Equine Sarcoids are considered a skin tumor.

But they are not.

Although common, sarcoids vary greatly in their size and appearance, the nature in which they grow and potentially spread and the way they respond to treatment. This variability makes sarcoids a challenge for both owners and vets.

Scientists dive deep into classifying sarcoids into groups:  occult, verrucous, nodular, fibroblastic, mixed, and malevolent.   This grouping is based solely on what they look like on the horse.

This "work" keeps scientists busy while they overlook the actual cause of sarcoids:   heavy metals.

Different types of heavy metals create different looking sarcoids.

I'll explain how to treat sarcoids in a minute. First, just a quick explanation of sarcoid classifications.

Sarcoid classifications

There are 6 classifications for equine sarcoids; occult, verrucous (warty), nodular, fibroblastic, mixed and malevolent. Again no two sarcoids are the same and may contain characteristics of several different types.

Fibroblastic sarcoid near eye
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Mixed sarcoids on neck of horse
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How to treat horse sarcoids

Sarcoids are caused by heavy metals.   The horse's liver is supposed to remove heavy metals.   So to treat horse sarcoids, you must help your horse be able to remove heavy metals.

This is why there are over 40 different treatments worldwide for Sarcoids. Because, depending on the which heavy metal(s) and what part of the body, different treatments work for different horses.

For your convenience, here are traditional veterinary medicine sarcoid treatments.  These do not address the underlying cause.   They are solely aimed at eliminating the visual sarcoid.

Traditional Veterinary treatments for horse sarcoids

Note:  these can remove sarcoid only, NOT address the underlying cause

Ann Rashmir-­Raven, DVM, MS, Dipl. ACVS, associate professor of Large Animal Clinical Sciences at Michigan State University's College of Veterinary Medicine talks about different treatments:

Surgical Removal­­---While this is a relatively easy procedure to carry out in most cases, Rashmir­Raven noted it has a recurrence rate of 15 to 82%, with the majority of tumors growing back more aggressively and within six months. "Surgical excision is better used to reduce tumor volume and improve killing efficiency of other treatment modalities," she suggested. She gave practitioners in attendance some tips on removing sarcoids, but stressed using adjunctive treatment options.

Laser Removal­­---The concept of laser removal isn't too different from surgical removal; however, it might offer some benefits over the latter option, Rashmir­Raven noted: "Because laser energy is absorbed by surrounding tissues, tumor cells are killed up to 0.2 mm beyond the wound margins." The downside? This method of excision has the potential to aerosolize infectious particles and agents from the sarcoid being removed, and Rashmir­Raven said it's unclear what impact this could have on the horse and/or surgeons performing the procedure. Like surgical removal, she suggested veterinarians use laser removal in conjunction with another treatment option.

Cryotherapy­­---Although cryotherapy is a cost­effective sarcoid treatment option, Rashmir­Raven noted, "recurrence rates vary widely for this procedure with some authors reporting little success (1%) and others reporting 100%." In this procedure veterinarians use liquid nitrogen to literally freeze the tumor off the horse's body. Rashmir­Raven noted that cryotherapy typically results in scarring and hair depigmentation at the site of removal, so this isn't the most cosmetic removal option. Additionally, she said, "due to the significant tissue destruction associated with cryotherapy, it might not be appropriate for tumors near the eye, nostrils, or similarly significant structures."

Intratumoral Hyperthermia­­---Intratumoral hyperthermia, in which the sarcoid is heated, has reportedly been successful in treating equine sarcoids, she said. "More recently hyperthermia treatments have also included concomitant (when multiple drugs are given at or almost at the same time) chemotherapy," Rashmir­Raven added. Unfortunately, hypertherapy units are not readily available in private practice.

Cisplatin Injections and Beads---­­One of Rashmir-­Raven's choice treatments is the chemotherapeutic drug cisplatin, which is used in both injectable form and beads. She reported that cisplatin "consistently provides long­term control of equine sarcoids with a 96.4% resolution rate (3.7% recurrence rate) after four years in 409 cases."

When using a cisplatin injection, she explained that tumors are generally injected three to five times, every two to three weeks. Large sarcoids, she said, should be debulked prior to cisplatin treatment. When using cisplatin beads ­­which release the drug slowly over the course of 30 days ­­the practitioner inserts the beads in the tumor and the surrounding areas, she explained. Rashmir-­Raven said she prefers the beads to the injection for most sarcoids due to the ease of placement. "Long­term results with cisplatin ... have provided the best tumor resolution rate of all the published sarcoid treatment modalities," Rashmir­-Raven said.

She briefly discussed the use of cisplatin electrochemotherapy in treating sarcoids, noting that one clinical trial that yielded a 99.5% success rate. Horses require general anesthesia for electrochemotherapy, so treatment cost is typically high, she noted.

Topical Acyclovir­­---Rashmir­-Raven explained the topical application of the antiviral drug acyclovir is considered a safe and cost ­effective treatment and surgical excision. In one study she discussed, acyclovir reduced the size of all 47 treated sarcoids and completely resolved 68% of those tumors. "Acyclovir is proposed to be routinely used for the treatment of flat and mild ­type sarcoids or potentially as a relatively economical way to shrink tumors prior to the use of cisplatin," she said. She added that the cream or ointment should be applied daily for two to six months.

