What to Expect when Treating Mange

Often when treating mange, things can seem to get worse before they get better.

Whether you are using a chemical or natural treatment, something is bound to happen when hundreds of parasites die, release all their toxins, and begin to decomposed all at once. This is known as the Die-Off Effect. Knowing what your dog is going through will prevent you from unnecessary panic when die-off symptoms appear. Knowing how to respond, and what tools to use, will help you heal your furry friend.

Die-off Effect from Demodectic mites

Demodex mites are follicle mites that hide deep. By the time mange has become obvious, there can be quite a few packed tightly into each hair follicle. The tight fit alone can cause problems, but they’re also living under layers of sebum, skin cells, and follicular debris that plugs the skin pores.

Bacteria and yeast build-up can cause inflammation and secondary infection. This often happens before treatment even starts, but once the mite killing begins, things can actually can get worse.

As odd as it sounds, die-off is an indication you’re on the right track and you have the mites on the run.

Illustration of dog mange demodectic mites in hair follicle.
Densely packed demodectic mange mites in hair follicle.

Topical mange treatment plan

When treating Demodicosis topically, the outermost clog must be softened and flushed out with Benzoyl Peroxide shampoo. This allows the topical drench, like  Mite Avenge® shampoo, to reach and kill the top layer mites. Once the top level is cleared, it’s time to repeat the cycle. This takes patience, but is important for two reasons:

  1. Killing the mites off a layer at a time limits the amount of toxins released at one time, lowering the risk of infection. (Mass kill methods are really harsh on a dog.)
  2. It gives you time to rebuild the dog’s immune system. No matter what treatment method you use, this needs to be done before you can stop treating your pup, or they’ll have no means to prevent the mites from coming right back.

What happens when the mites die?

When the mites die, they release all of their irritating toxins at once into a gelatinous glob which worsens conditions. The follicles and pores can get blocked again which harbors harmful bacteria and yeast and the decomposing mites themselves. The toxins they dumped can cause additional itchiness, inflammation, redness, swelling and irritation, minor infection, etc.

The dog’s defenses get even weaker as the dog’s system tries to resolve these new issues, which in turn can cause lethargy and symptoms of allergy and/or illness. This can be alarming for a concerned owner, but it’s actually to be expected.

How long does mange treatment take?

While chemical treatments can take up to a year, Mite Avenge often works in much less time. But with any method, it’s impossible to say how long the process will take.

Factors we can’t control like age, other health issues, length/severity of the infection, and immune function all directly affect the process of reducing the mite population to a normal level.

(The above applies to Demodectic mites only. Sarcoptic and Cheyletiella mites are different and can be totally eliminated which ends the infestation known as mange.)

During the process of exterminating these parasites things are happening that you can’t see. These can cause scary symptoms that may make you question your progress. This sudden worsening of symptoms is commonly known as the Die-Off Effect and it’s more positive than it looks! It’s a sign that the battle is underway, and you’re on top. Nonetheless, it’s best to be prepared for what might happen.

Symptoms of Die-Off effect:

Tingling or irritation from shampoo

The benzoyl peroxide shampoo does some serious work that can stir up mites and cause itching. Anything that can flush out the kind of gunk associated with Demodex mites is strong, and some dogs can experience agitation or irritation during and shortly after use.

If you’re using our Flush & Kill shampoo and you feel it’s too strong, drop back to plain benzoyl peroxide shampoo or alternate between the two. If straight benzoyl peroxide seems to be a problem, try using it every other wash and alternating with a gentle, non-oatmeal shampoo.

Stay with the Benzoyl peroxide as much as possible though, it’s necessary to remove the sebum and mite waste that the parasites push behind them. Without it, Mite Avenge won’t penetrate as far, and the blockages you leave behind can contribute to secondary infection (Demodectic pores & follicles are so packed with crud that some owners have reported the water running off their dog was visibly dark with filth).

In fact, even between treatments it’s helpful to continually bathe the dog with Benzoyl Peroxide shampoo to help keep the skin clear and free of secondary infection. Should drying become a problem, rub cold-pressed coconut oil onto the dry spots.

Reaction to mite toxins

Demodex mites contain toxins that a dog can’t tolerate. The toxins emitted by live mites are responsible for a large number of your pet’s mange symptoms; they trigger a histamine reaction in your dog.

