Feature Article


Skin Problems! What Are Your Alternatives?

Skin problems can be just as frustrating to the owner as they are to the horse.

By Frances Fitzgerald Cleveland

A horse's skin breathes, radiates, flutters at your touch and protects. It signals you that there are imbalances within its system - internally or externally. So how will you treat these imbalances? One way is a holistic approach. Why? Well, let's look at the horse's skin first.

The horse's skin is its largest organ, ranging from 12 to 24% of the animal's weight, depending on age. There are three major layers that make up the skin. These various cellular and tissue components consist of the epidermis, dermis and subcutis.

The outermost layer of skin is the epidermis and it is avascular, meaning it lacks blood vessels. Within the epidermis are three major cell types: the majority of cells are composed of keratinocytes, which manufacture the keratin in the skin. The other major cell types in the epidermis are the melanocytes, which produce skin pigment, and langerhans cells, which are responsible for generating immune responses in the skin. They do this by processing antigens in certain hypersensitivity states, such as an allergic reaction or contact dermatitis. This is the layer where you will find the major epidermal appendages such as hair, hair follicles, sebaceous glands and sweat glands. (These appendages also extend down to the dermis.)

The next layer, the dermis, is the thickest major layer, which provides the skin with most of its bulk. It is made up of connective tissue fibers that consist of 90% collagen, which is the major protein constituent of the dermis, and 10% elastin, which provides the skin with its suppleness and elasticity.

Finally, the third and innermost major layer of the skin is the subcutis, also called the hypodermis. The subcutis is composed of fat cells and thin strands of collagen-containing connective tissue. Within this layer the nerves and blood vessels supplying the skin weave their way through the strands of connective tissue to reach the dermis that lies above it.

This intricate composition of cells, tissues, chemicals, blood, nerves and energy is simply called skin. Yet, it has one of the most important jobs of the horse's body - protector. Your horse's hair provides mechanical protection and acts as a filtering system and insulator. The superficial layer of the epidermis with its highly developed, tough, durable, flexible membrane acts as a chemical and waterproofing structure. The skin provides protection from the sun's rays and it regulates the horse's temperature through its sweating mechanism. The skin tells you if the horse's immune system is out of balance. "If you see an allergic reaction skin problem on a horse, you know the whole immune system is overreacting," comments Dr. Allen Schoen, author of the newly released book, "Kindred Spirits".

With an allergic reaction the immune system is overreacting to an allergen and manifesting in the skin. A way to treat this situation is holistically. What does holistic mean? Webster's Dictionary defines it as, 'incorporating or identifying with the principles of holism; pertaining to or using therapies outside the mainstream of orthodox medicine', such as chiropractic, homeopathy, Traditional Chinese Medicine (TCM) or aromatherapy. A commonly used description of holistic is to consider the entire being, in body, mind and spirit. How can this pertain to the skin? Let's look at hives (urticaria). When a horse breaks out in hives all over his body we often view it as a physical problem. Another question to ask yourself is, "Is the horse under stress?" Dr. Schoen says, "A horse can appear more nervous or agitated with hives as the skin is more hyperirritable."

Horses might be confronted with a number of skin problems. They may encounter bacterial skin diseases, such as rain rot or scratches, also known as dew poisoning. There are fungal skin diseases such as ringworm. Horses also suffer from warts, a viral skin disease, parasitic skin diseases such as mange (scabies), lice, and midline dermatitis. Some horses suffer from saddle sores, sarcoids (benign skin tumors), dandruff, photosensitization, itchy skin and as mentioned before, allergic skin reactions, such as hives and sweet itch (an allergic reaction to the bites of tiny insects belonging to the genus culicoides, midges, no-see-ums).

Skin problems are challenging and the examples above are no exception. Holistic professionals agree - it is important to understand that there is more than just a cosmetic or superficial problem occurring; some of these skin problems can indicate an internal problem.

