Managing Dog Hot Spots and Acral Lick Granulomas

Published by Dr. Laci Schaible
3 min read

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If you find your dog chewing on themselves throughout the night, a skin condition may be hiding under their fur. Dog hot spots and acral lick granulomas are two skin conditions that may be responsible for your dog's incessant chewing and scratching.

Learn more about how these hot spots can develop into granulomas, the signs that your dog may have a skin condition and the processes for diagnosis and treatment.

Dog Hot Spots vs. Acral Lick Granuloma

Hot spots, sometimes referred to as summer sores (or acute moist dermatitis for a technical term), occur when the skin becomes traumatized by frequent, vigourous scratching or licking. This can occur because of underlying issues including allergies, mites, or fleas. However, it can also occur when moisture gets trapped against the skin (such as during times of humid weather or after swimming) under a thick hair coat. Once this scratching or chewing is underway, the protective barrier of the skin is injured, allowing an assortment of invading bacteria and yeast to invade. A skin infection often ensues in the form of a hot spot. As the hot spot develops, the skin becomes sensitive (and often painful) and prompts a stronger scratching response as the skin becomes itchier. This itching further traumatizes the skin and the hot spot starts to grow.

Lick granulomas, on the other hand, occur over time as your pup incessantly traumatizes an area of skin, usually around their wrists or paws. Why our pets develop these sores is not well understood, but is believed to influenced by both physical factors (pain, itchiness, etc.) and psychological factors such as anxiety or even manifestations of obsessive compulsive disorder. It eventually becomes a vicious cycle of your pooch causing self-inflicted damage to their skin, followed by gradual development of an irritating sore that further drives a compulsion to bother the area. It's important to understand this distinction in how lick acral granulomas develop because depending on the root cause, your veterinarian may need to pursue very different treatment approaches.

Clinical Signs of a Skin Condition

Dog hot spots can appear very suddenly. In fact, many pet parents feel as though they appear overnight. Hot spots may be:

Black German shepherd puppy standing in a forest.

  • Red or pink in color
  • Raw
  • Oozing or shiny
  • Bloody
  • Yellow or green from pus
  • Warm to the touch, hence their name
  • Hidden under fur during early stages

Hot spots can occur anywhere on the body, but they tend to occur in places where dogs can easily chew or scratch, such as the tail base, flanks, ears, top of head and neck and are often painful or sensitive to the touch. Lick granulomas, on the other hand, may appear worse than hot spots. The skin of these wounds may appear:

  • Pink to red
  • Dark gray to blackened
  • Gnarly and thickened
  • Wet
  • Scabbed or scarred
  • Bloody

Many pet parents will be able to tell that these aren't fresh wounds. Thickened skin is the body's failed attempt to lay down scar tissue and heal itself. The forelimbs and feet, in particular, are common places for lick granulomas in dogs.

Dogs at Risk of Hot Spots and Acral Lick Granulomas

A dog's fur provides ideal shelter for bacteria and yeast, and when warmer weather increases temperatures and humidity, the reproduction of microorganisms is inevitable. Dogs with thicker coats or dogs who haven't yet shed their winter coat are more at risk for the overgrowth of bacteria. All that extra insulation creates perfect conditions for the propagation of normally benign bacterial that inhabits your dog's healthy skin. Dogs prone to allergies or high-strung pets prone to boredom are also at risk for hot spots any time of the year.

According to veterinarians at Veterinary Information Partner, breeds commonly affected by dog hot spots are larger, working class breeds, such as the Labrador Retriever, Golden Retriever, Great Dane, Irish Setter, German Shorthaired Pointer, and German Shepherd. Dogs of all ages and genders may develop hot spots or lick granulomas.

Diagnosis and Treatment

Hot spots and lick granulomas are often diagnosed based upon history and appearance. Simple skin tests will determine if the lesion is overridden with bacteria or yeast, or if mites have invaded the skin. Skin biopsies are occasionally needed for stubborn granulomas that don't resolve with treatment.

While the treatment varies, long-term antibiotics along with topical and oral anti-inflammatory medications to help soothe itching and irritation are often prescribed. Your vet will likely clip and clean the affected areas and may send you home with a special cleaner as well. It is often recommended that you let your veterinarian clip and clean the affected area because improper care could make the area even worse. Laser therapy and behavioral modifying drugs may also be recommended for some dogs, especially in the case of granulomas.

Close-up of Irish Setting lying in grass.

Most dogs will also benefit from increased aerobic activity and mental stimulation as boredom is often a catalyst for dog hot spots and acral lick granulomas. Regular flea and tick medications, medicated shampoos and frequent grooming are also part of the ongoing maintenance for hot spots. Clipping and cleaning also helps keep granulomas dry and prevents reinfection from bacteria.

Prognosis and Prevention

Hot spots have a great prognosis and may resolve as quickly as they develop. Lick granulomas take significantly more time to heal and can be extremely difficult to resolve. Although lick granulomas can quickly become exceedingly frustrating, don't let this deter you. Full resolution can be achieved with persistence and following doctor's orders. According to Merck Veterinary Manual, the most common reason hot spots recur is that treatment was stopped too soon or the underlying cause was not identified. Remember this if you're ever tempted to stop the medications or therapies your vet prescribes. Just because a hot spot appears to be improving does not mean that your pup is fully in the clear just yet. If your dog is prone to recurrent hot spots or lick granulomas, consider discussing allergy testing with your vet to see if immunotherapy or allergy shots is recommended for your dog.

Preventing hot spots is easier said than done, but there are some simple tips you can implement. As the seasons change and warm humid weather sets in, try to keep your dog dry and clean, as well as engaged in enrichment activities to avoid boredom. And as guilty as your pup's sad face may make you feel when they wear an E-collar, early use can help the healing process by preventing self-trauma tied to acral lick granulomas.

Contributor Bio

Dr. Laci Schaible

Dr. Laci Schaible

Dr. Laci Schaible is a small animal veterinarian, entrepreneur, author, and speaker. A graduate of Texas A&M University College of Veterinary Medicine and Wake Forest University School of Law, Dr. Schaible is passionate about progressive change in the veterinary industry and serves as an advisor on a number of boards within the field.