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Ask A Vet: Lip Fold Pyoderma in Dogs – Causes and Treatments

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Sadly, skin problems are extremely common in our pets. In fact, problems relating to the skin are some of the most common reasons for a trip to the veterinary clinic. Lip fold pyoderma is a skin condition affecting the skin around the lips. It affects some breeds more than others and can be challenging to live with since it frequently recurs. Not to mention being itchy and sore. Thankfully, there are measures you can take at home to help minimize these recurrences. Read on to discover all you need to know about lip fold pyoderma.

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What is Lip Fold Pyoderma?

Literally translated, “pyo” means pus and “derma” means “skin.” Skin fold pyoderma describes skin infections that arise in the folds caused by excess skin. These folds create warm, damp environments with little airflow. Exactly the conditions that bacteria and fungi love! More specifically, lip fold pyoderma relates to skin infections that occur in the skin folds around the lips.

Lip fold pyoderma is common in breeds that have large folds, or skin flaps, around their lips. Common examples include Spaniels, St Bernard’s, Basset Hounds, and Bulldogs. Brachycephalic, or short-faced, breeds have deep skin folds and so are at high risk of skin fold pyoderma.

Basset Hound
Image Credit: Bill Anastasiou, Shutterstock

What Causes Lip Fold Pyoderma?

All animals have bacteria and fungus that live naturally on their skin. These only become problematic if they are able to multiply uncontrollably or pass through the skin’s defense barrier. Skin folds not only create the perfect environment for bacterial and fungal growth; they also create friction between the skin surfaces and this can cause inflammation known as “dermatitis.” When the skin is inflamed, its defense layer is broken, allowing bacteria and fungus to penetrate and cause an infection, rather than staying harmlessly on the skin’s surface. This is when skin infections occur and if left unchecked, skin fold inflammation (dermatitis) often leads to skin fold infection (pyoderma). Lip fold pyoderma is not contagious.

Factors that can contribute to lip fold pyoderma

Not all dogs with lip folds will suffer from lip fold pyoderma. However, some factors, other than breed, can worsen or cause lip fold pyoderma. These include:

  • Obesity, which makes skin folds more pronounced
  • An underlying skin complaint that causes inflammation of the skin, such as mites or allergic skin disease
  • Excessive saliva, which sits in the folds around the lips, encouraging bacteria to grow
  • Dental disease

Unless these underlying causes are addressed, once a dog has had a bout of lip fold pyoderma, they can be prone to flare-ups for life.

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What are the Symptoms of Lip Fold Pyoderma?

Red, moist, oozing, and smelly skin

Lip fold pyoderma causes the skin within the lip folds to become very red, moist, oozing, and smelly. You may notice a yellow or white discharge. Usually, the rest of the skin would not be affected and so would appear normal, with the exception of other skin folds.

Itching

Lip fold pyoderma can be a very itchy condition. You may notice your dog pawing at his face or rubbing his face along the ground, in an attempt to scratch the area. It can also be very painful, so your pup may be reluctant to let you examine or clean the area.

If skin fold pyoderma becomes chronic, meaning it goes on for a long time, then the skin within the fold may become darker and thicker than normal.

sad cavalier spaniel
Image Credit: Pixabay

How Do You Treat Lip Fold Pyoderma?

Treatment is aimed at cleaning the area, reducing inflammation, and dealing with the overgrowth of bacteria and fungus. Your veterinarian will be able to prescribe the best course of treatment, tailored to your dog’s individual needs. They may wish to take a swab from the skin folds in order to tell exactly which yeast and/or bacteria are causing the infection. This also allows them to determine the best treatment.

Keep lip folds clean and dry

It’s really important to keep the lip folds clean and dry during treatment, or the treatment may not work. Cleaning acts to remove dirt, bacteria, and fungus from the skin. Your veterinarian may prescribe or recommend a medicated shampoo or medicated wipes. These usually contain a skin disinfectant (such as chlorhexidine) and antifungals (such as miconazole). Remember to dry the area thoroughly after cleaning, which is usually twice a day. However, it is important to follow your veterinarian’s instructions, since every case is different.

english bulldog sitting on grass
Image Credit: BLACK17BG, Pixabay

Clipping the fur

It can help to ensure that the fur around the affected area is kept clipped as this allows the cleaner and treatment to reach the skin better. It also allows better airflow. However, some animals are sensitive to clipping and it may actually cause the skin to become more inflamed. The stubble may also make friction between the skin folds worse. It’s a good idea to ask your veterinarian’s advice before clipping your dog’s fur, especially if the skin already looks sore.

Topical treatments

In mild cases, cleaning the skin can sometimes be enough to reduce inflammation and resolve the issue. More commonly, however, a topical (meaning you apply it directly to the affected area) anti-inflammatory treatment is needed. Your veterinarian may prescribe a cream or an ointment containing a steroid (such as betamethasone). This often speeds up healing. In severe cases they may prescribe a course of steroids by mouth. If this is the case, it is really important to read the instructions carefully and to complete the course—stopping steroid treatment too suddenly can make your dog very sick.

Topical antibiotic creams and/or antifungal creams usually work very well. Commonly used treatments contain antibiotics (such as polymyxin, fusidic acid, or silver sulfadiazine) and/or antifungals (such as clotrimazole). These are usually applied twice a day to the area, after cleaning.

Antibiotics

If the infection has gone very deep, or covers a very large area, then your dog may need antibiotics by mouth. Thankfully this is very rare. However, if required, your veterinarian would take a swab to find out which bacteria are present, and which antibiotics would work against them. It’s really important to only use antibiotics by mouth in cases that really need it.

The good news is that treatment usually works pretty quickly. The bad news is that the condition frequently recurs, especially if any underlying causes are not also addressed.

basset hound tan
Image Credit: PickPik

How Can You Prevent Lip Fold Pyoderma?

Good medical management and daily cleaning

Lip fold pyoderma can often be prevented with good medical management and a daily cleaning routine, using medicated wipes or shampoos. Vetruus CLX wipes, Ceva Douxo Pyo pads, or Dechra MalAcetic wipes are good examples. Wiping within the lip folds twice a day, and importantly then drying the area, can sometimes be enough to keep lip fold pyoderma at bay. Daily cleaning also provides a good opportunity to check for any redness, odor, or discharge. This enables you to seek veterinary advice early, and hopefully prevent lip fold dermatitis (inflammation) from becoming lip fold pyoderma (infection).

Address any underlying issues

Other preventative measures aim to address any underlying issues that could be contributing to the lip fold pyoderma. These include:

  • Weight loss
  • Dental treatment, to address tartar and any dental infections
  • Treatment of any underlying issues, such as skin allergies or mites

If these underlying factors are not properly addressed, treatment may be unsuccessful. Or, the treatment may work, but the pyoderma may keep coming back.

In some cases, where the infection is very severe or keeps coming back, surgery is needed. This is called “cheiloplasty.” Surgery involves correcting the skin folds by removing excess skin. Your veterinarian can discuss this option with you if needed.

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Summary

Lip fold pyoderma can be a frustrating condition. Even when treatment works, it commonly comes back. It can also be painful and itchy for your pup. Luckily it is easy to treat and manage, in most cases! In less fortunate cases, surgery is an option to prevent any ongoing suffering. If you have any concerns about your dog’s skin, seek advice from your veterinarian.

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Featured Image Credit: Billion Photos, Shutterstock