When Chronic Dermatology Cases Are Actually Wounds: Rethinking Topical Wound Care in Practice

Board-certified veterinary dermatologist Dr. Julia Miller, DVM, DACVD, opened a recent Zarasyl-sponsored webinar with a reframe that changes how many chronic skin conditions get approached in general practice: a lot of what shows up as "dermatology" is, functionally, a wound. Treating it as one, she argues, changes the treatment plan and often the outcome.

The wound-not-just-a-rash mindset

Dr. Miller pointed to several presentations that are easy to categorize as infections or inflammatory disease first, when they may respond better to wound-focused topical management:

• Hot spots. Many are not primarily infected. They're traumatized tissue, essentially a small acute wound, and benefit from wound care rather than antimicrobial-first protocols.
• Post-grooming folliculitis and furunculosis. She described a case with severe post-grooming skin trauma that looked, in her words, like road rash. Treating it as a wound rather than purely as a bacterial folliculitis case was the turning point.
• Perianal fistulas. A staple use case in her practice, with what she described as consistently strong turnarounds when the lesion is packed with a barrier wound care product.
• Eosinophilic granulomas and plaques in cats. Increasingly part of her feline treatment protocol, particularly for cats with excoriation lesions on the neck and head.
• Ruptured anal sac injuries. She shared a case where a minimal-intervention approach, using only a topical barrier product with no oral or topical antibiotics or steroids, showed visible healing at the one-week mark.
• Equine distal limb dermatitis and pastern dermatitis. In a breeding stallion case where oral medication options were limited for reproductive safety reasons, topical wound management alone produced a clear improvement over several weeks, and the product is safe for use in competition animals.

Why the mechanism matters

The barrier cream product Dr. Miller referenced delivers orthosilicic acid via amorphous silicate nanoparticles. She described the tissue-level effects as increased collagen and elastic tissue production, along with a reduction in pro-inflammatory interleukins and anti-fibrotic activity. It's steroid-free and antibiotic-free, which she noted as a specific advantage in true wound cases, since topical steroids can slow wound healing.

Editorial note: the mechanism and tissue-effect claims above should be checked against Zarasyl's approved labeling before this post goes live to a DVM audience.

A practical takeaway for general practice

Dr. Miller's broader point: before defaulting to an antimicrobial or anti-inflammatory topical, it's worth asking whether the lesion in front of you is, at its core, a wound. If so, a barrier-based wound care approach may belong earlier in the treatment plan than it typically gets used.

She also noted that some of her more difficult cases, including a dog with a nonhealing wound that had failed multiple oral medications, took months rather than days to resolve. Client expectations around timeline are worth setting early in these cases.

Watch the full session. This is one segment of a longer Zarasyl-sponsored dermatology webinar with Dr. Miller. Watch the full recording, including her live Q&A with attendees, at zarasyl.com/pages/webinars.

About the speaker

Dr. Julia Miller, DVM, DACVD, is a board-certified veterinary dermatologist with Animal Dermatology Group in Louisville, Kentucky. Her path into veterinary medicine included work as a farrier and in mixed animal practice before she became an award-winning educator and a widely recognized voice in veterinary dermatology. She is known for making dermatology practical and approachable for general practitioners and their teams.