"Skin diseases are the most challenging problems in the veterinary practice. The challenge is partly related to the unique anatomy and physiology of the integument. The skin is the boundary between the inside of the animal's body and the external environment and plays a unique role. A skin disease is just a sign of a body with internal disorders," says Dr. Huisheng Xie, DVM, PhD, MS, a clinician of Veterinary Acupuncture and Chinese Medicine, Veterinary Medical Teaching Hospital, University of Florida.

When considering your horse and his skin problems, it is important to look at his entire system. "Many skin conditions originate with digestive or immune problems," states Dr. Madalyn Ward of Bear Creek Clinic in Austin, Texas. The skin can be looked at as a complex gauge of your horse's general health.

For this reason, one should look at the horse and his skin disorder holistically. "The joy and frustration of holistic medicine is that every animal is an individual and you need to treat everyone differently," says Dr. Joyce Harman of Harmany Equine Clinic in Washington, Virginia.

Your choices are many when considering various holistic modalities, a holistic veterinarian or practitioner. A few of your choices are homeopathy, nutrition, acupuncture, Traditional Chinese Medicine (TCM), herbs or aromatherapy. What are these modalities, how do they work, and how does one find a holistic veterinarian or practitioner?

Homeopathy & Nutrition


According to Dr. Ward, "Homeopathy is a system of medicine based on the principle that 'like cures like'." Samuel Hahnemann, the father of homeopathy, was the first person to purposely utilize this method of treatment. Hahnemann began to treat patients according to the principle of using minute doses of the medicines. He discovered that they would not only respond, but would have few of the side effects that were so common to the medications used by more conventional practitioners. He theorized that the homeopathic remedies, in their minute doses, carefully selected to match the patients' symptoms, gave the body the information it needed to heal itself.

There are over 2,000 known homeopathic remedies made from animal, vegetable or mineral sources. Therefore, it is important when considering homeopathy for your horse to find a person qualified in homeopathy. It is essential the practitioner conduct a thorough evaluation of your horse and his skin problem. "It is very complex to treat skin problems; there is no nice formula out there," says Dr. Harman. "Homeopathy is very tailored to the individual animal so the more history you get the better off you are. The reason for this is because you are working with the horse's immune system and this is a very complex system. The goal is to stimulate and balance the immune system, not over-stimulate. You have to look at the animal in a holistic way in order to choose the remedy." says Dr. Harman.

Looking at your horse holistically considers his past history, personality, and injuries. Old scars, for example, could indicate that the horse was on antibiotics at one time and as a result the horse's stomach is out of balance. If that were one of the issues, then both Dr. Harman and Dr. Ward would consider a probiotic for the horse. It is also important to discuss if the horse is receiving a nutritionally balanced diet. "In my practice hives is the most common skin condition I see. Hypersensitivity to insects is a close second. Homeopathy and nutritional support will help almost all of these cases," says Dr. Ward.

Dr. Ward goes on to say, "Hives respond well to diet management and the addition of a high quality human grade probiotic and digestive enzyme. It can take 1 to 3 months to see a significant improvement. Hypersensitivity may take several years to clear completely. I have had good results when holistic treatment was used. Management is a very important factor and can limit results - for example, if a horse is allergic to molds and still has to live in a damp barn."

Dr. Ward and Dr. Harman both use homeopathy when dealing with horses and their skin problems. Because homeopathy is individually specific it would be impossible to list the remedies. "Homeopathy is tailored to the individual, and there are 20 to 30 commonly used remedies to choose from, therefore I would hate to give a list because they are so case specific," says Dr. Harman.

Both doctors agree on the importance of providing nutritional support to your animals. Nutritional supplements help support the immune system. Dr. Ward suggests Blue Green Algae, probiotics and Cell Tech Original Enzymes. For more information on how to use these products you can contact Dr. Ward at her website and Cell Tech's Website, which are listed at the end of this article.

