Skin problems in animals are generally very difficult to cure using the conventional paradigm of “kill and suppress.” Treatments, including nutrition and supplements, that support repair and regeneration, and restore normal skin function, are a better approach.
The most frustrating skin problems integrative veterinarians see are chronic issues that have been treated by the conventional medicine paradigm of “attack and kill” (antibiotics) and suppressing the hyperactive immune system (steroids, antihistamines, chemotherapy). Unfortunately, these therapies offer no cure. Most medically-conscious pet owners, even without “being holistic” themselves, understand the likely outcome: no cure, side effects from drugs, and a lot of expense. These pet owners search the internet for advice or a holistically-minded veterinarian for a second or even third opinion.
After multitudes of conventional treatments that lead to no cure, where does one begin? Usually, after an onslaught of antibiotics, anti-fungal medications, steroids and antihistamines, the patient with skin problems is left to heal on their own. By this time, however, the skin has been sterilized, with a dead or dying microbiome in both the skin and digestive tract. Skin cells are unhealthy overall, and healing mechanisms and the immune system have been suppressed, making the patient more vulnerable to re-infection.
HEAL FROM WITHIN
Most of the focus in conventional veterinary treatment plans is on only the surface of the skin. Topical antibiotic ointments and steroid creams as well as immuno-suppressive drugs and injections are often prescribed to help suppress symptoms (inflammation, itchiness, and infection). To facilitate skin healing, however, it is important to consider nutrients obtained from the diet, as well as supplements, to support the individual needs of the patient.
Occasionally, veterinarians will recommend a “skin supplement” containing Omega-3 fatty acids and ground flax seeds. Integrative veterinarians might add evening primrose oil or hemp oil to decrease inflammation in the body and promote healing, and may also recommend vitamin, antioxidant, nutraceutical, and mineral supplements.
Veterinarians trained in TCVM (Traditional Chinese Veterinary Medicine) will add Chinese formulas to improve blood flow and energy circulation; improve detoxification and elimination of toxic by-products from metabolism, oxidative stress, and dead and damaged cells; and reduce inflammation.
DON’T TREAT THE DISEASE…TREAT THE PATIENT
Each skin problem is different, as is each patient. The tendency is to group similar symptoms into a category and give it a name (that does not explain the causative factors) such as atopic dermatitis. However, there are similarities among all the various acute and chronic skin problem patients:
• Most were raised eating puppy or kitten chow and have eaten commercial pet food and treats most of their lives.
• They do not get bathed enough with the proper shampoos.
• They are over-treated with harsh shampoos, anti-fungal drugs, antibiotics, and suppressive drugs.
• They take very few to no beneficial supplements to support skin regeneration and repair.
TREAT THE WHOLE ANIMAL
To create a successful treatment plan, it is important to consider the ailing pet’s overall condition: age, current medical problems, diet, supplements, current drugs, climate (temperature and humidity), geographical location (tropical vs. desert; mountainous vs. prairie; Northern hemisphere vs. Southern).
Most pets with skin problems have some underlying deficiency that has not been resolved: low thyroid hormones, lack of antioxidant-rich foods, impaired liver function, impaired digestion, nutritional deficits, and age-related problems (kidney and cardiac weakness) due to oxidative stress.
The most common supplemental deficiency is a lack of the appropriate number of antioxidants.
A REVIEW OF THE SKIN
The skin is composed of five cell layers (see Figure 1). Most skin therapies are focused only on this layer — i.e. the epidermis.
• The first layer, the stratum corneum, is made up of dead epithelial cells (think of scales) that protect the more sensitive inner layers from trauma, infection and inflammation. Among the cells of this layer live the beneficial bacteria, viruses, yeasts and fungi, as well as oils and acids (ecology of the skin) that make up the skin microbiome and form a barrier of protection against infection and trauma.
• Just underneath is the second layer, the stratum lucidum, which contains many immune system cells that function to remove foreign irritants, allergens, pathogenic microbes, metabolic wastes, and other toxins from the body at the surface level.
• The third layer of the epidermis, the stratum granulosum, provides “waterproofing” and moves keratinocytes from the stratum spinosum (fourth layer) into the upper layers of the skin to produce keratin, which is waterproofing and protective.
• The last layer, the stratum basale, creates and reproduces keratinocytes and transports these cells to the stratum spinosum. This layer supports the other epidermal layers and attaches them to the dermis.
The last three layers of the epidermis (stratum granulosum, stratum spinosum, and stratum basale) contain blood vessels, the lymphatic immune system, sensory nerves, and hormonal receptors.
