Hot Spots on Dogs

Hot spots on dogs are one of the most common skin conditions veterinarians see. Canine hot spots are patches of fur loss with sore, itchy, and oozing skin caused by a bacterial infection. 

Hot spots on dogs usually appear extremely quickly and spread fast, too. Thankfully, once treatment has started, they generally resolve quickly as well. 

What are Hot Spots?

Hot spots are also known as acute moist dermatitis or pyotraumatic dermatitis, which better describe the disease. 

So, what do hot spots look like? A hot spot is a patch of hair loss with oozing skin, hence the term “moist dermatitis.” It’s usually several centimeters in diameter and may actually extend under the fur for some way. They appear quickly, and it’s not unheard of for areas 6 inches or more across to appear overnight. The skin is often red through irritation and the ooze is typically pale yellow-white. The fur around the area is usually sticky with the ooze, so may clump and appear darker than usual. 

The areas that most commonly get hot spots are on the neck, face, and thighs, but hot spots can affect anywhere on the body. The spots are also intensely itchy and painful, causing frantic scratching and nibbling. Many dogs get a little grumpy with a hot spot. 

Rottweilers, Golden Retrievers, and German Shepherds are all more prone to hot spots than the average dog. They are also slightly more common in male dogs than female dogs.

Symptoms of Hot Spots on Dogs

Hot spots are often first noticed because the dog keeps returning to the same area to lick, chew, or scratch. They’re really very irritating, and a dog with a hot spot will think of little else but scratching the itch. 

You may also notice a wet patch of fur, or even an area of fur loss. They’re usually on the head, neck, or outside of the back leg. However, a dog can get hot spots on his paws, back, tail, and even hot spots on the belly. 

Be cautious about examining the area yourself—many dogs find these spots so irritating and uncomfortable that they’re prone to growling or snapping when others get close to the area.

The problem spreads extremely quickly if not treated. What starts out as a small area may be several inches in size after just a few hours. 

Symptoms of hot spot on dogs include:

• Itching (including scratching, biting, licking, or chewing) at one area
• Fur loss, usually in one area
• Wet or matted fur
• Oozing, crusty, or scabby skin
• Uncomfortable to touch
• Behavioral changes, such as being more grumpy

What Causes Hot Spots?

Hot spots in dogs are caused by bacteria, usually a type called Staphylococcus pseudintermedius. These bacteria are present on your dog’s skin and mouth most of the time, and they’re usually harmless. 

Normally, the skin has good defense against bacteria and keeps them at a safe level. But if a few conditions combine—such as a scratch to the skin (caused by foliage, playing with other dogs, or even itching at fleas) and a certain level of moisture (wet or sweaty fur from swimming, being bathed, or just running around a lot)—then the bacteria get past the defenses. They find the ideal environment to start to multiply, and you get an infected hot spot. This is very itchy. Unfortunately, each scratch and chew breaks the skin further, spreading the bacteria around and causing further problems.

Hot spots can occur in any breed or age of dog. However, they’re more common in thick-coated breeds such as Golden Retrievers and German Shepherds. Rottweilers are also particularly susceptible to hot spots, although it’s not clear why. 

Because they’re usually started by something itchy, hot spots are also more common in dogs with fleas, allergies, or anxiety, as these things increase the amount of time dogs spend scratching.

Diagnosing Hot Spots 

Your veterinarian can often diagnose hot spots simply by seeing the injured area, as they’re quite distinctive. They may take samples—such as with a swab or a slide pressed to the skin—or even recommend a biopsy, particularly if the area doesn’t look quite like a hot spot and they want to rule out other diseases. They may also recommend investigating an underlying cause, such as fleas, ear infections, or allergies—something that could have caused the original itch. 

This could involve closer examination of the ears and ear canal, combing for fleas, and even taking blood to test for allergies. The majority of cases, however, are simple to diagnose and treat. 

How to Treat Hot Spots on Dogs

The first thing your veterinarian will do to treat the hot spot is to clip the fur from around the area. Often the “leading edge” of the spreading infection is under the fur, so clipping away the fur allows appreciation of the full extent of the problem. It also allows air to get to the area to dry it out. 

Next, a good clean with an antiseptic solution such as dilute iodine or hibiscrub kills off many of the bacteria living on the skin. Finally, your vet will prescribe a cream. This usually contains antibiotics and steroids, to both stop the bacteria from spreading and take away the itch. 

This treatment is usually effective within a couple of days, and the hair begins to grow back within a couple of weeks.

In more complicated cases, such as those that have spread a long way or where the skin is severely damaged, oral antibiotic tablets may be required. Steroids, either injectable or oral, can also take away the inflammation and itch. 

To make sure your dog doesn’t damage the skin further, many vets recommend a plastic Elizabethan collar. Blow-up collars are also useful for some cases but may not work if your dog has a hot spot on the tail or back paw, as they can often reach around the collar. 

Although medical T-shirts or bandages are useful to prevent interference with wounds, they’re not recommended for hot spots, as it’s important to keep the area open to the air.