Dr. Harman suggests whole grains as part of the diet, Rush Creek Minerals free choice by Advanced Biological Concepts (ABC), and Pro-Bi also offered through ABC. If you want to give your horse free choice salt, you can offer them sea salt. The Grain & Salt Society offers an agricultural salt and ABC offers a free choice salt. "Free choice minerals are better than the red salt blocks we all throw out for our horses," says Dr. Harman. The red salt blocks are 95% salt and 5% minerals and they don't get all the minerals they need from that salt block," she explains. She also finds that if there is a problem with your horse's immune system it will crave and eat a lot of minerals to repair the body.

Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (TCM) is a term used to describe a system of medicine developed and practiced in China. The earliest written records of TCM date back 3,500 years. It is a modality that works on the principles and concepts of balancing a pair of opposites (Yin and Yang), and Qi, the vital force or life force, which is both energy and matter. It believes disease may be caused by internal and external factors. It involves the use of acupuncture, herbs, and more.

Dr. Xie says, "Traditional Chinese Medicine approach is to emphasize that the body is an organic holistic one. The TCM practitioner has to identify the etiology, the location of the lesion, the pathologic changes and body conditions by analyzing and summarizing the patient's symptoms and signs." It is up to a qualified TCM practitioner to discern this information.

"To identify a TCM diagnostic pattern involves discerning the underlying disharmony by considering the picture formed by all the symptoms and signs," says Dr. Xie. "Rather than analyzing these symptoms and signs one by one, Traditional Chinese Medicine forms an overall picture by taking all the symptoms and signs into consideration."

Dr. Xie expresses that he sees two categories of equine cases with skin problems: the first being the patient who fails to respond to conventional medicine, and the second, owners who want to pursue complementary therapies including TCM. Two examples he gives of the complementary approach are in his treatment of urticaria (hives) and skin allergies.

Dr. Xie describes urticaria (hives) as skin hypersensitivity disorder mostly associated with a variable of allergens. If the allergen cannot be identified or avoided, he proceeds with his TCM herbal treatments. "Urticaria is called 'Lung Wind Heat Pattern' (or fei feng huang) in TCM. Lung Wind Formula is designed for this condition and has been used since the Ming Dynasty (about 600 years ago). Ingredients in this herbal formula include scutellariae root, gardeniae fruit, artemisiae, dioscoreae stem, anemarrhenae rhizome, fritillariae bulb, coptidis root, phellodendri bark, forsythiae fruit, rhubarb root, curcumae root, schizonepetae, ledebouriellae root, menthae, and licorice root," explains Dr. Xie.

Another example Dr. Xie describes is the treatment of dermatitis. "Dermatitis is called 'shi zhen' in TCM. The most commonly seen patterns of this condition include Wind Heat, Damp Heat, and Blood Deficiency. Differentiating those patterns requires extensive TCM knowledge. For instance, a red tongue, excessive pulse, and itching skin is described as Damp Heat Pattern," he explains. "There is a specific Chinese herbal formula called Shi-re-fang (Damp Heat Formula) for this pattern. Acupuncture is also used to clear the pathogens of Damp Heat. As you can see, TCM practice is based on its own foundation and theories."

Skin problems can be challenging, but Dr. Xie states that the equine skin cases he has seen have responded to TCM treatment extremely well. His percentages speak for themselves: 50% of the horses had no clinical signs at all after TCM treatments, 40% showed some improvement, and 10% had no response.


Aromatherapy is the use of pure essential oils. Essential oils are extracted from plant parts (flower, leaf, blossom, petal, resin, tree, bark, root, twig, seed, berries, rind and rhizome) by way of distillation, expression or maceration. Essential oils are highly concentrated extracts and they contain hormones, vitamins and antiseptics (75 to 100 times more concentrated than dried herbs). Some of their uses are antiseptic (prevents or combats infection locally), bactericide (kills bacteria), bacteriostatic (inhibits growth of bacteria) and cytophylactic (promotes cell rejuvenation) when applied to the skin.

