All Manges Are Not the Same

I try to be careful when pronouncing a diagnosis of mange because some people freak. Fortunately, treatments are very effective today.

Demodectic vs. sarcoptic mange
Demodectic mange? Sarcoptic mange? By: AmazonCARES

A mange by any other name is never sweet!

Mange is a skin disease, primarily of dogs, although cats, ferrets and other animals can contract and spread mange.

There are 2 common forms of mange. Demodex, caused by the Demodex mite, and Sarcoptes, caused by the Sarcoptes scabiei mite (scabies), are 2 very different little buggers.

Demodectic mange:

  • Not very itchy, unless it becomes generalized
  • Most common in pups and young dogs
  • Begins with small hairless patches (alopecia)
  • Localized and generalized forms
  • Not contagious to other animals or people

Sarcoptic mange:

  • Itchy!
  • Any dog can get it
  • Contagious to other pets
  • Ears, elbows and ventral areas affected most
  • People can get infected, but it resolves quickly

I try to be careful in the exam room when pronouncing a diagnosis of mange because some people freak. This panic attack probably comes from old ideas when mange was considered untreatable, or extremely difficult to treat.

The picture of a “mangy” dog comes to mind, in the middle of a junk yard, hunting for scraps, hairless, scabby and scratching. Fortunately, treatments for mange are very effective today.


The skin lesions and history are enough to give your veterinarian a good idea of which mange mite we’re dealing with. Patchy, hairless lesions on a young pup: Think Demodex. An older dog that is scratching its ears and elbows off in the exam room: Think Sarcoptes.

  • Demodex mites are easy to find. Sarcoptes mites are not.
  • Demodex lesions are pretty obvious. Sarcoptes symptoms can mimic allergic skin disease, food allergies and other conditions.

In vet school, we were taught a highly scientific and high-tech tool for diagnosing Sarcoptes: If you scratch a dog’s ear, and it scratches furiously with its hind leg, you’ve got sarcoptic mange. Seriously, if a dog is scratching vigorously in your exam room, you’d better have mange on your rule-out list.

With severe Sarcoptes infections, people in the house may have a skin rash that comes and goes. I usually ask my clients if they have been itching. If they say yes, that’s more evidence that Sarcoptes may be the diagnosis.

Sarcoptes can’t live long on people. I have had it so many times, I’m not even grossed out by the idea anymore.

Only one thing about it bothers me. If I think I have a case of Sarcoptes, I go over all my skin cases of late to make sure I diagnosed a dog with scabies in the last week or so. If I have Sarcoptes, I had to get it from somewhere! If I didn’t diagnose a dog with scabies recently, I go over my skin cases until I find it.

The Skin Scrape

How amazing is it that the vast majority of dogs don’t care when I take a blade to their skin and scrape away a little layer and place it on a microscope slide!

The blade is dulled, the scrape is quick, and it truly doesn’t hurt very much.

Dog with mange
By: NatalieMaynor

Treatment for Demodectic Mange

Amitraz dips (Mitaban) or daily ivermectin are the most common drugs used to treat demodectic mange. These drugs are not that old. Before their existence, a severe case of generalized Demodex could be a death sentence. Some cases are still difficult to treat and some clients consider euthanasia.

Although some cases of generalized Demodex can take months to cure, with combinations of dips and oral medications, we usually achieve success. But the labor-intensive dips, daily medications and repeat visits to the vet get many clients frustrated.

Pups with one or two small Demodex lesions are considered to have localized disease. These may go away on their own without treatment. Occasionally, a single lesion is found on an older dog, and we definitely don’t treat these cases unless the lesions spread.

Treatment for Sarcoptic Mange

Not too many diseases are revolutionized by the discovery of a drug, but that’s what ivermectin did for the treatment of Sarcoptes.

Do you all remember the commercial about “the heartbreak of psoriasis”? Well, the heartbreak of Sarcoptes was a dog’s equivalent. Stinky lyme sulfur dips and baths were used with varying degrees of success before ivermectin.

Because certain breeds can be very sensitive to ivermectin, a newer, related product — selamectin (Revolution) — is a monthly topical heartworm preventive labeled to treat Sarcoptes and safe to use in all breeds. This, now, is my first choice for the treatment of sarcoptic mange.

Lyme sulfur dips can be effective. However, this dip smells like rotten eggs thrown on excrement. I hate to use it.

The Problem With Collies

I love collies and all the herding breeds. Unfortunately, collies, Aussies and other breeds can carry the MDR1 gene (multidrug resistance gene) that makes the use of high doses of ivermectin out of the question. These dogs can be treated with selamectin at normal doses.

Natural Remedies for Mange?

Generalized cases of Demodex and Sarcoptes are serious. Left untreated or treated with ineffective products, the mite infestation becomes more difficult to treat.

The large majority of veterinary dermatologists don’t believe home remedies for mange are effective. If you try recipes including hydrogen peroxide, vinegar, borax and other household items, do yourself a favor: If you don’t see significant improvement quickly, get to the vet!

I checked with a number of holistic vet colleagues. They like to use natural immune system support products for mange cases, but the vast majority reach for dips or ivermectin to achieve a cure.

Treatment Failures

When Demodex or Sarcoptes cases are not responding to treatment, the dog may have an underlying disease or be immunosuppressed.

Older dogs that develop mange should undergo testing for endocrine, metabolic or neoplastic disease. If a dog is immunocompromised for any number of reasons, curing mange can be difficult. These dogs need a full medical workup.

Breed Predilection

Demodectic mange is more common in bulldogs and Bulldog relatives such as Boston Terriers, pit bulls, pugs, etc.

Many other breeds are predisposed. Here is the list, probably not exhaustive:


Most veterinarians recommend not breeding a dog with demodectic mange because of the genetic component. Many breeders don’t like to hear this, and often insist “they have never seen it in their line before.” I question their veracity in many circumstances. Puppies often clear a mild Demodex infection and unscrupulous breeders breed that dog or sell it as a potential breeder. Certainly, Demodex is prevalent in puppy mills.

If you think your dog is exhibiting any signs of Demodex or Sarcoptes, get a diagnosis from your veterinarian and begin treatment.


This pet health content was written by a veterinarian, Dr. Debora Lichtenberg, VMD. It was last reviewed March 13, 2013.

Dr. Debora Lichtenberg, VMD

View posts by Dr. Debora Lichtenberg, VMD
Dr. Debora Lichtenberg, VMD, is a small animal and exotics veterinarian who has split her time between a veterinary practice in Pelham, Massachusetts, and her studio in New York City. Dr. Lichtenberg is a graduate of the University of Pennsylvania School of Veterinary Medicine with 30 years of experience. Her special interests are soft tissue surgery and oncology.

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