Inky, a seven year old female cat who had developed scabs around her head

Like many cats, Inky is fastidious about her appearance, spending a lot of time grooming herself, and in particular, cleaning her head with her front paws. She licks her feet, then rubs her own head all over, like a mother washing the face of a four year old child. She is very thorough, leaving no part of her head untouched during this process. Inky lives an active, outdoor life, yet she always manages to have a snow-white face and a clean pink nose. In March, for no particular reason, she developed scabs all over her face.  Her clean white face became pock-marked and patchy. The problem was immediately very obvious to Elaine. It was as if a smooth-skinned human teenager had developed severe acne overnight. Elaine brought her up to see me at once. At first Elaine thought that Inky had been in a nasty fight with another cat, yet there were no other cats in the area, so she could not understand how this could have happened.

When I examined Inky, I could see that the distribution of scabby skin did not fit the pattern that is seen after cat fights. The affected areas were “bilaterally symmetrical” – in other words, the scabby areas on the left side of her head were replicated identically on the right side. This would never happen with fight wounds, which are much more random and one-sided. Inky’s face was the most obvious affected area, but she also had scabs on her body, especially along her back.

The symmetrical pattern of skin disease was typical of two common problems: parasites and allergies. Both of these conditions cause a cat to feel generally itchy all over. The normal self-grooming behaviour becomes excessive, and affected cats start to damage their own skin by scratching and chewing the itchy areas. Once the skin is damaged by this self-trauma, it becomes infected, and the itchiness gets even worse. Soon, a vicious circle kicks in, with itchiness causing more self trauma, and the self-trauma making the skin even more damaged and itchy.

When I examined Inky on that first day, I could see that she was feeling uncomfortable, with her skin twitching occasionally because of the itchiness that she was feeling. I took a hair plucking and checked it under the microscope to make sure that she was not carrying fleas or other less common creepy-crawly parasites. There was nothing to be seen, so I knew that parasites were not the cause of her condition.  I gave her a general anti-parasite treatment anyway, to be extra-safe. Fleas are very common in Ireland, especially in the warmer months of the year, and it makes sense to give any itchy animal a regular flea treatment. Even if fleas are not the main problem, they can seriously aggravate any type of skin disease.

So what else could be causing Inky’s itchy skin? The broad answer is simple: an allergic reaction. Just like humans and dogs, cats can develop allergies to all sorts of things around them. It is very difficult to identify the precise cause of an allergy, and a ruling out process is the only way to do this properly.  In theory, a cat should be kept in a bland room, with no soft furnishings or carpets. Special hypoallergenic food would be given, in case she was allergic to something in her diet. If the skin condition improved, the cat would be gradually exposed to new items from her surroundings, one by one. This would include new foodstuffs, carpets, fabrics and furniture. If the cat developed a skin reaction, the cause of the allergy would have been identified, and the cat’s lifestyle could be adapted to avoid that item in the future.

In practice, this “ruling out” process is not at all easy to accomplish. Cats are free spirits, and it is difficult to confine them to enclosed areas for prolonged periods. They are fussy eaters, and they do not always take well to special diets with unusual ingredients. In Inky’s case, we decided that it would not be realistic to attempt to impose such restrictions on her. Instead, I gave her an injection of an anti-allergic drug, which lasted for a month. This would block the allergic reaction, so that her skin would settle down and return to normal. The treatment was very successful, and within a few days, the scabs vanished, and Inky regained her normal smoothly furred, clean-looking appearance.

At first, I was hopeful that the problem might have been a one-off allergic reaction. But four months later, the condition recurred, and another long-acting injection was needed to settle down her scabby skin. Then three months after that, she needed another dose of treatment. And finally, last month, she came in for her fourth dose of treatment. We know that there is something in Inky’s surroundings that is making her skin feel itchy from time to time, but her problem so far is at an in-between stage. She is not yet bad enough to force Elaine to go through with an intense lifestyle restriction to identify the cause. The injections work very well, curing the problem completely with no obvious side effects. In future, she may deteriorate, and we may need to change the treatment plan. But on the other hand, the allergy may settle down, and she may not need any more treatment at all. Inky, Elaine and myself are all carefully watching this space.


  • Scabby skin in cats can be caused by fighting, parasites or allergies
  • It is sensible to use routine flea treatments to rule out parasites
  • It is difficult to identify causes of allergies, so anti-allergy injections are often used instead.

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