Caring for Horses with Scratches (Pastern Dermatitis)

What Are Scratches?

Scratches, or pastern dermatitis, is a common inflammatory skin condition that affects the lower limbs of horses, particularly the back of the pastern and fetlock. It's often caused or worsened by prolonged exposure to wet, muddy, or unsanitary conditions and can involve bacterial, fungal, or parasitic infections.

Causes of Scratches

Scratches is usually the result of a combination of factors:

• Moisture and mud: Softens the skin and allows pathogens to enter.

• Irritants: Including sand, bedding, or rough vegetation.

• Bacterial infections: Commonly Staphylococcus species.

• Fungal or yeast infections

• Mites: Especially in feathered breeds.

• Photosensitivity or contact allergies

Signs and Symptoms

• Redness and swelling of the pasterns

• Scabs or crusts, often with thick yellow or gray discharge

• Hair loss in affected area

• Pain or sensitivity to touch

• Lameness in severe cases

• Cracked, oozing skin, sometimes with foul odor

Diagnosis

Your veterinarian may diagnose scratches based on:

• Physical examination of lesions

• Skin scraping or cytology (to identify bacteria, fungi, or mites)

• Culture and sensitivity testing (for persistent or severe cases)

Treatment Plan

1. Initial Cleaning

• Gently clip the hair around the affected area to allow air flow and better cleaning. This may not be possible due to discomfort - clip arount scabbed area.

• Soak scabs with warm water and a mild antiseptic solution (e.g., dilute chlorhexidine or betadine scrub) allow it to sit for 5 mins then rinse well and gently remove them—do not pick dry scabs, which can cause pain, bleeding, attract flies and damage tissue.

• Dry the area thoroughly after each cleaning session. Old bath towels are great for this. Use a clean towel each time to prevent re-infection and spread.

2. Topical Medications

• Apply a veterinarian-recommended ointment that may contain:

• Antibacterial agents (e.g., silver sulfadiazine or antibiotic)

• Antifungals (e.g., miconazole)

• Corticosteroids (for inflammation, if not contraindicated) only if prescribed by your vet.

• Other things we use/do:

  • Bev’s Equine Magic Salve mixed with Vaseline - helps with fungal infection and Vaseline helps protect skin from moisture.

  • Butt Paste - Zinc Oxide based - softens scabs for easy, gentle removal when washing and prevents new scabs forming once removed. Zinc oxide-based barrier creams may help protect against moisture. We LOVE Zinc Oxide Butt Paste.

  • Cornstarch Baby Powder - absorbs moisture under bandages and bell boots, plus repels flies!

  • If not improving we also like to use clotrimazole (Lotrimin AF), terbinafine (Lamisil AT) cream creams and powders for fungal infection.

  • For horses that live in bell boots, I like to put baby powder under the boot to help keep moisture away.

3. Systemic Treatment:

• Your vet may prescribe:

• Oral antibiotics for moderate to severe bacterial infections

  • BACTERIAL infection usually require veterinary prescription antibiotics (such as SMZ) if covering large areas, not improving with at home treatment, swelling, lameness or heat in legs.

• Antifungals or antiparasitic medications if a fungus or mites are present

• Anti-inflammatories for pain and swelling

4. General Management at Home

• Keep stable/stall area clean and dry

  • Use clean, dry bedding and avoid exposure to known irritants. We like pellet bedding, as it absorbs urine better than other bedding.

• Avoid over-washing—this can damage the skin barrier. Clean only as needed. We will wipe off barrier cream such as Zinc oxide, to avoid washing, if not contaminated.

• Prevention is key …

Preventing Scratches

• Provide dry shelter during wet weather.

• Avoid standing water, mud, and unsanitary turnout areas.

• Dry legs after bathing or exposure to dew or rain - If your horse is prone to scratches, use cornstarch baby powder and/or Zinc oxide based ointments

  • Use protective leg wraps or barrier creams when wet conditions can't be avoided.

    • If your horse is prone to scratches, use cornstarch baby powder and/or Zinc oxide based ointments before turnout.

• Regularly inspect and clean the lower limbs, especially in feathered breeds like Drafts or Friesians.

• Good nutrition supports healthy skin and immunity.

When to Call the Vet

• If the condition does not improve within a few days

• If the infection worsens or spreads

• If the horse becomes lame or severely painful

• If you suspect mites, fungal infections, or photosensitivity

Conclusion

Scratches is a manageable but potentially stubborn skin condition. Early intervention, diligent hygiene, and environmental control are key. With the help of your veterinarian, you can minimize discomfort and promote fast healing.