Both my horses with white socks are effected. No mud in the pasture, so I am thinking it’s the dew. I have been applying Equiderma zinc oxide paste twice a day without much improvement. They are in during the day (9AM-4PM).
Other medication I can try? Alter turnout schedule to avoid dew? (that would mean keeping them in from sunset to mid morning)
A couple things spring to mind - the company that makes Keratex has a “mud powder” that works well. Also, Le Mieux has mud fever boots that help reduce the wetness.
I think there is a different theory of cause and different idea for cure for every horseman/horsewoman who has a horse with this problem.
I’ve had 3 that had it in different degrees of severity, but none so sever that it interfered with daily use.
Two were OTTBs --one grey one bay. The third was a heavily feathered grey Percheron. What I learned from a veterinary (and I can give you his CV, but suffice to say he taught at a prestigious veterinary college before going into private practice) -in his opinion Pastern Dermatitis is caused by a fungus or bacteria (can’t remember which) that is present on all horses’ skin. Some horses immune systems are unable to target the cause and that horse has symptoms of what the vet and you call Pastern Dermatitis. That vet said (and this was 7 years ago, might be newer theory) that he could culture and treat and resolve the pastern dermatitis, but it would return as the horse’s immune system returned to normal after the course of antibiotics ended.
So, what I do is treat the symptoms when they are present. I’ve found daily application of “something gooy” like diaper cream, or Vaseline keeps the area soft and fly-free. I am cautious about leg wraps and fly boots as at times these can irritate an already irritated area.
FYI the OTTB that is bay, has the same occurrence on both hind legs, one completely black and one white sock. The draft with the heavy feathers had the same incidence with or without his feathers which we completely shaved at one point to address the pastern dermatitis.
So, what I think (and trust me, every horse person will have his/her own theory) is that unless the pastern dermatitis is causing the horse to be unable to work, or makes him uncomfortable, treat the symptoms. Of course, the best course is to talk to your vet before you do anything else.
If you think it’s due to wetness, try keeping them dry with athletes foot powder. It’s cheap at the dollar store.
For anyone wanting a good review article of pastern dermatitis:
https://www.chronofhorse.com/article/fact-or-fiction-setting-the-record-straight-on-scratches/
This is true, but on the other hand, fly leggings can also help keep the lower legs dry. I like @luvmyhackney’s suggestion to try athletes foot powder. For treating symptoms, I’ve had good luck washing with Malaseb shampoo and then coating the scabby areas with an iodine gel. Malaseb shampoo has chlorhexadine and miconazole, so it will target both bacteria and fungi. Iodine gel also will kill both bacteria and fungi, and the gel formulation helps keep the flies away. An iodine shampoo would probably work just as well as Malaseb.
Cowboy Magic makes a spray they call “Crud Buster,” which I’ve found effective for mild cases.
When the Goober’s pasterns get really bad, I mix a combo of diaper cream (zinc oxide), antibiotic ointment, and anifungal cream, and smear it thickly and liberally on bone-dry legs. The abx and antifungal works on healing, while the diaper cream keeps additional moisture out.
Diaper cream on its own can also be used as a preventative measure — but pasterns need to be completely dry before application.
My first go to is what is your nutrition. May not be the cause or contributor but rule it out. Are you getting enough zinc and copper, Vitamin E.
Then, because movement and mental health is so important, just coat it. My love these days is Red Horse products Honey Heel. Super sticky zinc oxide w honey etc and coats and heals. So you can turn out in the dew. You can knock it out and gone. If it comes back you know you’ve got something else going on.
Nutrition, inflammation, immunocompromised…for some reason.
What I’ve found in my immunocompromised dude is slowly getting him better in THAT way has helped with his Mallenders/Sallenders - whatever one is the hind leg crap on the back that now is gone . I’m like what? Been battling that for 3 years? And all of a sudden it’s gone. Interesting. Interesting to see if/when that comes back. At least it’s gone for the first time ever. Ever. Addressing nutrition, gut inflammation, inflammation in general has helped everything. All skin issues.
That’s my anecdotal report. 
if it’s just the white legs it’s probably something that is UV mediated. I would try the white pull on socks for a while.
I can tell you what has worked over the past couple of weeks for my gray horse.
I’ve washed the area with a mild soap; the first time I used a soap that was anti-microbial, but after that, I’ve just used a mild horse shampoo.
I’ve dried the area with a clean towel, and then let it air dry. Then I’ve rubbed a generic triple antibiotic cream or ointment onto any rash-y areas, then put on a layer of otc cortisone cream (liberally), then a layer of zinc oxide paste. The next day, I repeated, and so on for a week or so. I’ve also trimmed the bottom of her long, lush tail so that it clears the region of the legs that are affected.
