dog mouth for lip folds
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How to Control Lip Fold Dermatitis in Dogs

Lip fold dermatitis in dogs stinks. As a diligent dog mom who brushes her dog’s teeth daily, I could not manage to control the terrible smell coming from my dog’s mouth. Little did I realize lip fold dermatitis would not disappear despite daily teeth brushing. When I visited the veterinarian with my Cocker Spaniel, he knew what my dog had lip fold dermatitis while we sat in the waiting room before the examination. The smell was that bad.

You can control lip fold dermatitis in dogs by cleaning the lip folds, keeping hair at the fold shaved down, treating it with non-prescription methods such as coconut oil, applying medications prescribed by the dog’s veterinarian, and sometimes even surgery to correct chronic, ongoing cases that don’t respond well to treatment. Treatment of canine lip fold dermatitis varies according to the reason, severity, and frequency of the condition as well as pet parent compliance.

I get at least one email a week, if not more, asking for help to alleviate a dog’s smelly mouth. If you are diligently providing at-home dental care for your dog on a regular basis, seeing the veterinarian for regular oral checkups and examinations, and the smell still exists, it may not be a dental issue at all. Lip fold dermatitis can rear its ugly head—and smell—and it must be brought under control. Here’s how to prevent, control, treatment, and care for a dog with lip fold dermatitis:

What Is Lip Fold Dermatitis In Dogs?

Dogs with floppy loose lips that have longer-than-usual contact with saliva have a tendency to develop lip fold dermatitis. Any area on a dog’s body where it is dark, moisture can build up, air is unable to access the area freely, and there may or may not be hair in that spot is susceptible to lip fold dermatitis.

Derma means “skin” and “-itis” means inflammation, so when it affects the dog’s lip fold, it is usually an inflammatory result of excess saliva and/or food that was allowed to form in the fold where bacteria grew and the end result is a big smelly odor and irritation for the dog.

Dermatitis can occur on other parts of a dog’s body including the face, lips, neck, vulva, and tail folds. A breed such as a Shar-Pei, for example, is prone to face fold dermatitis since the breed has wrinkled, loose skin of the face (and body).

Wherever a pocket of flesh, in this case, a lip fold, is pendulous or allows for fluid, food, and debris to gather, you have a situation ripe for this condition.

lip fold dermatitis

Causes of Lip Fold Dermatitis

Sometimes, the anatomy of a dog’s lip folds are thick enough and loose enough to make for a nice host for bacteria to accumulate. Some breeds are predisposed and overly represented with cases of lip fold dermatitis due to their anatomy, and these include but are not limited to:

  • Basset Hounds
  • Bloodhounds
  • Cocker Spaniels
  • English Bulldogs
  • Pekingese
  • Pugs
  • Saint Bernards
  • Shar Peis
  • Shih Tzus

Other causes include changes in weather, such as in the summer and warmer months where dogs pant more and produce more saliva. Look at this photo of a dog with thick lip folds and you can understand how moisture can build up in the little pocket:

Though lip fold bacteria can form any time of year (as is the case with my Cocker Spaniel), dogs can also develop lip fold dermatitis on and around their lips simply due to saliva accumulation. Sometimes the change of chemistry in a dog’s saliva can cause bacteria to form. If you’ve ever developed a yeast infection after taking antibiotics, you know all about that. If your dog has been on antibiotics and his saliva chemistry changes, dermatitis can occur. I generally administer antibiotics with a probiotic in accordance with my vet’s instructions.

My dog never required an antibiotic for lip fold dermatitis but I know many dogs who have, such as my friend Joy at MyGBGVLife. who says, ” If you have a lip fold infection once, chances are good you will have one again down the road and need even more antibiotics.”

Symptoms of Lip Fold Dermatitis in Dogs

One of the first signs in most dogs is a pungent odor and/or inflammation and redness of the affected area. Truth be told, my dog didn’t have overt redness and initially I could not figure out where the foul odor was coming from. I was thinking it might have been a cavity, a growth in his mouth, or the doggie toothpaste wasn’t working. It was none of those things.

Symptoms of lip fold dermatitis in dogs include:

  • Redness or an inflamed area in the lip fold.
  • Foul odor of the lips or lip fold
  • Discoloration around the hair of the mouth. On my white dog, the fur turned a shade of yellow near the lip fold which then ran down his neck
  • Pawing, rubbing, or scratching at the mouth or face
  • Pain if the lips or mouth are touched or cleaned
dog with severe lip fold dermatitis on mouth
Photo credit: Today’s Veterinary Practice

How to Prevent Lip Fold Dermatitis

Prevent this nasty condition by keeping your dog’s lip folds clean and dry. Gently wipe the lip folds/jowls and be sure to brush your dog’s teeth. Keeping the mouth clean is essential. Never scold your dog and don’t clean the mouth right before he or she eats. Also make it a very happy experience and start slow. If you’ve never cleaned your dog’s mouth or lips before, you need to make it an easy process. Do not yell at the dog. Take your time.

