Acral lick dermatitis is the term given to a very frustrating skin condition we see relatively commonly in our canine companions. Also known as acral lick granulomas, acral lick dermatitis occurs when dogs continually lick an area of skin. Usually, they choose the lower foreleg as their preferred licking spot, but we see acral lick dermatitis in other areas, too. Anywhere a dog can lick is susceptible to becoming an acral lick granuloma.
Acral lick dermatitis starts out small. You may notice your dog licking her arm once or twice, but before you know it, what started as a barely noticeable spot turns into a large, ulcerated, oozing, thickened wound. Once this occurs, your dog gets caught in a vicious cycle of infection, compulsion, and lots and lots of licking.
There are many things that contribute to the formation of lick granulomas. Atopy seems to predispose dogs to lick granulomas, as does their personality. Breeds that are predisposed include:
- Doberman Pinscher
- Labrador Retriever
- Golden Retriever
- Great Dane
- Irish Setter
Boredom and confinement also have their roles, as dogs with nothing else to do will busy themselves at licking. Finally, there is surely a compulsive behavioral component to acral lick granulomas. We believe that there is a release of “feel good” endorphins that occurs from the licking in addition to the soothing feeling the licking provides to an extremely itchy area. Deep bacterial infections and ruptured hair follicles perpetuate granulomas once they form, trapping our pets in a perpetual cycle of licking, even if the initial incident that started the licking (allergy flare, insect bite) is well in the past.
If you notice acral lick dermatitis starting, visit your veterinarian as soon as possible. Breaking the lick cycle early can help with treatment. That being said, treating these beasts can be extremely frustrating for both you and your veterinarian. Therapy should always address removing the primary instigating factor, treating the secondary bacterial infection, and breaking the lick cycle. Topical and systemic antibiotics and steroids will almost certainly be prescribed, and a physical barrier to stop the licking must be used. This can be either an e-collar or bandaging, whichever works best for your pet.
Recurrent or chronic cases of acral lick granulomas may benefit from medications meant to treat the behavioral aspect of the condition. Selective serotonin reuptake inhibitors, such as Prozac, and tricyclic antidepressants, such as Elavil and Clomicalm, have been shown to be effective in controlling acral lick dermatitis when used in combination with the therapies listed above.
If these therapies fail, other options, such as laser therapy, cryotherapy, and acupuncture are available (your pet insurance should cover alternative treatments, too). Each patient is different and therefore responds differently to the various treatments. Try not to get too frustrated--eventually your veterinarian will come to a solution that works for your family, even if it means trying every trick in the book!