Proud Flesh in Horses: Causes, Treatment & Prevention

Horses are prone to injuries – a cut in the paddock, a scrape on a fence, or a kick from a stablemate.

Most wounds heal without trouble, but one complication can turn a small cut into a stubborn problem: proud flesh (1).

Proud flesh – also called exuberant granulation tissue – develops when normal wound healing goes into overdrive (1). Instead of stopping when the skin surface is reached, the tissue continues to grow. This prevents the skin from closing and leaves the wound open, increasing the risk of infection and re-injury (1).

What is Proud Flesh in Horses?

• Also known as hypergranulation tissue (1)
• Most common on the legs, below the knee or hock (2)
• Appears as swollen, lumpy tissue, usually bright pink or red (2)

Symptoms of Proud Flesh

Spotting it early makes treatment easier (3):

• Mushroom-shaped tissue protruding above the skin
• Bright pink or red colour
• Warm to the touch
• Swelling around the wound edges
• Pain when touched
• Excessive wound discharge
• Wound not reducing in size over time
• Fragile tissue that tears and reopens easily

Causes and Risk Factors

Main causes:

• Infection – bacteria from mud, bedding, or manure keep inflammation active (4)
• Movement – wound edges in moving areas are repeatedly pulled apart (1)
• Skin loss – insufficient surrounding skin to close the wound (1)
• Improper bandaging – moisture build-up or pressure points (4)

Why mostly on the legs?

• No muscle layer to help contract the wound (5)
• Tight skin with little elasticity (5)

Treatment of Proud Flesh

Always have a veterinarian examine the wound (6).
Treatment options in the UK and EU include:

• Steroid cream to slow tissue growth
• Pressure bandaging to reduce swelling
• Laser therapy for minor overgrowths (6)
• Surgical removal for severe cases (6)
• Skin grafting for large skin defects (6)

After removal, the vet may prescribe antibiotics, anti-inflammatories, and specialised dressings to prevent recurrence (6).

Preventing Proud Flesh

1. Clean the wound properly
   • Rinse gently with a safe wound cleanser like Vetericyn Plus (7)
   • Remove dirt and bacteria without damaging healthy tissue
2. Apply correct bandaging
   • Use clean, breathable dressings (4)
   • Change daily and stop bandaging once the tissue is level with the skin (1)
3. Fight infection
   • Apply an antimicrobial gel to reduce bacterial growth (7)
4. Limit movement
   • Stable rest for wounds on moving parts (1)
   • Restrict exercise as advised by the vet (1)

Vetericyn Products for Equine Wound Care in Europe

Vetericyn Plus keeps wounds clean, moist, and protected, supporting healing and reducing the risk of proud flesh (7).
Available across the EU and UK via our online shop and selected tack stores.

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References

1. The Horse – Understanding Proud Flesh
2. University of Minnesota Libraries – Large Animal Surgery
3. Horse Life – Understanding Proud Flesh in Horses
4. New England Equine – Equine Proud Flesh
5. Practical Horseman – Equine Proud Flesh Problems
6. Del Oeste Equine Hospital – Skin Grafts
7. Horse and Rider – Prevent Proud Flesh