You know that area where the upper canine tooth sits on the lower lip of the dog? Think of all the saliva, germs, and bacteria that can harbor in that small and seemingly innocuous area. Keep it clean.

A local irritation from something as simple as the material of the dog’s food/water bowl can cause lip fold issues. The same thing happens to people when we have a reaction or an allergic issue. Any sort of friction or moisture can also flare up lip fold dermatitis.

If your dog has thick jowls and his anatomy is such that nothing is helping, surgery may be considered as a final option. Joy at MyGBGVLife had lip fold surgery on her dog.

Dexter and Bailey
MyGBGV Life meets Fidose of Reality

To keep it at bay and to keep the jowls and lip folds clean and free of bacteria, I learned to clip the hair around the mouth of my dog. You can hurt the dog if you are unsure as to how to use clippers at home. If you are interested in a small set of clippers that are good for a novice and handy to have, consider these on Amazon. If you are interested in learning more about grooming your dog at home, even if in between professional grooming visits, read my article on How to Groom a Cocker Spaniel at home. Most dogs can benefit from the tools and tips in this article.

Two products that really helped my dog maintain clean lip folds are ProBioraPet Oral Probiotics that you simply sprinkled on your dog’s food. I also keep Mal-a-ket Wipes on hand or chlorhexidine antiseptic wipes.

treatment for dogs with lip fold dermatitis

In the warmer months when my dog pants and drools a bit more, we are extra diligent. Any time you have a dog with folds in the lip or even on the ski, the propensity for bacteria to form in that nice, dark, warm place is high. Bacteria and yeast thrive in such an environment; consider the dark and hairy ear canal: Yeast and bacteria often cause ear infections.

Here’s a great video on how to keep a dog’s lip folds clean:

Treatment For Lip Fold Dermatitis

When Dexter was first diagnosed with lip fold dermatitis, the vet prescribed Pyoben antifungal shampoo, one droplet to be massaged into the area and cleaned out followed up with Pyoben ointment.

Something to keep on hand for dogs with wrinkles and to help keep lip folds clean is Wrinkle Balm by the Natural Dog Company, which is available on Amazon.

dog treatment for lip fold issues

Topical or systemic antimicrobials, which are prescribed by a vet, may help manage this condition. If surgery is required, be certain you feel comfortable with it and always get a second opinion if you are uncertain. The goal of skin fold surgery is to prevent dermatitis from ever affecting the lip folds again.

A veterinarian may prescribe antibiotics, antifungals, antibacterial wipes, or specialized shampoos. Over-the-counter products include chlorhexidine gluconate, hydrocortisone cream, and ketoconazole shampoo. Your vet should show you HOW and WHERE to apply the ointment or any other sort of treatment. You don’t want the dog ingesting anything and the area in question is NOT the lip, but specifically, that dark, dank place called the lip fold.

Treatment for this condition is multifactorial. Since learning to keep my Cocker Spaniel’s jowls and lip folds cleaned, groomed, and dry, we haven’t had a flare-up in years. Sometimes despite all efforts, lip folds get overrun with bacteria.

The Merck Vet Manual, aka the Bible for Pet Care, says, “Medical management of lip fold dermatitis includes clipping the hair, cleaning the folds 1–2 times/day with benzoyl peroxide or a mild skin cleanser, and keeping the area dry.”

The key is in making sure you apply the product to the exact area of the lip fold: Not to the mouth, not in the mouth, but in the fold, as shown here:

dog jowl

More Help For Dog Mouth Issues

10 Tips for Dogs Who Hate Their Teeth Brushed

What Are Dog Plasmacytomas and How Are They Treated?

Bark Back

Have you ever heard of this condition and/or dealt with it in your dog(s)? Let us know in the comments below.

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36 Comments

  1. Ha! We got a few more tips now from you to add to our arsenal. It sure is a pest of a problem that never will go away 100%, so vigilance is the key to prevention. Thanks for posting with us 🙂 So many dogs need help with this condition and don’t know what to do.

  2. I’ve never heard of this condition. Thanks for all the info. I’ll be sure to pass this along.

  3. I’ve never heard of this condition and fortunately haven’t experienced it. Im always interested in natural & organic products so thanks for telling us about Natural Pet Co. Very informative post, I’m sharing.

  4. Thanks for letting me know about this. Our dog drools a lot! He doesn’t really have many folds, but I’ll be keeping a nose out for that smell!

  5. Taffy’s mouth odor improved after getting some ointment from the vet. A few weeks later and it’s starting to come back. Think we’ll check out the Wrinkle Balm as we used their Snout Soother before for her and liked that. Taffy wants to keep her breath fresh for Dex! Taffy’s Mom

    1. Dex sez hubba hubba. Try those Mal a Ket pads – you have to keep on top of it or it stinks to no end. You can get them on Amazon.

      1. I am so glad I saw this! My toy poodle started having issues only after having most of her teeth pulled. Now in the area where her canine teeth that were left meet her bottom lip and under her chin food tends to gather and cause this irritation. Glad to learn about the ointment and the pads. It itches her horribly so now I can clean it after she eats with the pads and use the ointment for healing!

