifolia) and St John’s Wort (Hypericum perforatum). Other topical herbal salves can also be useful.

Homeopathics are especially effective in treating scratches, though a topical to keep the skin softer and more pliable while healing takes place is useful. Some of the most common remedies are Antimonium crud, Sulphur and Causticum, usually beginning with a 30C potency and repeating the remedy daily for a week to ten days.


Many equine skin conditions can be treated effectively with the use of complementary modalities. Consider complementary medicine for these cases, especially the refractory ones.

1“Treatment of clinically diagnosed equine sarcoid with a mistletoe extract (Viscum album austriacu)”. J Vet Intern Med. 2010 Nov-Dec;24(6):1483-9. doi: 10.1111/j.1939-1676.2010.0597.x. Epub 2010 Oct 12.

This article has been peer reviewed.


Dr. Joyce Harman graduated in 1984 from Virginia Maryland Regional College of Veterinary Medicine. She is certified in veterinary acupuncture and chiropractic and has completed advanced training in homeopathy and herbal medicine. Her practice in Virginia uses holistic medicine to treat horses. Her publications include The Horse’s Pain-Free Back and Saddle-Fit Book – the most complete source of information about English saddles.