A certain mite—like this one—in big numbers can lead to hair loss, red skin, scabbing and, worst of all, lots of itching and scratching in dogs. Here are the facts about these Demodex mites and the mange they cause in your favorite pooches.

What’s the matter with mange?

Signs of demodicosis can include hair loss, reddened skin, scabbing, crusting, and, sometimes, itching. These signs can pop up in small areas or all over a dog’s body.

How does your veterinarian know?

Demodicosis is diagnosed by looking at a small sample of scraped skin or a plucked hair under a microscope. (In a skin scraping, a scalpel blade is used to gently but firmly scrape the skin layers to collect cells and parasites—like those pesky mites.) There are three types of Demodex mites, but they’re all treated the same way.

What’s the treatment?

Most dogs with a spot or two don’t need to be treated— their immune system will fight off the infestation. But all dogs with generalized demodicosis (that’s lots of hot spots) require treatment. Your veterinarian will probably recommend one of these:

Isoxazolines: These medications have all demonstrated higher efficacy and safety for treatment of demodicosis than any other drugs out there.

Ivermectin: is can be given orally daily to treat demodicosis. Some dogs’ nervous systems—especially herding breed (like collies)—are sensitive to high doses, so dogs typically receive a low dose and then gradually more, while being monitored for side effects.

Milbemycin oxime: This can be given daily to treat demodicosis. Some breeds can also have a nervous system sensitivity to high doses of milbemycin, but it’s less common than ivermectin sensitivity.

Amitraz: This dip is still available and the only FDAapproved treatment for demodicosis. However, amitraz isn’t recommended for pets or pet owners with diabetes, Chihuahuas (reported sudden death) or pets or pet owners who are receiving monoamine oxidase inhibitors (often prescribed as an antidepressant).

Your pet may also receive an antibiotic to treat infection due to skin damage by the mite. If a dog with demodicosis is scheduled for elective surgery, such as a spay, neuter or routine dentistry, it should be postponed until the demodicosis has resolved past three negative skin scrapes, as the stress of surgery can cause a flare-up.