First Aid for Hot Spots in Dogs

What is a hot spot?

Canine hot spots, also known as pyotraumatic dermatitis or acute moist dermatitis, are red, inflamed skin lesions that appear quickly, ooze, and may contain pus.

Hot spots can be found anywhere on a dog’s body, but the most common sites are the head, legs, and hips. These painful, itchy, smelly sores may be obvious or may be hidden under matted fur.

What causes hot spots?

Hot spots are usually caused by self-trauma when a dog scratches an itchy spot so vigorously that it creates an open wound. Dogs scratch for many reasons, but regardless of the cause, hot spots are bothersome. 

When a dog licks the sore spot, it irritates superficial nerve endings in the skin, which stimulates more itching, followed by more licking, biting, and scratching. This lick-itch-lick cycle is the basis for the self-trauma that causes hot spots. 

Hot spots can dramatically increase in size in a very short period. Pet owners may go to work after noticing a pinpoint area of redness and come home to find a raw lesion the size of a pancake.

How are hot spots treated?

The goal in treating a hot spot is to stop the trauma and prevent the development of a deep skin infection. The first step in treatment is to stop the self-mutilation. Some options to prevent your dog from hurting themselves include:

• Using an Elizabethan collar (also known as an E-collar or cone) that stops the dog from chewing at the hot spot.
• Covering the hot spot with a sock or bandage to act as a barrier.
• Giving your dog topical or oral steroids (e.g., prednisone) and antihistamines (e.g., diphenhydramine [Benadryl®], cetirizine [Reactine®, Zyrtec®]) to reduce the itching. Consult your veterinarian before using any medications intended for humans, as they are often toxic to dogs

It often takes a combination of all options to stop the trauma. In the meantime, the underlying cause of the hot spot must be addressed. Treatment depends on the cause:

• Impacted anal glands: The anal glands will need to be expressed.  
• Flea allergy: Your dog will need monthly flea control to eliminate fleas and control their life cycle (e.g., Frontline® Plus, Advantage®, Advantix®, Revolution®, Nexgard®, Simparica®, or Bravecto®).  
• Arthritis: Your veterinarian may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), such as meloxicam (Metacam®), carprofen (Rimadyl®, Vetprofen®), or deracoxib (Deramaxx®), or other pain medications such as gabapentin (Neurontin®).  
• Inhalant or food allergies: Your veterinarian can help you begin allergen avoidance or desensitization therapy and may recommend a hypoallergenic diet.  
• Ear infections: The underlying yeast or bacterial infection will be treated.  
• Boredom or behavioral problems: Training and behavior modification, increased exercise and environmental enrichment, and sometimes medications such as fluoxetine (Reconcile®), clomipramine (Clomicalm®), or amitriptyline (Elavil®) may be recommended.  
• Poor grooming: Seek a professional groomer who knows how to safely use clippers.  

Clipping the hair away from the hot spot and the surrounding area is crucial to successful treatment. The hot spot will heal more quickly if the hair is removed so that the lesion can dry properly. Grooming may be painful, so your dog may need to be sedated.

After clipping, the lesion should be disinfected with a chlorhexidine solution that kills bacteria. Topical antibiotics, desiccating (drying) sprays, and soothing reagents will be more effective when applied to a clipped, clean skin surface. Oral antibiotics and steroids/antihistamines may also be helpful for serious hot spots.

Warning: Do not use scissors to trim the hair away from the hot spot, as it is easy to accidentally cut your dog’s skin, resulting in an even greater problem that may require sutures.

How can hot spots be prevented?

Continued monitoring and treatment of the underlying cause should prevent future hot spots. Some dogs also benefit from seasonal grooming, as well as regular brushing and bathing.