Cracked Heels in Horses: Greasy Heel Causes, Treatment and Red Flags
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By Dr Duncan Houston
Cracks and sticky scabs behind your horse’s pastern are often called greasy heel, mud fever or scratches. The names describe a pattern of skin damage, rather than one specific infection.
A small sore patch can become very painful, particularly when swelling spreads up the leg. The useful question is what is damaging the skin and whether deeper tissues are involved.
Quick Answer
Cracked heels usually need a dry environment, gentle handling and treatment directed at the underlying cause. Wet conditions, bacteria, mites, irritation and sunlight-related inflammation can all contribute. Call your vet promptly for painful, spreading or recurrent lesions, and urgently for marked swelling, fever or severe lameness.
What causes greasy heel?
The skin barrier can break down after repeated wetting, friction or irritation. Infection may then complicate the original problem. Heavy feathering can hide early lesions and retain moisture, but any horse can be affected.
UC Davis explains that pastern dermatitis is a disease complex. It should not automatically be attributed to one bacterium. White-skinned lower legs can also develop sunlight-associated inflammation, including conditions that need more than an antibacterial wash.
Look for red skin, small crusts, matted hair, ooze and sensitivity before obvious cracks develop. Compare all four legs. Note whether the horse stamps or rubs, whether only white skin is affected, and whether new boots, washes or bedding were introduced.
How serious is it?
| Finding | What to do |
|---|---|
| Small local patch; horse comfortable and otherwise well | Keep the area dry and arrange veterinary advice before selecting treatment. |
| Raw skin, repeated episodes, discharge or mild lameness | Arrange a prompt examination; do not keep trying different creams. |
| Rapidly increasing swelling, marked pain, fever or reluctance to bear weight | Call your equine vet urgently. |
What else might it be?
Mites are especially relevant in itchy, feathered legs. Ringworm, contact reactions, wounds and photosensitivity can resemble greasy heel. In some heavy breeds, persistent lower-limb swelling and thickened skin warrant assessment for chronic progressive lymphoedema.
A hoof abscess or deeper injury can explain lameness even when scabs are also present. Your vet may examine the hoof, take skin scrapings or cultures, or recommend a biopsy for unusual or persistent lesions. A photo alone cannot reliably separate these causes.
When is this an emergency?
Call immediately if the leg becomes very hot and swollen, the horse is systemically unwell, or weight-bearing becomes difficult. Spreading infection beneath the skin can cause severe lameness, as described in the MSD guidance on scratches. Stop work and keep the horse somewhere safe while awaiting instructions.
What should you do next?
- Change the environment. Provide clean, dry bedding and a well-drained standing area. Avoid prolonged mud exposure.
- Record the starting point. Photograph each affected area and note heat, swelling, pain and walking comfort.
- Handle gently. Do not forcibly peel off firmly attached scabs. Ask whether clipping or softening crusts is appropriate; painful horses may need professional handling.
- Use the prescribed plan. Cleaning frequency, topical medication and any antibiotics depend on the diagnosis. Rinse products as directed and dry thoroughly.
- Recheck progress daily. Increasing discharge, new lesions or worsening discomfort warrants earlier review. Agree a review date instead of treating indefinitely.
Bandages and barrier products can sometimes protect skin, but they can also retain moisture or conceal deterioration. Ask your vet whether they suit this particular lesion. Improvement in surface crusting does not necessarily mean a swollen leg has recovered.
Common mistakes
- Scrubbing every day until the skin becomes raw.
- Mixing antiseptics, oils and steroid creams without a diagnosis.
- Riding through lameness because the problem looks superficial.
- Leaving damp boots or wraps in place.
- Assuming all recurrent cases are caused by mud.
Reducing recurrence
Improve drainage around gates and water points, remove wet bedding and check beneath feathers regularly. Use clean, individually assigned grooming equipment when infection is suspected. If washing is necessary, dry the pasterns afterwards. Treatment also needs to address mites, irritation or sunlight sensitivity when these are involved.
Frequently asked questions
Should I remove greasy heel scabs?
Not by pulling them off. Your vet can advise whether gentle softening and removal of loose material is appropriate.
Does every horse need antibiotics?
No. The underlying cause and evidence of bacterial infection determine treatment.
Can I ride a horse with cracked heels?
Do not ride a lame or painful horse. Ask about suitable activity if the skin is sore but walking is comfortable.
How long does greasy heel take to heal?
There is no fixed deadline. Depth, underlying cause and continued moisture exposure affect recovery.
Early attention usually makes management simpler. Protect the skin, identify the cause and take increasing pain or swelling seriously.
For help understanding your horse’s care and preparing questions for your veterinarian, visit ASK A VET™. Urgent signs need an equine veterinarian in person.