Topical Immiquimod­­---Known by the trade name Aldara, Rashmir­-Raven said that in studies immiquimod has reduced nondebulked tumor size by as much as 75%, and she added that her personal results with the drug have been even more effective when used on tumors that have been debulked. The drug is applied every other day for 32 weeks or until the tumor is resolved, she said. Potential side effects from immiquimod use include inflammation, oozing, hair depigmentation, and hair loss.

Topical Bloodroot Extract---­­Rashmir­-Raven discussed the use of a bloodroot extract salve used to treat a variety of skin conditions, including sarcoids. She relayed that the salve, marketed under the trade name Xxterra, is an economical option for some small sarcoids and larger sarcoids for which more expensive treatment isn't an option. Sarcoids typically begin sloughing in seven to 10 days, and treatment is often required more than once.

Bacillus Calmette­Guerin (BCG) Injection­­---Rashmir­-Raven explained that BCG injections ­­one type of sarcoid "immuno-stimulant"­­ are known to have good success rates in treating sarcoids around the eyes (83­-100% efficacy). However, the success rates drop to less than 50% when treating sarcoids located elsewhere on the body. Additionally, she said, severe inflammatory and allergic reactions and anaphylaxis (a rapidly developing and sometimes life­-threatening allergic reaction) have been known to occur when using BCG.

Autogenous Vaccines and Sarcoid Implantation­­Essentially autogenous vaccines are created using tissue from the patient's own body to prompt an immune response, Rashmir-­Raven explained. "Similarly, the removal, freezing, and re-implantation of a sarcoid into the same horse has demonstrated success in a limited number of cases," she added. Also, while tumor implantation using sarcoids from a different horse has decreased the size of some sarcoids, it has also been known to stimulate the growth of new tumors,

she reminded. "Because other less­ invasive treatments frequently work well and tumor transplantation from a donor horse bears risks ­­such as tumor production and transmission of other diseases­­ this procedure should be reserved for refractory cases," Rashmir­-Raven stressed.

Alternative sarcoid treatments for your horse

Note:  these can remove sarcoid only, NOT address the underlying cause

Electric Zapping

A somewhat unconventional treatment, electric zapping is another effective option. An electric zapper, invented by Hulda Clark, electrifies the blood and kills any parasites, bacteria or other infection ­causing organism. As sarcoidosis is often caused by fungus, this treatment is typically effective for eliminating the condition.

Crest Toothpaste

Leta’s Herbs and Animals tried an experiment with Crest Toothpaste. Hearing that the fluoride in the toothpaste would help dry up the sarcoid. In about two weeks it was starting to dry up the sarcoid just like she had read. Despite there being no medical evidence for the treatment, some people claim that it does work. Accord to Horse and Hound Magazine Professor Derek Knottenbelt — an equine dermatology expert at Liverpool University says,” that this is completely ludicrous” while there are many that disagree with him.

Fluoride mouthwash

Richard with Horsekeeping LLC had heard from dozens of horse owners who have treated their horses' sarcoids with fluoride mouthwash. Some had the same good results just like he had, the sarcoid dried up and went away. Others saw the sarcoid diminish in size but not go away, while others saw no effect whatsoever

Hydrogen Peroxide

Hydrogen peroxide is a safe antibacterial agent comprised of oxygen and water. As such, hydrogen peroxide effectively kills the infection associated with sarcoidosis via oxidation, or a process much like burning. The product is an effective cleanser, which functions to eliminate infection and, in turn, reduce inflammation.

How to treat the CAUSE of horse sarcoids

If you would like to fix your horse so that the sarcoids go away and do not come back, here are your options:

1) Support your horse's liver

The liver removes heavy metals.  If overloaded, it cannot.   Because the skin is a secondary filtering organ for the liver, the heavy metals are directed to the skin when the liver is overloaded.

Note: by the time your horse has sarcoids, the liver is very stressed.

Sarcoids show up in different forms and different areas of the horse because of the type of heavy metal(s) involved, as well as the horse's overall circulation.

The best treatment to help horse sarcoids is TBT Liver Revival.

2) Discontinue dewormer

I realize this is confusing and tough to understand.   We've been taught that "parasites" are bad for our horses.  Actually, they're part of a symbiotic relationship.    Parasites are the horses first line of defense against heavy metals.

Parasites eat heavy metals.   If the parasites eat them, then the horse's liver doesn't have to deal with those heavy metals.

When the parasites eat enough heavy metals, they die and get pooped out.

So, seeing worms in your horse's poop is actually a good thing.   It shows this symbiotic relationship is effective.

3) Decrease heavy metals in horse food

If you can get organic hay, this would be best.   Pesticides, fertilizer, fungicides and the like all contain heavy metals.

Bagged feeds also contain heavy metals as preservatives.

Ideally, all bagged feeds should be eliminated.  Horses are most healthy on mixed-species hay (no rye, no alfalfa, no clover), available 24/7.

Once the liver is working well (typically about 4 months of TBT Liver Revival), and the parasites are doing their job, the sarcoids will go away.