Common Medications

• Chlorhexidine (as wipes, mousse, shampoo, or scrub) as an antibacterial cleaning solution
• Betamethasone (cream or spray) as an anti-itch and anti-inflammatory
• Hydrocortisone (cream or spray) as an anti-itch and anti-inflammatory
• Fusidic acid (in creams) as an antibacterial 
• Oral antibiotics in severe cases

Natural Remedies for Hot Spots

The vast majority of healing a hot spot comes from clipping, bathing, and applying an Elizabethan collar. These natural methods don’t require drugs to work and you can even administer them (carefully) at home. When bathing your dog, try using dilute saltwater or chlorhexidine scrub, which you can purchase from your local vet clinic.

If you do decide to try these home remedies for hot spots, do be aware that your dog will likely find the area uncomfortable when touched and may snap.

There’s no shortage of other home remedies for hot spots mentioned online. Most are likely to do no harm, although some may slow healing. Oatmeal baths, for instance, are soothing but the area is far too itchy for this to work. Plus, regular wetting of the area is likely to make it worse. 

Diluted apple cider vinegar is another commonly recommended home remedy for hot spots. But due to the acidity of vinegar, it’s likely to be painful to apply and there are other more suitable solutions. 

Some people recommend aloe vera as a home remedy for hot spots on dogs. While aloe vera gel is known to be safe and soothing, experts do not recommended applying it in anything more than a very thin layer, as allowing the hot spot to dry out and air is important to the healing process. Bathing the area twice daily with hibiscrub, drying, then following with a thin layer of aloe vera gel may work to treat a hot spot at home.

Burow’s solution may also work, given its antibacterial properties. However, more intensively tested medicated creams generally supersede it.

Some studies show that St. John’s Wort has benefits against skin bacterial overgrowth, but no safety testing has been done to evaluate whether this causes any harm when applied to the skin. It is a common poison of cattle, so it’s worth being cautious and using tried-and-tested drugs until science shows some evidence either way.

How Much Does Treatment Cost?

As long as the hot spot remains uncomplicated, treatment is likely to be in the region of $40-$100, depending on consultation and drug costs in your locality. 

Severely damaged skin can die off, leaving a wound that needs to heal. This will significantly increase costs and time taken to heal, and is an excellent reason for treating hot spots as soon as they appear.

Treatment costs increase when hot spots recur or an infection develops. Some of the more common reasons and costs associated with hot spot recurrence include:

• Anal gland hot spot: If a dog is unable to express his anal glands naturally through a bowel movement, hot spots may occur. Treatment costs include anal gland expression (Between $10 and $30). If the glands are impacted and infected, medications ranging from $20 to $100 may be prescribed. 
• Hot spots as the result of allergies or food sensitivities may require allergy testing ranging from $50 to $300. If your vet recommends blood test, the range grows between $150 and $300.
• Hot spots due to environmental issues may be treated with special shampoos or omega-3 fatty acids, both of which range between $20 and $50. 
• If a bacterial infection occurs at the hot spot location, your veterinarian may send a skin biopsy off for analysis. Depending on the treatment recommended, medications and special creams and shampoos range between $25 and $100.

What may seem like an innocuous lesion can quickly turn into something more serious. Address hot spots as soon as you find them. One way to keep costs down is with a pet health insurance plan from Lemonade. The sooner you have a plan in place, the sooner it will take effect to help during unexpected accidents and illnesses.

An ounce of prevention is worth of cure, and there are some time-tested ways to prevent hot spots in the next section.

How to Prevent Hot Spots on Dogs

Preventing hot spots centers around two things: preventing the initial scratch injury and keeping dogs cool and dry. 

In order to prevent your dog from scratching, regularly treat against fleas and other itchy parasites such as lice and mites. Keep allergies well controlled with medications and diet, and flare-ups treated by a vet as soon as possible. If your dog has allergic itch and inflammation due to skin allergies, your vet may prescribe Apoquel, an oral tablet that provides fast, effective relief. It can be used for long-term maintenance or short-term therapy in dogs.

Dogs with anal gland problems should have these treated, usually by emptying them and increasing fiber in the diet. 

Ensuring that the skin is as healthy as possible is sensible, too. Dog skin supplements designed to increase skin barrier function may help. You should also keep nails trimmed and the sharp point filed to reduce the risk of scratch injuries. 

If your dog is prone to ear infections, discuss regular ear cleaning with your vet as a preventative measure. Itchy ear infections can become hot spots on the face or neck.

Since hot spots are more common in longer-coated breeds, regular grooming to ensure they don’t have too much coat is an important part of preventing hot spots. It’s also a good idea to make sure dogs are completely dry after swimming or baths, so that the moisture doesn’t encourage the bacteria.

Pictures of Hot Spots

Related Conditions 

• Atopic dermatitis (allergy)
• Food-responsive dermatitis (dietary allergy)
• Anal gland impaction
• Otitis externa (ear infection)
• Flea allergic dermatitis (flea allergy)
• Fleas
• Anxiety