Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Written by Leslie Kasperowicz
Farmers CSR for 4 Years Leslie Kasperowicz

Melanie Musson is the fourth generation in her family to work in the insurance industry. She grew up with insurance talk as part of her everyday conversation and has studied to gain an in-depth knowledge of state-specific car insurance laws and dynamics as well as a broad understanding of how insurance fits into every person’s life, from budgets to coverage levels. She also specializes in automa...

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Reviewed by Melanie Musson
Published Insurance Expert Melanie Musson

UPDATED: Nov 17, 2020

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Acral Lick Granuloma Treatment Cost: $50 to $1,500

What is Acral Lick Granuloma in Dogs?

Acral lick granulomas, or lick granulomas, are also known as acral lick dermatitis. They are one of the most frustrating conditions for veterinarians and pet parents.

A lick granuloma is a chronic and infected skin lesion.

They usually start as a small, harmless spot. But the spot isn’t the problem. A granuloma forms when the dog obsessively licks and chews the tiny spot. The result is a big, oozing wound.

Granulomas affect the deepest layers of the skin. The dog’s compulsive licking forces bacteria far down, even to the base layer. Most granulomas have broken hair follicles, scarred oil glands, and wounded blood capillaries.

Acral lick dermatitis most often occurs on the front lower legs and paws because these areas are easily accessible by the dog’s mouth.

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Causes of Acral Lick Granuloma

It might seem like a bothersome bump causes that kind of licking that eventually forms a granuloma. However, there are many things that cause a dog to lick themselves:

Dog Anxiety and Stress

Many granulomas occur because of dog anxiety. Dogs “self-stimulate” to cope with feelings of anxiety. One method of self-stimulation is repetitive licking.

For a dog with moderate to severe anxiety, the licking becomes compulsive. Unfortunately, by trying to self-soothe, a dog inflicts painful wounds.

Stress in dogs can be caused by a new child or pet in the home, separation anxiety, or unfamiliar surroundings. There are many other sources of stress for dogs.

Boredom in Dogs

Some veterinarians believe that boredom can lead to lick granulomas. With nothing else to do, dogs lick themselves excessively to pass the time.

Canine Allergies

Allergies can cause skin inflammation and itching. Dogs will lick to manage the discomfort. Even mild allergies can cause itchiness. Dogs can be allergic to food and environmental allergens, such as pollen.

Foreign Bodies

A bee sting, splinter, or thistle spine can be painful if not removed. Dogs will groom a painful area in order to get rid of whatever is bothering them. Grooming may become excessive if the foreign body can’t be easily removed.

Hypothyroidism in Dogs

Some cases of acral lick granuloma are due to hypothyroidism in dogs. This is more commonly seen in black Labs than any other breed.

Dog Breeds Prone to Lick Granuloma

Any dog can suffer from excessive licking, but certain breeds are more prone to acral lick granulomas. These breeds are:

Treating Acral Lick Granuloma

The obvious treatment for lick granulomas is to stop the licking. But it’s not that simple. It’s very hard to get a dog to stop licking themselves, especially when they’re left alone.

Lick granuloma treatment is complicated and frustrating. The wound may begin to heal, but the dog will begin licking again and all progress is lost.

Stop Dog from Licking a Granuloma

Pet parents and veterinarians may apply a bandage or cast-like material to the granuloma to protect it. Most often, the dog will begin licking the other leg and cause a second granuloma.

Other recommended treatments are to apply a foul-tasting topical to the area or to make the dog wear a medical collar. These are temporary solutions that don’t provide a long term fix. The dog will resume chewing at the granuloma once the collar is removed or the topical becomes tolerable.

Acral Lick Granuloma Laser Surgery

Recently, laser surgery has become an effective treatment for lick granulomas. Veterinary surgeons carefully laser the granuloma to remove the diseased surface layers.

At the same time, nerves are sealed off so the dog doesn’t experience ongoing pain or discomfort. This reduces the desire to lick (if the granuloma isn’t due to psychological causes).

Not all veterinarians have laser instruments. Ask your vet for a referral if you are interested in laser treatment for your dog’s lick granuloma.

Anxiety Medications for Lick Granulomas

Unfortunately, laser surgery may not be very helpful in the long run for dogs with a psychological compulsion to lick and chew. Lasers can’t prevent a dog from causing another granuloma.

In anxious dogs, anti-anxiety medications may reduce self-soothing behaviors. This can lead to less lick dermatitis, but it is usually not a complete solution.

There over the counter products for dog anxiety. Many pet parents trust these products to help calm their dog.