The term 'aromatherapy' was coined in France (Aromathérapie) in the early 1900's by Dr. René Maurice Gattafossé to describe his work with essential oils. In the book "Gattafossé's Aromatherapy" according to Dr. Gattafossé, essential oils are widely used for their antiseptic and bactericidal properties and they possess anti-toxic and antiviral properties. He also stresses that the oils have extensive therapeutic properties and an undeniable healing power.

When considering aromatherapy as a form of treatment remember that what works for one horse may not work for another. For skin problems, it is important to look at the whole horse and evaluate what they may need by consulting a qualified aromatherapist.

Take the case of Nadine, a beautiful bay Quarter Horse mare with a skin problem and extreme moodiness. Nadine's skin problem resembled 'sweet itch', but was never successfully diagnosed by the vet. The mare had extensive hair loss and a rash that extended from underneath her neck all the way down her stomach. The reason for her moodiness was never determined. Nadine was given four essential oils: ti-tree, carrot seed, lavender and vanilla. Ti-tree oil has anti-infectious, anti-inflammatory, antiseptic, fungicidal and immune stimulant properties. Carrot seed oil is an excellent immune stimulant and skin aid that stimulates cell repair and helps to keep coat, gums and teeth healthy. Lavender oil has immune stimulant and vulnerary properties (helps heal wounds and sores by external application). Lavender oil is also very soothing and helps with nervous tension or stress-related conditions. Vanilla oil helps to ease tension, balances the hormones, and acts as an excellent anti-depressant. In addition to these oils, 'Pete's Equine Remedy', a product made by Frog Works with pure organic essential oils, was also used topically on Nadine. This product was designed to heal the damage caused by skin problems, such as sweet itch, over-rubbing, ringworm, rain rot, dermatitis etc.

Within two weeks of using the oils and 'Pete's Equine Remedy', the owner reported that Nadine's skin condition was completely healed and her hair was already growing back. Nadine's mood was restored to a pleasant demeanor (indicating healing on more than the surface) and working with her was much more enjoyable.

The horse's skin is very complex. It is the horse's revealer. Therefore, the next time a skin condition appears, try to look at the situation in a holistic way. As stated earlier, every horse is different and may need its own specific remedy. Remember that when considering homeopathy, TCM, herbs or aromatherapy, it is important that you contact a qualified practitioner or a veterinarian qualified in these modalities. So be good to your horse and listen to his skin.

About the author:

Frances Fitzgerald Cleveland has worked with horses for over twenty-two years. She founded her company, Frog Works, in 1996. She is a Certified Aromatherapist through the Institute of Dynamic Aromatherapy. She is also a graduate of Caroline Ingraham's intensive Equine Aromatherapy course in England. She provides individual consultations and offers a range of products for people and their pets. Contact information: Frog Works 303-973-0109 or email FrogWorks@Worldnet.att.net

For more information:

Allen Schoen, DVM, MS & Associates, LLC
15 Sunset Terrace
Patterson, NY
(Author of three books: "Kindred Spirits", "Love, Medicine and Animal Healing", and "Complementary and Alternative Veterinary Medicine")

Huisheng Xie, DVM, PhD, MS
Clinician of Veterinary Acupuncture and Chinese Medicine
Veterinary Medical Teaching Hospital
College of Veterinary Medicine
University of Florida
Gainesville, FL 32610-0136
352-392-4700 ext. 4076

Joyce Harman, DVM, MRCVS
Harmany Equine Clinic
Washington, VA 22747-0488

Madalyn Ward, DVM
Bear Creek Clinic
Austin, TX 78737

Advanced Biological Concepts
301 Main St.
PO Box 27
Osco, Illinois 61274-0027
USA 800-373-5971
Canada 800-779-3959
email: helfter@a-b-c-plus.com

The Grain & Salt Society
273 Fairway Drive
Asheville, NC 28805