Hot Spots on Dogs: A Vet's Guide to Treatment and Prevention

You notice your dog obsessively licking or chewing at one spot. You part the fur and find it: a raw, red, wet, and angry-looking sore that seems to have appeared overnight. That's a hot spot. Medically known as acute moist dermatitis or pyotraumatic dermatitis, it's one of the most common and frustrating skin conditions dog owners face. It's painful for your dog and can spread alarmingly fast if not addressed. The good news? With the right approach, you can treat it effectively and, more importantly, learn how to stop it from happening again. This guide cuts through the generic advice and gives you a clear, step-by-step plan based on practical experience.

What Exactly Is a Hot Spot and What Causes It?

Think of a hot spot as a bacterial skin infection that your dog creates through self-trauma. It starts with an itch. Anything can cause that initial itch—a flea bite, a pollen allergy, a mat of fur, even a drop of water trapped in the ear. The dog scratches or licks the spot for relief. This breaks the skin's surface. The moisture from saliva and the warmth create a perfect breeding ground for the normal bacteria on the skin (usually Staphylococcus pseudintermedius) to multiply out of control. The resulting inflammation and infection are intensely itchy and painful, which makes the dog chew and lick even more. It's a vicious cycle that can turn a pinprick of irritation into a palm-sized wound in less than a day.

I've seen it happen with my own dog, a Golden Retriever named Sam. One summer evening, he seemed a bit bothered by his hip. The next morning, he had a quarter-sized, weeping sore. I knew immediately—classic hot spot. The trigger? Probably a combination of seasonal allergies and a slightly damp coat from playing in the sprinkler.

The underlying causes are the key to long-term prevention. Here are the most common culprits:

How Do I Treat My Dog's Hot Spot at Home?

If the hot spot is small (smaller than a silver dollar) and your dog is otherwise acting normally, you can start treatment at home. The goal is to break the itch-lick cycle, clean the area, and let it dry and heal. Always wear disposable gloves if possible.

Step 1: Safe Trimming and Air Exposure

This is the most critical step that most guides underemphasize. You must gently clip the hair away from around the sore. Use blunt-nosed scissors or clippers with a guard, working from the outside in. The aim is to expose an inch of healthy skin around the entire lesion. Why? It removes hair that's matted with discharge, allows air to reach the skin (bacteria hate oxygen), and lets you apply topical treatments directly to the skin. It also prevents discharge from spreading the infection to surrounding fur.

If your dog is too painful or the area is too large, don't force it. This is a sign to go to the vet, who can do this quickly and painlessly, often with a mild sedative.

Step 2: Gentle Cleansing and Disinfection

Once the area is clipped, clean it with a mild antiseptic solution. I recommend chlorhexidine solution (diluted to the instructions, usually 0.05% to 0.1%). It's effective against the staph bacteria common in hot spots and is less stinging than iodine or hydrogen peroxide. You can find chlorhexidine shampoo or solution at most pet stores or from your vet.

Soak a clean gauze pad in the solution and gently wipe the area, removing any crust or debris. Pat dry thoroughly with a clean paper towel. Do this 2-3 times a day.

Step 3: Applying a Topical Treatment and Creating a Barrier

After cleaning and drying, apply a thin layer of a vet-recommended topical antibiotic/anti-inflammatory spray or cream. Products containing hydrocortisone can help reduce inflammation and itch. Your veterinarian can prescribe the most effective ones. Over-the-counter options like Vetericyn Plus Antimicrobial Hydrogel can be soothing and promote a moist healing environment, which is actually better than trying to "dry it out" completely.

The single most important part of treatment, however, is preventing your dog from accessing the spot.

Step 4: The Non-Negotiable Step - The Elizabethan Collar (E-Collar)

You cannot out-willpower a dog's instinct to lick a painful, itchy wound. Do not rely on "watching them." The moment you turn your back, they'll lick. A proper cone or inflatable "donut" collar is absolutely essential. It's not cruel—it's what allows the wound to heal. Leave it on 24/7 until the hot spot is completely scabbed over and dry, which usually takes at least 3-5 days with consistent care.

When Is It Time to Call the Veterinarian?

Home care isn't always enough. Don't wait if you see any of these red flags. Prompt veterinary care can prevent days of suffering and more aggressive treatment later.

• The hot spot is large, deep, or spreading rapidly. If it's bigger than your palm or looks like it's digging deeper into the skin, you need professional help.
• Home treatment isn't working after 2-3 days. If it's getting worse or not improving, the infection may require oral antibiotics or stronger anti-inflammatories.
• Your dog is in obvious pain, lethargic, or has a fever. This indicates a systemic infection.
• The hot spot keeps recurring in the same spot. This points to an unresolved underlying cause like an allergy or hidden pain source (e.g., arthritis making them lick a joint).
• The hot spot is on the face, near the eyes, or in a sensitive area where safe trimming at home is impossible.

Your vet will likely clip and clean the area thoroughly, and may prescribe a course of oral antibiotics (like cephalexin) and anti-itch medication (like Apoquel or Cytopoint). They can also give you a much more potent topical spray. In severe cases, they might use a steroid injection to quickly knock down the inflammation.

How Can I Prevent Hot Spots from Coming Back?

Treating the current hot spot is only half the battle. If you don't address the root cause, you'll be dealing with another one soon. Prevention is about managing the triggers from that first table.

• Aggressive Flea and Tick Control: Use a high-quality, vet-recommended preventative year-round. For flea-allergic dogs, even one bite can start a hot spot.
• Investigate Allergies: If hot spots are seasonal, talk to your vet about environmental allergy testing or management (allergy shots, daily antihistamines). If they're year-round, a food elimination trial might be needed.
• Master the Art of Drying: After baths, swimming, or rain, dry your dog thoroughly, especially if they have a thick double coat. Use a high-velocity dryer or multiple towels, paying attention to armpits, groin, and between toes.
• Regular Grooming and Coat Maintenance: Brush your dog frequently to prevent mats, which trap moisture and irritate the skin. For some breeds, regular professional grooming is a health necessity, not a luxury.
• Address Anxiety and Boredom: Provide plenty of physical exercise and mental stimulation. For dogs with compulsive licking habits, puzzle toys, training sessions, and in some cases, behavioral medication can help.
• Don't Ignore Ear Infections or Anal Gland Issues: These are common hidden drivers of hot spots on the cheek/neck or base of the tail, respectively. Get them treated promptly.

I started giving Sam a daily fish oil supplement for his skin health and became religious about drying him after every swim. We also got his seasonal allergies under control with a prescription from the vet. We haven't had a serious hot spot in over two years.

Your Top Hot Spot Questions Answered