When medicated shampoo therapy is prescribed for a pet, the instructions must be followed closely if the pet is to receive the full benefit of the treatment. Most shampoos and topical rinses are to be used as an adjunct to other forms of therapy. Shampoos are also often recommended as a maintenance protocol to guard against relapse of the dermatologic condition and to prolong the health of the skin.

Topicals have become much more important in recent years as we have learned (and continue to learn) more about the epidermal lipid barrier of the skin. Alterations in that barrier have been identified in atopic dermatitis patients and there appears to be a direct link between the increased absorption of allergens in these patients as well as an association with increased bacterial folliculitis. 

Topical therapy not only mechanically removes allergens from the skin surface (decreasing pruritus) but also has the ability to kill surface microorganisms and prevent over-colonization (e.g. antiseptics such as Na Hypochlorite - not hypochlorous acid). Some topicals also target the epidermal lipid barrier and contain ingredients to aid in maintenance and repair (ex. Ceramides, phytosphingosines, etc.) 

Keys for Success

• The air temperature in the bathing area should be warm; the water temperature should be lukewarm, unless otherwise specified. Wet the coat thoroughly.
  
  
• Pay particular attention to the affected areas of the pet’s skin. Apply sufficient shampoo to these affected areas and rub in well.  Then proceed to lather the rest of the pet’s haircoat.  Some shampoos will lather better than others although the active ingredients may be equally effective.
  
  
• Allow the shampoo to remain on the coat for 15 to 20 minutes. Contact time with the shampoo is very important.  For best results, use a timer.  If bathing in the backyard, you may allow the "soapy" dog to run about during the required 15 to 20 minutes.
  
  
• Rinsing is as important as shampooing. Un-rinsed shampoo may cause irritation to the skin.
  
  
• Apply a medicated conditioner or rinse to the skin and coat (if prescribed). If indicated, lightly rinse the coat after application.
  
  
• Towel dry. You may use a blow dryer, but be sure that the temperature is warm and not hot.

Your veterinarian will recommend the frequency of bathing and may prescribe other topical medications to treat the pet's skin condition.

Contributed by: Karen Helton-Rhodes, DVM, Diplomate ACVD