My horse is turned out early in the morning and comes in late in the evening. There’s only a little mud in her paddock, but she loves it with a passion! So she’s hardly mud-free.
The routine has done a good job of clearing it up. But I agree with those posters above that there’s a lot of individual variance in terms of what may be causing the problem and what will help resolve it.
^^^^^ 
IME, MOST scratches and rain rot get resolve by adding a decent amount of copper and zinc to the diet and, if on a hay-only/mostly diet, some extra Vit E
For treating an existing scratches situation, my go-to is a tube of (generic) desitin, the 40% zinc oxide), a tube of cortisone cream, a tube of Neosporin ointment, some find it helpful to add in a tube of fenbendazole (Safeguard, Panacur) and mi it all together.
Wash and thoroughly dry the area ONCE. Then apply the mi. Wipe it off and reapply twice a day until there’s pink skin and no scabs. Scabs will start falling off when you wipe old goop off, don’t try to force them off. Then applying once a day until there’s good hair coverage again is good.
In the meantime, add copper and zinc, and the chances are very good you won’t have an issue again.
It’s funny how everyone has their own potion for this. My recipe (taught to me by the vet) is equal parts Desitin, Preparation H, athlete’s foot cream, and triple antibiotic. This is very fun to buy all at once at the Walgreens staffed by high school students.
I also alternate washing the leg with chlorhexidine and a mild soap like Ivory or Castile, and use baby powder with aloe to help finish drying so I don’t irritate the skin with vigorous toweling off. Towel until damp, liberal application of baby powder, brush off in 5 minutes.
I’ve got a senior with Cushings, so his immune system has to get by with a little help from pharmaceutical friends.
Generally, I don’t want to keep washing the affected areas. The goal is to clean, then protect, while keeping moisture off.
But things like Gold Bond powder or similar, brushed in, can be great in helping prevent another occurrence for those for whom this is a deeper immune issue that can’t be resolved with diet.
How do you manage the buildup of scratches potion + dirt/mud/clay/whatever else the horse stood in in the field if you don’t wash the leg? A daily leg wash, or at least a spot treatment with a washcloth, has always seemed like a necessary evil in treating the crud. Hair of a certain length preventing the skin from breathing + humidity + barrier products + it rained last night and horse stood in the mud = skin hygiene issue that just seems counterproductive.
(On that note, given that my horse is inclined to grow feathers and a native breed type of hair coat, the most effective thing I’ve ever done for spring and summer skin funk is clip that off and let air get on it. If the case is not advanced, sometimes just letting the skin breathe for 24 hours just fixes the problem with no further intervention. Don’t rip off the scabs, get as close as you can to them and then take a #10 or a body blade in the direction of the hair.)
Desitin really keeps crud off the leg, so a good wipe down removes it pretty well. Then, reapply. If the original application was thick enough, there’s little to no dirt on the leg itself
If it’s just really gross, then a wash is a good idea
It IS a good ideal to clip the hair as best you can, working around scabs, to shorten eisting hair as much as possible, going with the growth, not against it. If the scabs are super bad, it’s a good idea for a vet to sedate and get rid of all the hair and scabs so you have a clean slate.
We have very different experiences with this and I wonder if it’s application, nature of horse’s hair, or local soil!
I do agree that Desitin is practically body armor. I’m a runner and I used to use it as an anti-chafe barrier but the problem became that after 3 hours, I hadn’t sweat it off, it hadn’t rubbed off, AND it got so embedded in the troublesome clothing seams that I had to scrub it out with a toothbrush because the laundry detergent couldn’t get it all out on a normal cycle.
oh for sure! Zinc oide is the devil to remove. I use paper towels, wipe as much off as I can which is definitely just smearing what’s left, and apply new. Rarely have I had to wash, and this was with the horse living out full time on red clay pasture
For cases that need a little pharmaceutical help, I prefer using a betamethasone/gentamicin pump spray that is labeled for use in canine pyoderma, because IMO, any goopy topical is going to pick up dirt and debris.
This is the only thing that cleared up my horse’s persistent pastern dematitis, and it was like magic after months of various concoctions of messy goops to just spray this on twice a day and have it clear up in days. He was biopsied and found to be UV sensitive. I’ve kept it from reoccuring by never clipping his white legs and keeping him in fly boots anytime he’s in a paddock.
My horse recently ran out of his copper/zinc supplement, and within a week has developed a very mild case of pastern dermatitis. My DH was making up feeds (prepped 12 days at a time in containers) and forgot to mention that he was out. I went to make up feed and noticed this.
It’s not coincidence that this horse has some pastern dermatitis since he stopped receiving this supplement. So I cannot emphasize enough how much that can play a role.
I know that there are other factors, but this one seems significant to this horse.
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