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Acral Lick Granulomas in Dogs

What Are Acral Lick Granulomas in Dogs?

Acral lick granulomas in dogs, also referred to as lick granulomas or acral lick dermatitis, manifest as self-induced skin lesions. Typically observed on the legs, particularly the lower extremities and paws, this condition results from a dog excessively licking a specific area. The primary site for a lick granuloma is often the wrist, or carpal joint, of the front limbs, followed by the hock, or ankle, of the hind legs. Indicators of this condition include hair loss, redness, and thickened skin.

When a dog repetitively licks one area of the skin, it initiates a cycle of self-trauma, inflammation, and potential infection. Treating these skin lesions can be challenging, especially in chronic cases, with interventions often yielding only partial effectiveness. Timely medical attention significantly improves the chances of successfully managing lick granulomas in dogs. If you suspect your dog may have developed a lick granuloma, it is crucial to promptly seek veterinary examination and treatment.


The primary behavioral symptom of acral lick granulomas in dogs is repetitive licking, leading to the formation of a distinct, raised, firm, hairless, eroded, or ulcerated skin lesion. These lesions typically exhibit a red coloration and remain moist due to the leakage of saliva and serum, preventing them from drying.

Acral lick granulomas commonly appear as oval patches of skin or skin nodules located on the front surface of a leg, although occasionally more than one leg may be affected. These lesions frequently predispose the affected area to secondary bacterial or fungal skin infections and may result in ruptured hair follicles.


Acral lick granulomas in dogs stem from a variety of factors, reflecting both physical and psychological elements. This condition typically arises from boredom, fear, anxiety, or obsessive-compulsive disorder in dogs.

Underlying triggers for lick granulomas encompass several factors:

  • Stress
  • Allergies
  • Skin infections
  • Trauma or injury
  • Pain
  • Behavioral abnormalities
  • Osteoarthritis

These factors often prompt dogs to engage in excessive licking, resulting in the development of skin lesions. Among these causes, allergies, whether environmental or related to food sensitivities, stand out as the most common catalyst for acral lick granulomas. This condition predominantly affects medium- to large-breed dogs, notably including:

  • German Shepherds
  • Dobermans
  • Great Danes
  • Labradors
  • Golden Retrievers
  • Weimaraners
  • Irish Setters


Excessive licking leading to a skin lesion often serves as a primary indicator for diagnosing lick granuloma in dogs, with the location and appearance of the lesion guiding the diagnosis. When consulting your veterinarian, it’s crucial to provide comprehensive information about your dog’s history, including:

  • Known allergies
  • Recent travel
  • Introduction of new food or treats
  • Changes in environment
  • Instances of stress or trauma

A thorough physical examination enables the vet to assess the underlying cause of the skin lesion. Additionally, they might suggest an x-ray of the limb to identify any signs of arthritis or other bone/joint conditions causing discomfort or pain.

To further investigate the lesion, various skin tests may be conducted, including:

  • Acetate test: Involves adhering clear tape to the lesion, which is then examined for bacteria or fungus.
  • Skin culture: A swab is used to collect samples from the lesion’s surface to determine the most suitable antibiotics or antifungal medications for treatment.
  • Skin scraping: Utilized to diagnose mite infections.
  • Skin biopsy: If traditional diagnostics are inconclusive, a piece of the affected skin is excised and sent to the laboratory for analysis, particularly in long-term cases of lick granulomas where the skin has thickened significantly.


Treatment for acral lick granulomas in dogs primarily targets the underlying cause. It’s crucial to use an Elizabethan or inflatable collar to prevent further self-harm both before and during treatment. Applying bandages should only be done under veterinary guidance, as covering an infected wound can hinder healing and worsen the condition.

If a food allergy is suspected, your veterinarian may initiate a food trial with a highly restricted diet, excluding all other foods and treats. Medications prescribed may include antibiotics, antifungals, anti-inflammatories, pain relievers, anti-anxiety drugs, and/or antihistamines. Topical therapy with creams, wipes, or shampoos is often advised to address infection.

Behavior modification training may be recommended to address psychological factors like anxiety or stress, especially if allergies are not the root cause. Increasing exercise and playtime can help redirect your dog’s focus away from licking. Referral to a pet behaviorist may be suggested for extreme behaviors.

CO2 and cold laser therapies, as well as acupuncture around the affected area, have shown benefits in some cases. Over-the-counter products like Douxo S3 wipes and mousses, along with medicated shampoos and sprays, can be used at home in addition to the collar. Treatment duration typically spans 7-14 days on average to heal the wound effectively.

Living and Management

The outlook for a dog with a lick granuloma is often guarded, as it is seldom life-threatening but can be a source of frustration for both the dog and the pet parent. Determining the most effective treatment for lick granulomas typically involves a process of trial and error, often requiring multiple visits to the veterinarian to identify the optimal combination of therapies. In many cases, lick granulomas are managed on a long-term basis rather than aiming for complete recovery or resolution. It is crucial to note that any significant stressors or changes in your dog’s life may contribute to the recurrence of the problem.

Given that a dog’s mouth harbors bacteria and other pathogens, it is essential to consistently use a protective collar, especially when the dog is alone or at night, to prevent further licking and potential infection of the wound. Left untreated, persistent licking can lead to severe infections in the underlying muscles and bones of the skin. Dogs receiving early treatment for lick granulomas generally have a more favorable prognosis for recovery compared to those with chronic or severe conditions.


To prevent acral lick granulomas in dogs prone to behavioral issues leading to excessive licking, increasing their playtime or extending their walks can help reduce the time they spend focusing on licking.

Regular veterinary examinations, ideally conducted annually, are essential for all dogs. These exams aid in early detection of medical conditions, which can help prevent secondary licking behaviors. Immediate examination should occur at the first sign of any illness or skin condition to mitigate the development of lick granulomas.

Many medications used to manage arthritis, behavioral issues, or allergies must be administered throughout a dog’s life to prevent undesirable behaviors like repetitive licking, which can cause lick granulomas. If stress is suspected as a trigger for your dog’s behavior, it’s crucial to assess the dog’s environment and eliminate stressors where possible. Management of arthritis may involve medications, gradual weight loss, providing soft bedding, implementing massage therapy, and adjusting the diet.

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