My dog has a white-headed pimple on its back. What's the cause?

Without a [physical exam](https://www.petcoach.co/article/what-does-your-veterinarian-look-for-during-a-physical-exam), I can't say for certain what they are, however, I can tell you that small bumps on the skin which are filled with pus are called pustules. These can be caused by a bacteria infection of the hair follicles (bacterial folliculitis), autoimmune diseases, a bacterial skin infection ([pyoderma](https://www.petcoach.co/article/staphylococcal-pyoderma-a-common-skin-infection-in-dogs-pup/)), a fungal skin infection among others. I would recommend taking Sadie to the vet to determine the cause of the pustules, and to prescribe the proper treatment. In the meantime, do not squeeze them or try to pop them, as you could potentially spread infection. An [e-collar](https://www.petco.com/shop/en/petcostore/product/well-and-good-e-collar) (cone) can be used to prevent lickign or chewing until she sees the doctor.

I don't think this is a serious issue at this point. It looks like a pustule/pimple which may be from an ingrown hair or she may have had an insect bite. You can use these medicated pads on the affected area once a day. If for some reason it does not appear to be going away, or if she gets more lesions, then I would say a vet visit would be warranted. https://worldtails.securevetsource.com/itemView/view/198944_HomeDelivery.pml?productId=117958

It sounds like this is likely to be a cyst of some kind, but could also be an abscess, localized skin infection or some other type of skin growth - pus from an abscess would usually have an odor to it, but not always. You can clean the area thoroughly with warm water and soap, and it's fine to use topical antibiotic ointment like Neosporin as well. But in order to find out for sure what it is and get it treated more effectively, you will need to take your dog to a vet for an exam. He/she can take a sample of the white substance for analysis to help determine what it is, and will advise you based on the results whether it needs to be treated with oral antibiotics or other medication, or if it needs to be surgically removed.

In most cases these skin infections, called bacterial pyoderma, are allergy-related. The antibiotics will help, but as you've experienced the skin problems will come back if the primary allergic disease isn't controlled. The hydroxyzine Becher took was an antihistamine, and that may have helped control the itchiness, however it sounds to me that he needs something a bit stronger to control the allergies and thus the skin infections. Talk to your vet about using Apoquel or Atopica on him; these are great drugs with minimal side effects that really help allergic dogs.

It looks like a pimple, a minor skin infection. You can use a Benzoyl peroxide topical cream or an antiseptic cream in order to help it resolve quicker, but otherwise it should resolve itself without treatment.

The bald spots and pimples may indicate minor infection or may be a symptom of a broader underlying condition. Skin problems can have a variety of causes, sometimes more than one. It is important to have the condition addressed by your veterinarian to determine if there is a medical cause for your pet’s skin issues and treat accordingly. Young dogs can get skin infections, commonly referred to as 'puppy pyoderma'. This usually occurs on the belly and inside the hind legs. This type of infection usually resolves without treatment as the puppy gets older. [*Staph* infections](https://www.petcoach.co/dog/condition/staphylococcal-pyoderma-1/) are common in dogs of all ages and may requires antibiotic therapy to treat. In pets of all ages, [fleas](https://www.petcoach.co/dog/condition/flea-allergy/), [food allergies](https://www.petcoach.co/dog/condition/food-allergies/) and [environmental allergies](https://www.petcoach.co/article/food-allergies-vs-environmental-allergies-whats-the-difference) (contact or inhaled) can be a cause. Any one of these may not be enough to trigger the breakouts, depending on how sensitive your pet is, but a combination can be enough to start the itch-scratch cycle. Finding out the cause and eliminating it is the best course of action. With flea allergies, if your pet is sensitive enough, a single bite can cause them to break out scratch enough to tear their skin or cause a [hot spot](https://www.petcoach.co/dog/condition/hot-spots/). Diagnosing the cause of allergies may require [allergy testing](https://www.petcoach.co/article/allergy-testing-immunotherapy-in-dogs) and [food elimination trials](https://www.petcoach.co/article/food-trials-for-allergies-in-pets-what-to-expect). [Check for fleas](https://www.petcoach.co/article/how-to-check-your-pet-for-fleas-and-ticks) with a flea comb. Look for fleas and/or tiny black granules, like coarse black pepper. This is flea feces, consisting of digested, dried blood. You may find tiny white particles, like salt, which are the flea eggs. Applying a good topical monthly flea treatment and aggressively treating your house and yard will help break the flea life cycle. If you use plastic bowls, this is a possible cause for hair loss, though this tends to be on the chin, where their skin touches the bowl while they eat. If you suspect this to be the culprit, try changing the bowls to glass, metal or ceramic. Food allergies are often caused by sensitivity to a [protein in the food](https://www.petcoach.co/article/all-about-protein-in-pet-food). Hill's Science Diet offers some non-prescription options for sensitive skin as well as [prescription hypoallergenic foods](https://www.petco.com/shop/en/petcostore/category/dog/dog-food/prescription-dog-food-and-treats) for more severe cases. Royal Canin carries limited protein and [novel protein](https://www.petcoach.co/article/what-is-a-novel-protein-pet-food) diets that may also offer some relief. Your vet can recommend a specific diet that will help.

This is likely to be due to a folliculitis secondary to superficial bacterial infection of the skin.A check up, appropriate disinfection and possibly antibiotics (oral, topical or in a shampoo formulation) are needed to solve the problem. Disinfection may be started at home with very diluted hibiscrub or betadine or salted water baths. Buster collar may be useful as well to avoid any licking/scratching (if any). Hope this answer was helpful, but please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further. If this answer was helpful please let us know, this will be used to improve our service!