🩹 Vet Guide 2025: Lick Granuloma in Dogs – Causes, Treatments & Managing the Itch-Lick Cycle 🐶

By Dr Duncan Houston, BVSc

Lick granulomas—also known as acral lick dermatitis—are chronic, painful skin sores that dogs create by licking or chewing the same spot repeatedly. These stubborn lesions often occur on the lower limbs and can be hard to cure. In this comprehensive 2025 guide, I’ll explain what causes lick granulomas, how to diagnose them, and the many treatment strategies available. 🐾

🔍 What Is a Lick Granuloma?

A lick granuloma is a self-induced skin sore. It starts when a dog obsessively licks one area of skin, most commonly on the lower legs. Over time, this leads to:

• 🔴 Open wounds or ulcerated lesions
• 🩸 Chronic inflammation and secondary bacterial infection
• 🧬 Skin thickening (fibrosis) and hair loss

These lesions are itchy, painful, and become part of a cycle that’s hard to break: itch ➝ lick ➝ wound ➝ more itch ➝ more licking. 🔁

📌 Common Causes of Lick Granulomas

1️⃣ Medical Causes

• 🌿 Atopic dermatitis (environmental allergies)
• 🦟 Flea bite allergy
• 🍗 Food allergy
• 🧠 Neuropathic pain or joint pain (arthritis)
• 🦠 Bacterial infection or folliculitis

2️⃣ Behavioral Causes

• 😟 Stress, anxiety, or obsessive-compulsive behavior
• 📉 Boredom or lack of stimulation
• 🚪 Long periods of isolation or confinement

🧬 Breeds Most Affected

• Dobermans
• German Shepherds
• Labrador Retrievers
• Golden Retrievers
• Great Danes
• Irish Setters
• Pointers

🔎 Signs & Symptoms

• 📍 Single or multiple thickened sores on front legs, lower limbs, or ankles
• 👅 Excessive licking or chewing at the lesion
• 🎨 Discoloration of fur (often brown/red from saliva)
• 💥 Swelling, scabbing, or bleeding of the affected area
• 😔 Limping or pain when walking

These lesions are commonly mistaken for tumors or infections. Proper diagnosis is key. 🧠

🧪 Diagnosing a Lick Granuloma

Diagnosis includes ruling out other skin conditions such as cancer, fungal infections, and mange. Tests may include:

• 🩺 Physical exam and history
• 🔬 Skin cytology and culture
• 📷 Biopsy and histopathology
• 🦴 X-rays to check for underlying joint or bone problems

🩺 Treatment Options

1️⃣ Treat the Underlying Cause

• 🦠 Antibiotics for infection
• 🍽️ Food trials for suspected allergies
• 🦴 Pain management for joint disease
• 🧠 Behavior modification for stress or OCD

2️⃣ Break the Lick Cycle

• 🧴 Topical sprays (bitter-tasting or medicated)
• 🦺 E-collar or soft recovery cones
• 👕 Recovery garments or bandaging (if advised)

3️⃣ Medication Support

• 💊 Corticosteroids (short-term anti-itch)
• 💊 Antidepressants or anti-anxiety medications
• 💊 Endorphin blockers (for compulsive licking)
• 💊 Pentoxifylline (to reduce fibrosis and inflammation)

4️⃣ Other Therapies

• ❄️ Cryotherapy
• 🔬 Laser therapy
• 💉 Acupuncture
• ✂️ Surgical removal (last resort)

⚠️ No treatment works for every dog. Expect to try several approaches. Patience and consistency are crucial. 🔁

📈 Prognosis

• 🤞 Prognosis is fair with consistent care
• 📅 Treatment can take weeks or months
• 🔁 Recurrence is common if root causes aren’t addressed

Frequent rechecks and monitoring are essential to track progress and adjust treatment. 🔄

📲 Ask A Vet for Lick Granuloma Help

If your dog has a stubborn sore that won’t heal, or you're struggling with repeat lick granulomas, AskAVet.com can help. 🐕

The Ask A Vet App gives you:

• 📸 Remote evaluations of sores and licking behavior
• 💬 Support on allergy testing, behavior management, and topical options
• 📅 Reminders and follow-up care recommendations

📝 Final Thoughts

Lick granulomas are frustrating, chronic skin conditions—but with a comprehensive, patient approach, most dogs can find relief. Success comes from treating the body and the mind, and interrupting the itch-lick cycle early. If you suspect your dog has a lick granuloma, don’t wait. Speak with your vet—or connect instantly through Ask A Vet for help today. 🐾