"Hot Spots" are localized areas of self-induced trauma otherwise known as pyotraumatic dermatitis/ surface pyoderma. Staphylococcus is the most likely organism involved although Malassezia may also affect certain dogs. They are usually moist due to licking and /or weeping (exudation), and hot due to inflammation, itching, irritation and infection. A certain amount of compulsiveness overtakes the dog, as if it were trying to put out a fire at the affected site. Hotspots occur most often in atopic animals and/or as a result of an insect (usually a flea) bite. Below is my Protocol for treatment:

Uncomplicated "hot spots":

With a #40 blade remove all hair around the infected lesion. Be sure to clip as close to the skin as possible.
Bathe the entire animal in MalAcetic or MalAcetic ULTRA Shampoo (MalAcetic ULTRA has both antimicrobial and anti-inflammatory effects) to remove all possible antigens from the "dustmop" like coat of the dog. This also should medicate other areas, which might be on the verge of being affected. Apply MalAcetic ULTRA Conditioner to the entire body after rinsing off the suds from the shampoo. Allow the Malacetic ULTRA Conditioner to dry on the coat.

On a 1-2 times daily basis, have the owner cleanse off the affected area with MalAcetic Wet Wipes; some people use MalAcetic HC Wipes here since they have the anti-itch component. This will remove the exudative debris, kill the surface bacteria (Staphylococcus) and dry the lesion. MalAcetic HC Wipes will also reduce the pruritic sensation.

Apply an ectoparsiticide such as imidocloprid, fiprinol or selamectin.

In some cases, the treatment described above fails to yield the expected, relatively quick results. The judicious use of short acting systemic corticosteroids (oral and/or injectable), such as prednisone may be necessary to ensure a speedy recovery.

Certain dog breeds, particularly golden retrievers, tend to develop "hot spots' that require an additional regimen of antibiotics (such as cephalexin 10 mg/lb/bid/21days). Oddly enough, deeper pyodermas in the golden retriever seem to be "foci predisposed" to the side of the face.

"Complicated " Hot spots may require further treatment, or a dermatologic workup to determine the exact cause of the problem.

"Tear Stains" and intertrigo may be treated similarly although it is unusual to need systemics such as antibiotics and/or corticosteroids.

More details are available in an updated Shampoo Therapy article.