Excessive licking and chewing of paws or other body parts is a frustrating and common problem for dogs and their owners. This condition, known as acral lick dermatitis or acral lick granuloma, results in hair loss, skin damage, infection, and discomfort. While the behavior may seem innocuous at first, it can spiral out of control into a chronic condition that is challenging to treat. Dogs will lick so intensely that they create a thickened, firm mass of inflamed tissue called a granuloma. The area often becomes irritated, raw and weepy. Understandably, this persistent licking is worrying for owners who just want their dog to stop this harmful behavior. Getting to the root cause of acral lick dermatitis is key, as the approach to treatment will depend on the underlying trigger. With patience, trial and error, and the guidance of a veterinarian, it is often possible to curb the licking for good. But first it is essential to understand why dogs feel compelled to lick themselves raw in the first place.
What is acral lick dermatitis?
Acral lick dermatitis, also known as lick granuloma, is a skin condition seen in some dogs where they compulsively lick a specific area of skin, usually on their legs or paws, leading to hair loss, irritation, and thickened dark skin [1].
Despite the name, it is not technically a true granuloma. The condition involves an area of alopecia (hair loss) and inflamed skin that the dog licks excessively. The licked area often becomes ulcerated and uncomfortable for the dog.
This disorder typically develops on the front legs, especially the carpus (wrists) and metacarpus, but can also occur on the hind legs. The licking behavior leads to progressive hair loss, thickening of the skin, and dark discoloration of the area [2].
While the exact cause is unknown, it appears to be psychogenic in origin, meaning the licking starts from stress, anxiety, or a compulsive disorder. The act of licking then causes physical skin changes that further stimulate more licking, creating a self-perpetuating cycle.
Causes
There are several potential causes for acral lick dermatitis in dogs:
Allergies can trigger excessive licking and chewing at the paws or legs. Food allergies, environmental allergies, and skin allergies may all lead to itching and irritation that prompts a dog to lick affected areas (Source).
Parasites like fleas, ticks, and mange mites can cause severe itching and skin irritation that may initiate acral lick dermatitis. The presence of parasites often leads dogs to lick, bite and scratch at their legs and paws (Source).
Anxiety disorders or obsessive compulsive disorder can cause dogs to excessively lick themselves, sometimes leading to hair loss and sores. Licking may be a self-soothing behavior for stressed, bored or under-stimulated dogs.
Joint pain and arthritis, especially in older dogs, may prompt excessive licking at the legs and paws. The act of licking can release endorphins that provide temporary pain relief.
Bacterial, fungal or yeast infections on the skin can cause itching, irritation and discomfort that leads to licking and chewing of the infected areas.
Diagnosis
Diagnosing acral lick dermatitis usually begins with a veterinary exam of the affected area to rule out physical causes like parasites, allergies, infections or foreign objects stuck in the skin. The vet will look for signs of irritation, redness, hair loss, scabs, wounds and thickened skin.
The vet may take skin scrapings or hair samples of the irritated area to check for ringworm fungi, mites and other parasites under a microscope. Skin cytology involves looking at skin cells for signs of bacterial or yeast infections.
Blood tests may also be done to check for underlying issues like thyroid disorders, Cushing’s disease or allergies which could cause itchiness and licking. X-rays or ultrasound imaging of joints may be done to diagnose arthritis or bone issues which can cause discomfort and licking behaviors.
According to EasyPetMD.com, “The process of diagnosing acral lick dermatitis first begins with observation and testing of the affected area to eliminate physical causes.” Diagnosing the underlying cause is key to treating excessive licking and preventing further skin damage.
Treatment
Treating acral lick dermatitis involves addressing the underlying cause of the excessive licking as well as stopping the itch-lick cycle. The first step is identifying and treating any skin infections or parasites with antibiotics or antiparasitics (Lick Granuloma in Dogs – VCA Animal Hospitals). Oftentimes, antibiotics like cephalexin are prescribed for several weeks along with anti-itch medication (Acral lick granuloma: stopping the itch-lick cycle).
