What is canine lick granuloma?
A lick granuloma, also known as acral lick dermatitis, occurs when a dog obsessively licks at an area, often on a lower limb, most commonly the wrist or carpal joint of the front limb. These dogs find a spot to lick and start a cycle of self-trauma, inflammation, and infection. This condition is thought to be both physical and behavioural.
The condition occurs mainly in medium to large breeds, particularly Doberman Pinschers, Great Danes, Labrador Retrievers, Weimaraners, Golden Retrievers, and Boxers. However, any breed may develop lick granuloma.
The exact cause of lick granuloma is unknown. However, it is believed to be caused by multiple factors that are both physical (e.g. allergies, infection, joint pain) and behavioural (e.g. fear, anxiety, compulsive disorder). In some cases, the licking may start because of a minor irritant such as an insect sting. Although it can occur on the back legs, the top and outside surfaces of the front legs are most affected. These are areas that the dog can constantly lick while lying in a normal position.
Written by Dr. Mariella Roberts, Veterinary Surgeon, Animal Trust Vets CIC | Published May 2025 | Review date May 2027 | This advice is for UK pets only and is not a replacement for seeing a vet
Symptoms
Persistent, repetitive licking at a specific location, usually the front of a leg.
Well-defined, raised, firm, oval, hairless skin lesion or nodule.
The lesion is typically red, moist, and may appear eroded or ulcerated due to constant licking.
Possible secondary bacterial or ringworm infections and ruptured hair follicles.
When to contact your vet
Lick granuloma is not an urgent condition, but it can significantly affect your pet’s quality of life. If the area becomes sore, infected, or prevents your pet from resting comfortably due to irritation, it’s best to schedule a veterinary appointment.
Diagnosis
Appearance and history are a major guide to diagnosis.
X-rays may help rule out underlying bone issues like arthritis
Conscious skin samples to check for infections e.g. bacteria, yeast, parasites
Skin biopsies may be necessary if there is no response to treatment or to rule out other causes such as deep mites or tumours.
Dog granuloma treatment
The treatment will vary depending on your pet's condition. Identifying the underlying cause is important in determining the best course of treatment. Most dogs require treatment aimed at inflammation, infection, and behavioural components for resolution.
Topical and oral anti-inflammatory medications, such as steroids, are helpful in reducing inflammation.
Protective devices used to prevent self-trauma, such as e-collars, bandages, or shirts may be recommended in the initial stages of the disease while the medication is starting to relieve the itch.
Antibiotics are often required to treat secondary skin infections.
Therapeutic laser and acupuncture have also been used successfully for this condition.
Behaviour modification and medications may be needed to manage anxiety and compulsive behaviour disorders. Addressing any underlying anxiety by providing the dog with more pleasant interaction and stimulation as well as eliminating anxiety triggers is often strongly recommended.
Prevention
The best way to prevent lick granuloma is to address it before it begins. Lick granuloma can be challenging to treat, especially if it is due to behavioural causes.
Keep these prevention tips in mind:
Promptly report any changes to your dog’s pain or anxiety levels, level of itchiness, skin appearance, to your vet.
Administer prescribed medications as recommended by your vet.
If your dog suffers from environmental allergies, work with your vet to identify the type of allergy.
Consider naturally calming treatments and supplements.
Use an E-collar or lick deterrents if you notice that your dog is starting to constantly lick an area.
Outlook
These lesions can often be chronic, relapsing problems that require long-term therapy. While the condition can be frustrating to get under control, most cases of a lick granuloma can be successfully managed.