It’s essentially a severe allergic reaction to the mites, which is why the condition is so often misdiagnosed as skin allergies. This histamine reaction can cause symptoms like itching, irritation, secondary infection and lethargy.

Unfortunately, when mites die they release all their toxins. When this happens, expect symptoms to get worse.

Spreading mange

Sometimes the mites will actually spread, and other times it just looks that way. After treatment the surviving mites are more exposed and they make an attempt at self-preservation. They instinctively try to move to safer locations causing the mange to actually spread. This is why we treat twice a week, in an attempt to limit this reactive spread.

In other cases, new mangy areas pop up in totally detached places that previously looked fine. This happens because there are mites that were on that part of the dog all along (remember, these mites are still present on healthy dogs, just scattered around in smaller numbers). Mange wasn’t evident because the volume of mite toxin emitted wasn’t enough to cause problems.

This is why we recommend treating the entire dog, not just the areas where symptoms are visible.

Increased itching (especially at night)

Stirred up mites are not happy campers. The frenzied activity of the mites who survive treatment can cause exacerbated itching. This is especially prevalent at night.

Secondary infection

With Demodectic mange, this is common. Inflamed and irritated skin traps bacteria, yeast and mite detritus, which compound the suffering the dog is already in.

In addition to frequent Mite Avenge, using daily Povidone Iodine wipe-downs can help lessen the severity of secondary infection and in some cases let you dodge it entirely.

Try to keep your dog off of antibiotics if possible, as they have a suppressive effect on your dog’s immune system. Natural supplements like Ester-C and Milk Thistle can help in less severe cases that don’t absolutely require medical attention.

Avoid any type of steroid. These take a heavy toll on your dog’s immune system (like throwing gasoline on a fire). And unlike antibiotics, they won’t help your dog get any better in exchange for the setback.

Ongoing itching is a possibility, since your dog must heal from a maze of tunnel wounds and eliminate the remains of lots of decaying parasites. Avoid resorting to antibiotic ointments and steroid creams like cortizone if possible, as they can lower immune system function.

Because die-off is inevitable, you just have to power through it. Unless serious complications arise, it’s best to stay the course so you don’t lose ground and have to start over. Just be aware that it can happen and that you’re not failing. Stay aggressive.

Treat the entire dog thoroughly at least twice a week, until the skin looks completely clear and hair is starting to grow back. At that point we recommend weekly treatments for another 4 weeks to make sure you kill any nymphs as they hatch.

It’s a process. No matter how you approach the disease, resolving Demodectic mange takes time. Demodicosis is essentially an immune system disorder, the rampant mite populations are just a symptom of a weakened immunity. Don’t get me wrong, they have to go. But we can slay them all day long and never cure the problem.

To keep the symptoms gone, your dog needs to be able to keep the mites under control on his or her own. Unless other steps are taken to rebuild the damaged or deficient immune system, mange recovery will stalemate or even rebound. Your dog can become stuck in a cycle of remission and recurrence that can become chronic. Sadly, your vet may not explain that the root cause is related to poor immune health.

But now you know, and knowing is half the battle! The only truly effective solution is a big-picture approach that includes correcting getting rid of the mite overpopulation while rebuilding healthy immune function.

The Immune Health sections of our site have a ton of information on yeast, diet, immune support and democidosis that will help you get there. Good luck!

Die-off Effect from Sarcoptic and Cheyletiella Mites

Severe die-off effect is rare in Sarcoptic or Cheyletiella mite infestations, but it does happen.

Female Sarcoptic mites dig tunnels into the epidermis to reproduce, not unlike ants. She deposits her eggs and dies. The eggs then hatch unto countless larvae, then nymphs, and finally adult mites that dig more tunnels and repeat the cycle.

Cheyletiella mites live under the thin upper layer of Keratin, and the skin (or dandruff flakes) may appear to move as the mites crawl about.

While all this goes on, the parasites are carelessly leaving a trail of angry gnawed tunnels, necrotic skin, and lots of waste. Besides itching like crazy from the damage, the dog’s system has to deal with the massive load of foreign substances in its body. And once the mites die, the byproducts of thousands of tiny decomposing bugs may cause problems like secondary infection.

Frequent bathing (preferably with Benzoyl Peroxide shampoo)and Povodine Iodine wipe downs, are your best defenses when treating Sarcoptic and Cheyletiella mange.

Sarcoptic Mange mites burrow into the skin.

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