Because of its popularity after being introduced to North America in the 1970s, the breed suffered much inexperienced or rushed breeding. This resulted in not only a dramatically different look for the Shar-Pei (as its most distinctive features, including its wrinkles and rounded snout, were greatly exaggerated), but also a large number of health problems. The American breed club states that few Shar Peis make it to age 10 and has a longevity program that records dogs that live 10 years or more.
Compared to other breeds, Shar Peis have increased risk of developing atopic dermatitis, a chronic allergic skin disease. Dogs with allergic skin disease often get allergy-induced skin infections. Shar Peis are also at increased risk of demodicosis, a disease which happens when Demodex canis mites proliferate and cause skin irritation, inflammation and infection.
Familial Shar Pei fever (FSF) is a serious congenital disease that causes short fevers lasting from 24 hours, sometimes up to three days and usually accompanied by accumulation of fluid around the ankles (called Swollen Hock Syndrome). Amyloidosis, a long-term condition, is most likely related to FSF, caused by unprocessed amyloid proteins depositing in the organs, most often in the kidneys or liver, leading eventually to renal failure. The disease is associated with the western type and it is estimated that 23% are affected. The Australian breed standard was changed in 2009 to discourage breeding for heavy wrinkling.
A common problem is a painful eye condition, entropion, in which the eyelashes curl inward, irritating the eye. Untreated, it can cause blindness. This condition can be fixed by surgery ("tacking" the eyelids up so they will not roll onto the eyeball for puppies or surgically removing extra skin in adolescent and older Shar Pei). In Australia, more than 8 in 10 Shar Peis require surgery to correct eye problems, contributing to them being the most expensive breed to insure.
The Shar-Pei is also prone to chronic yeast infections in its ears. This is due to tight inner ear structure with a wrinkled appearance, making cleaning very difficult; exacerbated by the tight "flap" that the ear creates over the canal, promoting a moist environment. Vitamin B12 deficiency is a common problem in the Shar Pei and is suspected to be hereditary.