Shar Pei care: fever, eyes, ears and skin folds

The Shar Pei's wrinkles come from hyaluronosis, an excess of hyaluronic acid in the skin, and several of the breed's common health problems have been linked to it. In UK primary-care records for 1,913 Shar Pei, the most common problems in a single year were entropion (17.9% of dogs) and ear inflammation (16.4%), followed by other ear disorders, aggression and skin infection. The median age at death was 7.3 years, and kidney disease was the second most common recorded cause after cancer. Care for this breed centers on eyes, ears, skin folds and recurrent fever.

Shar Pei fever and amyloidosis

Shar Pei fever, also called Shar Pei autoinflammatory disease, is an inherited syndrome. The Merck Veterinary Manual explains the link with the wrinkled skin: when hyaluronic acid from the skin enters the bloodstream, it triggers inflammatory signals that cause fever. Episodes last 12 to 48 hours and come with painful joint swelling, most often at the hocks. Some dogs have them every few weeks.

It is common. In a UK survey of 106 Shar Pei, 49% had had at least one fever episode that a vet attributed to the disease, with a median temperature of 40.1°C (104.2°F). Owners reported about twice as many episodes as appeared in the vet records, and loss of appetite was common. Surveys depend on the owners who choose to respond, so the true figure across the breed may differ, but the gap between owner and vet reports suggests that many fevers are never seen by a vet.

The long-term danger is amyloidosis. During and between episodes the liver makes serum amyloid A, an inflammatory protein, and it is laid down as amyloid in the kidneys, liver and other organs. That can end in kidney or liver failure at a young age.

A genetic test is available to identify dogs at risk. No diet prevents Shar Pei fever. If kidney disease develops, the vet will recommend a kidney diet based on test results.

Eyes and entropion

Entropion is an eyelid that rolls inward, so lashes and hair rub the cornea with every blink. It causes pain, squinting and tearing, and can lead to corneal ulcers. Across all dogs in a 2025 UK study of eyelid disorders, the Shar Pei had the highest annual prevalence of entropion, at 15.4%, ahead of the Chow Chow and the Neapolitan Mastiff.

In young puppies with heavy facial folds, a vet may place temporary tacking sutures to hold the lids out while the face grows. Entropion that persists may need surgery to turn the lid outward; in the UK study, 18% of newly diagnosed cases across all breeds were managed surgically. The AKC lists glaucoma, retinal dysplasia and sudden acquired retinal degeneration among the other eye disorders known in the breed. Squinting, tearing, redness, cloudiness or pawing at the eye all need a prompt vet visit. Delay risks the cornea.

Ears

Shar Pei have small, folded ears that sit close to the head. In a UK study of otitis externa, the Chinese Shar Pei had 3.44 times the odds of crossbred dogs, among the highest of the breeds reported.

The American Kennel Club recommends cleaning the ears weekly from puppyhood, without overdoing the products. It advises an ear-cleaning solution to float debris out of the canal, and no cotton swabs or hydrogen peroxide. A typical routine:

• Fill the canal with the solution and massage the base of the ear for a few seconds
• Let the dog shake, then wipe away loosened wax from the outer ear with cotton wool
• Dry the outer ear after baths and swimming

Head shaking, scratching at the ears, odor, dark discharge, redness or pain are signs of infection. Treat early, because repeated infections can thicken and narrow the canal. A dog with recurring ear problems should also be checked for an underlying allergy.

Skin folds

Deep folds hold warmth and moisture, which allows bacteria and yeast to overgrow. Pyoderma, a bacterial skin infection, affected 4.3% of Shar Pei in the UK records in one year, and skin disorders as a group affected about a fifth. Daily care is simple:

• Check the folds on the face, neck and body for redness, moisture, discharge or a yeasty smell.
• Clean with a damp cloth or an unscented, alcohol-free cleanser recommended by the vet.
• Dry thoroughly. Moisture left in a fold undoes the cleaning.

Folds that stay red, smell, ooze or seem painful need a vet, since fold infections may need medicated treatment. Puppies often grow into some of their wrinkles, but adult Shar Pei keep enough folds to need regular checks for life. According to the AKC, the coat itself needs little grooming, and a bath about once a month is enough.

Itchy skin and food allergy

Itching, paw licking and recurrent skin and ear infections are common in Shar Pei, and food allergy is one possible cause among several, including environmental allergy and parasites. We found no published data showing that Shar Pei have a higher rate of food allergy than other breeds.

If the vet suspects food, the standard test is an elimination diet: a prescription hydrolyzed diet or a diet built on proteins the dog has not eaten before, fed with no other food or treats. A review of trial lengths found that at least eight weeks are needed for more than 90% of food-allergic dogs to improve fully. The old food is then reintroduced to confirm the diagnosis. The ingredients most often implicated in dogs are beef, dairy, chicken and wheat.

Omega-3 fatty acids from fish oil are often used to support the skin in allergic dogs. Doses depend on body weight and on what the food already contains, so ask the vet for a figure instead of following a generic label.

Temperament and exercise

Aggression was among the five most common problems in the UK records, and behavioral disorders were the third most common recorded cause of death. The AKC recommends early socialization and puppy classes, with consistent training from the start.

The AKC describes the breed as adaptable in its exercise needs, content with daily walks or with a few short walks in an apartment, and some take part in obedience, tracking, agility and rally. Short training sessions and food puzzles help with mental exercise. At an adult weight of 45 to 60 pounds (20 to 27 kg), a Shar Pei is easy to overfeed if walks are short, so weigh the dog regularly and count treats.

Sources

1. Is it now time to iron out the wrinkles? Health of Shar Pei dogs under primary veterinary care in the UK. Canine Medicine and Genetics, 2023.
2. Shar-Pei Fever. Merck Veterinary Manual.
3. A survey on Shar Pei autoinflammatory disease in the United Kingdom. Journal of Small Animal Practice, 2023.
4. Conformational eyelid disorders in dogs under primary veterinary care in the UK: epidemiology and clinical management. PLOS ONE, 2025.
5. Frequency and predisposing factors for canine otitis externa in the UK: a primary veterinary care epidemiological view. Canine Medicine and Genetics, 2021.
6. Chinese Shar-Pei Dog Breed Information. American Kennel Club.
7. Critically appraised topic on adverse food reactions of companion animals (1): duration of elimination diets. BMC Veterinary Research, 2015.
8. Critically appraised topic on adverse food reactions of companion animals (2): common food allergen sources in dogs and cats. BMC Veterinary Research, 2016.