The five layers of the epidermis form the “support team” of the body (Wei Qi) that expels “pernicious influences” (TCM) including toxins, pathogenic microbes, metabolic wastes, dead cells, allergens, and blood and skin parasites, and brings nourishment to the skin.
Topical medicinal herbal teas, shampoos, and lotions can best be utilized to treat and affect the first three layers of the epidermis. Oral medicinal herbs and functional supplements and foods will affect the health of all layers of both the epidermis and the underlying dermis. The dermis has very important functions that include providing strength and nourishment to the epidermis and restoring the skin to normal function. The dermis also contains hair follicles, sweat glands, sebaceous glands, nerve endings, and blood vessels.
WHAT’S THE TREATMENT PLAN?
Before a plan for “healing the skin” can be created, we have to consider what treatments have been used that might have caused a delay in healing (inflammation, infection, immune suppression) and possible nutritional deficiencies.
Problems arise with the use of strong chemical and antimicrobial shampoos, dips, ointments and salves, all of which are usually indicated to quell inflammation and kill pathogenic bacteria.
Although it is important to quell inflammation and control infections, veterinary topical ointments will too often suppress healing and cause an imbalance to the protective microbiome, increasing susceptibility to re-infection.
WHERE TO BEGIN
Many skin problems develop due to an underlying deficiency (weakness) that goes unnoticed. These deficiencies can include:
- Nutritional (minerals, vitamins, essential fatty acids, collagen)
- Depletion of vital energy due to oxidative stress (inflammation, cell death, metabolic toxins, DNA damage, organ dysfunction)
- Deficient detoxification system (lack of antioxidants, liver, spleen, kidney and/or digestive dysfunction)
- Immune system imbalance (hyperimmune responses, susceptibility to infection)
- Hormone system issues (hypothyroid, deficiencies of pregnenolone, DHEA, and cortisol)
- Deficiency of body fluids (Yin Deficiency); i.e. chronic state of dehydration (blood, cellular fluid, enzymes, collagen)
- Digestive problems, which cause issues with the absorption of nutrients essential for the skin as well as the body.
Optimal food and supplements
A healthy diet rich in antioxidants, carotenoids, zinc, selenium, Omega-3 and Omega-6 fatty acids, and B-complex vitamins, as well as high biological-value proteins is necessary for healthy skin. Whatever nutrients are missing in the diet should then be supplemented.
Whether your current treatment plan involves pharmaceuticals or herbs, concurrent administration of focused nutrition for the skin and antioxidants is essential.
Zinc-containing foods are probably the best way to administer this mineral to pets:
• Beef, lamb, pork, chicken
• Chickpeas, green beans
• Flax seeds
• Pumpkin, squash seeds
• Nutritional yeast
Vitamin A is important for skin healing. Most pets are deficient because they do not eat enough foods containing vitamin A and carotenoids. Sources of various forms of this vitamin include:
• Cod liver oil
• Fish: sardines, mackerel, anchovies, black cod, halibut
• Wakame seaweed
• Dandelion leaves, beet greens, carrots, collard greens, kale, broccoli, tomatoes, blue-green algae, spirulina — for beta, alpha, zeaxanthin, lutein, cryptoxanthin
• Squash, pumpkin
• Algae, seaweed, shrimp, salmon, red sea bream — for astaxanthin (BioAstin)
Nicotinamide (vitamin B3 niacin) protects against sun radiation and skin mutations and decreases inflammation in the skin and nails.1 Nicotinamide-rich foods include:
• Fish (tuna, salmon)
• Poultry (chicken and turkey breast)
• Pork, beef, liver
• Legumes (peas)
• Nutritional yeast
• Cereal grains (organic brown rice, wheat berries)
Vitamin C can be supplemented (doses necessary for skin healing range from 250 mg to 1,000 mg bid) but it is also available in certain foods such as raw bell pepper, tomato, papaya, dandelion greens, snow peas, and kale.
Essential fatty acids quell inflammation and speed up healing. Omega-3 GLA is found in evening primrose oil and borage oil.
Collagen will speed up the healing of wounds and skin and can be supplemented with hyaluronic acid, bone broth, glucosamine, noni, and gotu kola, as well as amino acids (proline, glutamate, arginine, and ornithine.)
