Treat the cause not the symptom Be sure to rule out medical conditions like fleas and mites, first. Secondly, are his hot spots due to allergies (enviornmental or food) or maybe even less than desirable nutrition? Lucky had some pretty nasty hot spots when he was on a corn based food. The vet gave some topical medication that worked temporarily. A few food switches later, Lucky's skin conditions and immune system have improved and we have not seen hot spots for years! Hope that bit of info will help you determine the cause.