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Lick Granuloma Cortisone Injections

Cortisone injections can provide rapid relief for lick granuloma symptoms. Cortisone reduces swelling and itchiness.

However, the calming effect only lasts as long as the wound is left alone. Once the dog begins licking the area, the granuloma is activated again

Antibiotics for Acral Lick Granulomas

Long term antibiotics may be the best treatment for acral lick granulomas.

Most dogs with chronic granulomas have success with 3 to 6 months of antibiotic medications, in conjunction with topical treatment.

Related: 10 Things You Must Know Before You Buy Pet Insurance

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Preventing Acral Lick Granulomas

There is no cure for lick granulomas, but pet parents can take steps to prevent them from recurring.

Paying close attention to areas that seem bothersome and treating them quickly can prevent incessant licking.

Dog Food and Lick Granulomas

There is no doubt that diet plays an important role in granuloma formation (as well as other dog skin issues). A wholesome diet is necessary for healthy skin and coat.

If your dog is suffering from chronic granulomas, consider switching to a whole-foods based or a raw-food diet.

Dog food allergies are to proteins only, so experiment with switching proteins. For example, feed turkey instead of chicken.

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Lick Dermatitis and Nutritional Supplements for Dogs

Also, adding nutritional supplements can make a huge difference in your dog’s skin.

Omega-3 fatty acids strengthen the skin’s protective barrier. Probiotics address digestive issues that lead to skin conditions.

Pet Insurance and Acral Lick Granulomas

Many pet insurances cover prescription medications, nutritional supplements, and veterinary treatment for acral lick granulomas.

If your dog needs surgery for acral lick dermatitis, pet insurance can reimburse you for up to 90% of the surgery cost.

Additionally, some dog insurances offer wellness plans for preventative care.

We recommend comparing pet insurances to find a plan that offers the best coverage for your dog while fitting your budget.

We also recommend insuring a puppy before they develop acral lick granulomas or other medical issues.

Be aware of pet insurance pre-existing conditions.

If your dog is diagnosed with lick granuloma before you invest in pet insurance, treatment may not be covered.

Return to the Dog Health Problems glossary.

Other articles you may find helpful: 

Is Exotic Pet Insurance Necessary? 

The Best Pet Insurance By State 

What Is Pet Insurance?

Fun Facts, Dog FAQ, And Unsolicited Dog Advice

5 Training Commands to Save Your Dog’s Life

The Ultimate Guide to Safe Foods for Dogs

Dog Health Problems

Dog Breeds


Cat Health Problems

Cat Breeds


We get it, your dog is like your child and when your puppy or dog has health problems it is scary. Luckily there is pet insurance companies that will help you pay for any veterinarian care they made need. Checkout the best puppy and dog pet insurance companies and learn about common puppy health issues and ailments in older pets


Common Health Problems:

Acral Lick Granuloma in Dogs

Alopecia in Dogs

Antifreeze Toxicity in Dogs

Aortic Stenosis in Dogs

Arthritis In Dogs

Bladder Stones in Dogs

Boxer Cardiomyopathy

Cataracts In Dogs

Cherry Eye in Dogs

Chronic Active Hepatitis in Dogs

Collie Eye Anomaly In Dogs

Constipation in Dogs

Cruciate Ligament Tear in Dogs

Cryptorchidism in Dogs

Cushing’s Disease in Dogs

Degenerative Myelopathy | Spinal Cord Disease In Dogs

Dementia in Dogs | Canine Cognitive Dysfunction

Demodicosis In Dogs

Dental Problems in Dogs

Diabetes In Dogs

Dog Comedones (Schnauzer Bumps)

Dog Diarrhea: What Can You Do To Help?

Dog Ear Infections

Dystocia in Dogs

Ectropion in Dogs

Elbow Dysplasia in Dogs

Entropion In Dogs

Eye Problems in Dogs

Fleas in Dogs

Gallbladder Obstruction in Dogs

Gallstones in Dogs

Gastroenteritis In Dogs

Glaucoma in Dogs

Heart Murmurs In Dogs | How To Identify Them

Hip Dysplasia in Dogs

Hot Spots On Dogs

Hyperparathyroidism In Dogs

Hypothyroidism In Dogs

Intervertebral Disc Disease In Dogs

Nasal Solar Dermatitis In Dogs

Patellar Luxation in Dogs

Progressive Retinal Atrophy In Dogs

Renal Failure in Dogs

Seizures in Dogs

Wobbler Syndrome In Dogs

The Dog Flu – Symptoms & Treatment for Canine Influenza

Dog Biting Nails