Antihistamines like hydroxyzine or diphenhydramine can help reduce itching. Topical or oral corticosteroids like prednisone may also be used to control inflammation and itching. Applying a bitter tasting topical solution to the affected area can deter licking. An Elizabethan collar may be necessary to prevent licking and allow the area to heal. Identifying and addressing any underlying allergies is also an important part of treatment.
Prevention
There are several ways to help prevent acral lick dermatitis in dogs:
Control fleas and ticks. Flea allergy dermatitis is a common cause of itchy skin that leads to licking and biting. Using monthly flea and tick preventatives can help reduce this irritation (Chappelle Veterinary Clinic).
Manage allergies. Food allergies, environmental allergies, and skin allergies can all contribute to itchiness. Identifying and controlling allergy triggers can reduce licking behavior (WagWalking).
Provide mental stimulation. Boredom and stress are common causes of obsessive licking. Giving your dog plenty of exercise, playtime, chew toys, and training can help prevent obsessive licking behavior (VCA Animal Hospitals).
Home remedies
There are some home remedies that can help deter dogs from licking and chewing their legs raw. These include:
Bitter sprays – Applying a bitter-tasting spray to the affected area can help discourage licking. Look for sprays made specifically for dogs that contain safe, natural bittering agents like grapefruit extract or yucca.
Distraction techniques – Keeping your dog distracted and engaged with toys, puzzles, or training can reduce obsessive licking behavior. Rotate different interactive toys to keep them novel and interesting. Food puzzle toys that require licking or chewing can also satisfy oral needs.
Deterrent collars – Collars designed to prevent licking, such as the cone collar, inflatable collar, or turnout collar, physically block your dog from accessing problem areas.
Compression wraps/clothing – Wrapping the area with gauze or using tight-fitting clothing like dog leggings can make it difficult to lick. But take care not to make clothing too tight.
Stress reduction – Anxiety and stress can trigger obsessive licking. Try relaxation techniques like exercise, massage, calming music or supplements to reduce stress.
When to see a vet
Veterinary care is necessary in severe cases of acral lick dermatitis, if signs of infection develop, or if there is excessive bleeding. Some signs that indicate it’s time to see a veterinarian include:
- The wound is very deep, into the fat/muscle layers
- There is a foul odor coming from the wound
- The area is hot and inflamed
- Your dog has a fever
- There is significant drainage, oozing, or bleeding
- Your dog seems very bothered by the wound and is constantly licking or chewing it
Infections require antibiotic treatment, while excessive licking and chewing may necessitate an Elizabethan collar and medication. Surgery can close severe, refractory wounds. Your veterinarian will determine the best treatment plan based on your dog’s specific condition.
It’s important not to delay veterinary care with this condition, as the longer the wound is present, the higher the risk of developing a deep tissue infection. Always consult your vet if you notice your dog excessively licking an area raw, or if an existing wound seems to be getting worse.
Long term outlook
The long term outlook for dogs with acral lick dermatitis depends on the underlying cause and how well it can be managed. According to VCA Animal Hospitals, this condition can often be a chronic, relapsing problem that requires long-term therapy. In many cases, the underlying cause such as anxiety or boredom cannot be fully resolved, so the licking behavior may return periodically.
Potential complications include secondary skin infections, tissue damage from excessive licking, and self-trauma. Dogs may lick the affected area so much that hair loss, ulceration, and thickening of the skin occurs. Therefore, close monitoring and quick treatment is required to prevent complications. With consistent management of the condition, most dogs can live normal, happy lives. But diligent observation and care is needed to keep acral lick dermatitis from returning or worsening over time.
Conclusion
In summary, acral lick dermatitis is a skin condition in dogs caused by excessive licking, often stemming from an underlying issue like allergies, anxiety, or infection. It’s diagnosed through physical exam and ruling out other causes. Treatment focuses on addressing the underlying trigger, providing symptom relief, and preventing further licking damage with solutions like Elizabethan collars. With proper treatment, most dogs recover well, though relapse is common if the underlying cause isn’t resolved. It’s important for dog owners to determine why their pet is licking excessively and work with their vet on the best treatment plan. Recognizing signs early and stopping the cycle of licking is key to healing acral lick dermatitis lesions and improving a dog’s quality of life.