  6. We had that issue with a past pup….I forgot about it and now i wonder if it’s an issue with Sonny and Brynley. They have stinky breath!!!

    1. Once you get that fold clean, it really helps. I use Mal-a-Ket wipes (from Amazon) on Dex nightly and I clean his lip folds after each meal, too. Coupled with nightly teeth brushing, no stink 😉

  7. Our dog had the stench and for weeks tried every breath thing going even going to the vets who never explored his joules. Then one day he was laid on his back exposing those lovely joules and my god raw ulcerated flesh I was horrified!

    It’s flared up once since but now much more aware and prevention techniques help. More poor dog must have been in agony!!!

    1. Happy to hear you got it controlled – it sure does cause issues. Thanks for stopping by!

  8. Our 5 year old Lab/Beagle mix was just diagnosed with ‘Cocker Mouth’. We aré applying a prescription antibiotic ointment, but he licks it off. We had switched to natural antler chews from Nylabone about 3 weeks before this started. My husband is sure the antlers are the cause. I don’t know. I just hope we can get it cleared up and avoid surgery. I appreciate the advice here very much.

    1. Hi Laura – Those folds can get quite yeasty. It would not be the antler as much as it would be the buildup of bacteria in those folks. I would use the cleaning pads and then apply something from the vet that he prescribes. Let us know how it goes

  9. Very good article. We’ve just returned from the vet after having to put my Great Dane under general anaesthetic to look for why her breath was so bad. Been to vet twice before we decided to do this. she’s a bit skittish and wouldn’t let me or vet look at mouth. At no point was this a probable diagnosis. Low and behold though today this is what she’s been diagnosed with and we are home with steroid cream you wrote about. She must be in quite a bit of pain. They said her teeth were in good order. £260 to find out it wasn’t her teeth in the first place! Glad we’ve got to the bottom of the smell though. We could hardly go into the room with her it was that bad.

  10. How can I tell if its lip fold dermatitis or oral melanoma. I had a cocker that had oral melanoma and now a coker that was diagnosed with lip fold dermatitis the smell is the same and I am a little paranoid. It took my old vet a while to figure out that my previous coker had oral melanoma which is why I am a little paranoid. Is there a way to tell the difference?

    1. Since the dog has a history of oral melanoma, I’d go back to the vet to have that double checked. Lip fold dermatitis has a terrible odor in most dogs.

  11. Just found our Watson has this Lip Fold Pyoderma, and wanted to share my story in case it helps other dogs – he had zero smell! We clean his teeth every night with an electric toothbrush btw which means less moving the brush around, shorter time but better results. Anyhoo, we noticed this last week he was lethargic, and air licking, a new behaviour. We checked every inch but found nothing. We took him to the vet yesterday and after much detective work, the vet checked his lips closely and lo and behold, a big infected lump that was well hidden by his labradoodle fur. We have antibiotic cream but once its healed I’m going to start work on keeping them clean – so many things fell into place about 3 year old Watson – now we know why he rubs his face against furniture constantly, and is always itching his face and hates his beard being touched! Sadly I can’t get any of your recommend wipes or solutions in UK but will ask the vet and will potentially use diluted Hibiscrub with a cotton bud. Thanks so much for your helpful post!

  12. The problem with Hibiscrub (chlorhexidine) is that, as with antibiotics, the bacteria develop an immunity to it – in other words, don’t use it unless you really have to, and certainly not all the time. It would be useless if it didn’t work when you really needed it to. It can also be an irritant.
    Herbal pet supplies in the UK make a lip fold wash that works well for one of our old Italian Spinone girls – we give her lip folds a quick spray about twice a week, which keeps them free from irritation and (very smelly) infection.

  13. I really enjoyed (!) reading this because our mixed breed hound has a mouth and saliva that stinks to high heaven. No one wants him near or the stink gets on them. He is a very loving and mouthy dog. I asked our vet, but she thought he might be emptying his full anal glands himself, rather than having mouth issues. I’ve not witnessed him doing that but it is possible. He is crated while we work. I will try the pads and move on to the wrinkle balm. Thank you for posting this.

  14. I my dog has recently developed this after a surgery and it’s smells awful! I’m so glad I found your post, I’m struggling to know if I’m applying products to the the correct place due to not being able to be in the room with the vet for them to show me ! She has it along both bottom jowls the vet said . And the stink is awful

  15. My girl was diagnosed with this after having a operation in November for an infection in the womb, after surgery there was this awful smell that she hadn’t had before and we returned to the vets who put her back on antibiotics, three trips were made, each time the tablets stopped the smell returned. Then finally they diagnosed her with dermatitis, we’ve been cleaning the area daily with wiles and using dentisept recommended by the vet , while it might improve for one or two days it always returns and the poor thing is so unhappy so this week we have surgery booked. In worried and nervous about the pain she will be in but fingers crossed it may just stop the daily pain for her

    1. Some dogs have to have the surgery and I am sure your sweet dog will be okay. It sounds like you are on top of things and please keep us posted. Hugs to you and your pup.

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