Antioxidants are important for decreasing DNA damage to the skin, reducing inflammation, and supporting regeneration of new healthy skin cells. Antioxidants are commonly deficient in geriatric pets and those eating commercial pet foods. Antioxidant vitamins, flavonoids, essential oils, nitrogen-containing compounds (indoles, alkaloids, amines and amino acids), monoterpenes, and phenolic acids play the main role in preventing the oxidative stress that produces DNA damage to skin cells, increased inflammation, and the generation of more toxic free radicals (reactive oxygen species ROS) which are the main cause of numerous negative skin changes.
Improve the health of the digestive system
A healthy GI system is necessary for skin problems to clear up and heal.2 Pets treated with antibiotics, those with food sensitivities and/or allergies, or pets eating commercial processed foods need to take a probiotic.
There are many different types and bacterial strains of probiotics, so it is necessary to try another brand when results are not optimal. Use live strains whenever possible, such as Theralac (human brand) and/or Protegrity GI by Vet Classics.
The dysbiosis or imbalance of the digestive system microbiome and other dietary factors can have a negative influence on the skin’s microbiota, and upon keratinocyte regulation and homeostasis as well as skin barrier function.3
THE IMPORTANCE OF BATHING
Bathing is important for cleansing, detoxifying, and to repair, regenerate, and facilitate healing. Bathing every three to four days will improve skin and hair quality as well as control fleas and ticks.
The protective layer of the skin contains water-soluble compounds as well as lipids. The shampoo should not destroy these layers. Therefore, it is important to keep the pH of the shampoo between 6.5 to 7.5. A dog’s skin normally has a pH of 7.5.
To heal the skin, we must also quell inflammation and control the infection. In allergic pets, the immune system has become “hyper-sensitized” to allergens and responds with strong reactions (inflammation, itchiness, swelling). Mast cells, Th1 and Th2 cells, are primarily responsible for the inflammation and irritation because they have become hyper-stimulated to attack foreign compounds and allergens that pose a threat to the body by secreting histamines and acids. Quercetin, Omega-3, evening primrose oil (GLA), vitamins D, A, and C, vitamin B complex, turmeric, milk thistle, green tea, proanthocyanidins, and Chinese herbal formulas help control the reactions of the hyper-vigilant immune system.4
Toxins from pathogenic bacteria and fungi can cause inflammation, cell death, and swelling of the skin areas. It’s best if the infections can be controlled topically and without antibiotics, whenever possible.
Besides oral supplements, shampoos, lotions and salves can be of great benefit. Oil extracts of beneficial plants are good for dry skin as well as for longer duration of effects.
Teas and lotions (water, glycerin soluble) can benefit wound healing, rashes and infections. The pet owner can make a tea using some of the ingredients listed in the sidebar at left, and either add it to their current shampoo, or make a topical skin lotion, depending on the goals and focus of the treatment.
Rose glycerin can easily be made at home by collecting red rose flowers and steeping them in vegetable glycerin for about two weeks. The solution will turn a cranberry color. The rose flowers contain many antioxidants for the skin, and are antimicrobial.
Skin problems in general are very difficult to cure using the conventional paradigm of “kill and suppress.” What is missing in the conventional approach are treatments that support repair and regeneration and restore normal skin functions.
Deciding on a treatment plan after a patient has been treated with drugs and antibiotics by other veterinarians can initially be confusing to an integrative veterinarian. However, careful study of the patient’s history, along
with a thorough examination, lab testing, identifying and supplementing deficiencies, as well as restoring the microbiome of the gut and skin will generate a treatment plan that produces more positive results, and possibly a cure.
1Nicotinamide. Memorial Sloan Kettering Cancer Center (mskcc.org)
2Korać RR, Khambholja KM. Potential of herbs in skin protection from ultraviolet radiation. Pharmacogn Rev. 2011;5(10):164-173.
3Huang ZR, Lin YK, Fang JY. Biological and pharmacological activities of squalene and related compounds: potential uses in cosmetic dermatology. Molecules. 2009;14(1):540-554.
4Griffiths CE, Cumberbatch M, Tucker SC, et al. Exogenous topical lactoferrin inhibits allergen-induced Langerhans cell migration and cutaneous inflammation in humans. Br J Dermatol. 2001; 144(4):715-725.
5Katherine L. Brown MD Tania J. Phillips MD, FRCPC Nutrition and wound healing. Clinics in Dermatology Volume 28, Issue 4, July–August 2010;432-439.
6Fleck, Erin, Madigan, NMD., L.E., L.E.I. The Microbiome: Gateway to the Skin’s Ecosystem. Skin Inc. November 2020.
7Schmitt, Walter, H., DC, DIBAK, DABCN. The Immune System and Its Effect on the Brain and HPA Axis. August 23, 2014.