Actual red paw stains could be caused by many things, from potentially toxic paint to strawberry syrup. If your dog's licking red stains on her fur or the bottoms of her paws, it's likely something to wash off. Otherwise, a lesion called an acral lick granuloma is probably forming, especially if she's losing hair where she's obsessively or compulsively licking. Boredom, stress, anxiety, pain and chronic itchiness or irritation can cause excessive licking that leads to acral lick granulomas.
When your pet excessively licks the same spot, fur rubs off and a bald spot develops. As the protective layer of fur diminishes, underlying skin becomes shiny and red. With continuing irritation, the skin raises, thickens and hardens, taking on a scarlike appearance and losing sensation. Acral lick granulomas continue looking fresh with ongoing irritation. Some dogs even break the skin. See your vet promptly about the so-called red stains, as early intervention is essential.
Acral lick granulomas are difficult to treat. The cause of obsessive-compulsive licking must be addressed. For example, more stimulation and attention are needed for bored pets; desensitization and medication can help with anxiety; and parasites, allergic skin conditions, injuries and other conditions causing itching or pain must be remedied. Bandages help stop licking, but some pets begin licking elsewhere. Bandages are best reserved for licking due to discomfort rather than psychological distress. Injected steroids or radiation treatments may shrink lesions, and cryotherapy or surgical removal are options for some acral lick granulomas.