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Lick granulomas (or acral lick granulomas) are chronic skin lesions in dogs caused by — you guessed it — incessant licking. What makes them frustrating for pet parents and veterinarians alike is that they often persist despite all of our best efforts to “lick” them!

Lick granulomas are characterized by a hairless area of thickened, ulcerated skin. Usually, the lesions are isolated, but sometimes there can be more than one. They frequently occur on the lower extremities (the lower front legs are often the favored spot), but anywhere a dog can reach to lick is fair game.

Though lick granulomas may sound similar to hot spots, they differ in a few ways. While hot spots show up suddenly, lick granulomas develop slowly over time. Hot spots are easily treated and heal in a matter of days, but lick granulomas can persist for weeks or months — even with treatment.

A dog may start licking his skin for any number of reasons or for no real reason at all. Bug bites, foreign bodies (like splinters), healing wounds, food allergies, atopy (skin allergies) and joint pain can lead to licking, as can behavioral problems or sheer boredom. The constant licking can lead to secondary skin infection and itchiness, which in turn leads back to licking! Making matters worse, dogs get a release of endorphins when they lick (similar to when you scratch), giving them a “feel good” reason to continue the behavior.

Your dog’s breed can play a part in his likelihood of developing lick granulomas — they tend to occur more often in Doberman Pinschers, German Shepherds, Golden Retrievers, Great Danes, German Shorthaired Pointers, Irish Setters and Labrador Retrievers.

Your veterinarian can easily identify a lick granuloma based on clinical signs and your dog’s history, though some vets may request a biopsy for definitive diagnosis. To rule out any other skin conditions, skin scrapes and fungal cultures will likely be done to confirm the findings.

Treatment centers on correcting the underlying problem, be it physical or behavioral:

  • Topical or oral antibiotics fight secondary infection, and sometimes treatment with a CO2 laser is recommended.
  • Discouraging licking behavior is key — a physical barrier like a cone collar or bandage can be useful, as can applying a distasteful substance like bitter apple spray to the lesion.
  • Some dogs will benefit from behavior modification and/or medications like antidepressants.

Individual dogs respond differently to different treatments, so some trial and error will likely be involved in resolving this stubborn problem. It can be difficult, but with diligence and persistence, granulomas can be licked!

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