Sweet itch: how to draw up a treatment plan

What exactly is sweet itch?

Sweet itch is not an infection, but an immune system hypersensitivity reaction. The horse overreacts to proteins in the saliva of Culicoides midges, which are most active around sunrise and sunset. The typical symptoms are intense itching at the mane, tail base, belly line, and ears, followed by rubbing, hair loss, and sores. Some horses show symptoms after just one midge bite; others require repeated exposure before the hypersensitivity develops. Once present, the allergy generally worsens each year. This makes early intervention essential.

Recognise the first signs in time

The earlier you intervene, the less damage the horse sustains. At the start of the midge season, watch for these early signs:

• Restlessness during grazing at dusk, more swishing and stamping
• Slight hair loss or thinning hair at the tail base or mane
• Small scaly or moist patches on the belly line or back
• Rubbing against fence posts, trees, or the stable wall
• Sores or crusts without a clear external cause

The core of a good treatment plan

An effective treatment plan for sweet itch rests on three pillars: reducing midge contact, protecting the skin, and treating existing symptoms. Do not wait until the itching becomes severe. Start with preventive measures at the first warm nights in May. Always combine an eczema rug or fly sheet with midge-repelling products, as no single measure is sufficient on its own. Also make sure your vet is involved early in the season if the horse had symptoms last year — corticosteroid injections are most effective when given before the itching escalates.

Practical measures to reduce midge contact

• Stable the horse during dusk and night (midges are most active from 18:00–21:00 and 05:00–08:00)
• Use a sweet itch rug with a mesh size smaller than 1 mm, including a belly wrap and neck cover
• Avoid grazing near standing water, ditches, or low-lying pastures where midges breed
• Apply midge repellent to uncovered areas: ears, tail base, and belly line
• Install fans in the stable — midges are poor flyers and avoid airflow
• Use midge lamps or traps in and around the stable

Treating the skin: from mild to severe

For mild symptoms, soothing creams based on zinc or calendula help to calm and protect the skin. For moderate itching with early sores, corticosteroid creams can be used on veterinary advice. In severe cases — where the horse already has extensive hair loss or open wounds — injectable corticosteroids or antihistamines are required. Some horses respond well to immunotherapy, in which the horse is gradually exposed to small amounts of midge allergen. This is a process lasting several months and requires coordination with a veterinary dermatologist. Discuss this option if symptoms return every year despite all preventive measures.

Tracking symptoms and treatment

Consistency is key to the success of your treatment plan. Record daily which measures you are taking and how the horse is responding. In the horse profile of EquiSight you can log symptoms, products used, and observations — allowing you to see clearly whether an adjustment is having an effect. The calendar helps you remember when the rug needs washing, when the next vet check is scheduled, or when you started a new product. EquiCoach can recognise patterns based on your notes and alert you to recurring triggers.

Supporting nutrition and general condition

A horse in good condition reacts less severely to allergic triggers. Add omega-3 fatty acids via linseed oil (50–100 ml per day), which also help to dampen the inflammatory response in the skin. Ensure adequate vitamin E and zinc in the diet — both support the skin barrier. Avoid excess weight, as this increases susceptibility to inflammation. Limit sugar-rich feed in summer and ensure access to fresh pasture with sufficient crude fibre. Discuss the diet with your farrier or vet if you are unsure whether the current ration is contributing to the symptoms.