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    PeterDobias.com / Blog / health knowledge

    A complete guide to skin hot spots in dogs - natural treatment

    By Dr. Peter Dobias, DVM

    Dr. Peter Dobias, DVM has 30 years of experience as a veterinarian. His love of dogs and passion for natural healing and nutrition led him to writing, teaching and helping people create health naturally, without drugs, chemicals and processed food.

    Healing hot spots naturally without antibiotics, steroids and other harmful chemicals 

    Article summary:

    1. Introduction to hot spots
    2. A closer look at hot spots
    3. How does conventional medicine view hot spots?
    4. An A-HA moment of transformation
    5. What is the connection between hot spots and the spine?
    6. Hot spot locations and their relationship to spinal segments
    7. Conventional treatment overview
    8. How to treat hot spots naturally - 8 step first aid
    9. 7 steps to prevent hot spots from coming back!
    10. What to do if the hot spots reoccur or don't heal?
    11. Dietary recommendations
    12. Supplements for better and faster healing
    Introduction to hot spots

    If you have ever seen a dog with patches of missing hair or dressed in a T-shirt or sporting the familiar “cone of shame” it may be because this pooch is suffering from hot spots. 

    The medical term for hot spots is surface pyoderma, which means a painful, itchy and uncomfortable skin condition that affects mainly the surface of the skin. 

    This condition is more common in the spring and summer which leads many people to mistakenly believe that the hot spots are primarily related to heat, moisture and perhaps allergies. But this is not completely correct.

    In the early years of my veterinary practice, I obediently followed treatment protocols commonly presented in veterinary textbooks.  I saw hundreds of dogs going through regular cycles of hot spot flare-ups, steroids, antibiotics and special diets. I could clearly see that there was a missing piece in the hot spot puzzle.

    My curiosity (and also a good dose of frustration) made me look outside of the box of conventional medical explanations for hot spots. Luckily, this allowed me to see things differently and find a natural and very reliable approach to treating hot spots. I am happy to report that it has helped tens of thousands of dogs since!

    If your dog is suffering from hot spots, there is a very good chance that this complete guide to the natural treatment of hot spots (or surface pyoderma) will help. All you need to do is to keep on reading and keep your mind open!

     A closer look at hot spots 

    Surface pyoderma usually starts as a microtrauma of the top layer of the skin due to scratching, which increases blood perfusion in the area. Skin trauma together with increased blood flow provides ideal conditions for bacteria to thrive. The opportunistic pathogenic bacteria simply take advantage of “the situation” and contribute to more inflammation, pain, swelling and hair loss.  

    The most common locations of hot spots are the neck, head, feet, chest, torso, hind legs and abdomen. 

    How does conventional medicine view hot spots?

    Conventional medicine often sees hot spots as a result of local skin trauma, too much swimming, environmental and dietary allergies, flea infestation, yeast infections or hormonal issues such as Cushing’s disease.

    While all of the above causes are partially true, they only account for a relatively small portion of cases of hot spots in dogs.

    An A-HA moment of transformation

    At the beginning of my veterinary career, I was already aware of the damage steroids caused and never used them. However, I used antibiotics, antihistamines and special hypoallergenic kibble diets because nothing else was available.

    It took me some time to discover that there is one much more frequently missed set of causes: undetected injuries, over-exercise, sprained muscles and back problems. I was able to make the connection between hot spots and how they relate to a particular spinal segment. 

    Sometimes I would find sprained or sore muscles beneath the segment of affected skin. In other cases, I would find nothing locally but when I trailed the nerve line (or energy meridian) from the hot spot area to the spine, I would see that a particular spinal segment was tight, inflamed and appeared injured. 

    This is how I discovered that many hot spots start as a back or spine injury and nerve impingement near the spine. The impinged nerves were unable to function normally which generated an abnormal sensation similar to a feeling “pins and needles” or numbing. Some of us have experienced this after a back or neck injury. 

    When this happens, dogs have no other way of dealing with such an abnormal sensation than chewing and licking.  This causes microtrauma of the skin and creates the perfect conditions for bacterial growth and surface pyoderma – the dreaded hot spot! 

    Since I discovered this many years back, treating hot spots, in general, became much easier and most dogs healed quickly when the muscle and back injuries were treated and herbal Skin Spray was used.

    What is the connection between hot spots and the spine?

    When I looked at the location of hot spots, there were many different locations but some of them appeared more frequently. I also saw that skin lesions had a tendency to occur in the same location in a particular dog. 

    To summarize, an injury and tight muscles lead to decreased blood and nerve flow to the adjacent region of the skin. Refer to the chart below for more clarity on this principle.

    I have been using this principle in treating hot spots for many years now and most dogs heal surprisingly quickly when the muscle and back injuries are treated.

    Hot spot locations and their relationship to spinal segments. 

    As you can see, this chart outlines the location of spinal segments and their relationship with the different regions of the body. 

    • The head, neck, ears and eyes are closely connected with the upper and mid cervical spine as well as the tightness of chewing muscles.  If a dog is a strong puller or a big chewer, skin lesions may appear on the head, ears and eyes. Dogs who have tight cervical and chewing muscles often scratch and traumatize their neck and head. 
    • The forefeet nerve lines originate from the mid-neck to the two upper thoracic vertebrae as do the skin of the ears, eyes and the head.  
    • The armpits and the forearms get their energy supply from the lower neck, the front portion of the chest and the inter-scapular region.
    • The abdomen gets its energy supply from the caudal (rear) portion of the thoracic spine and the front portion of the lumbar spine. 
    • The groin, the flanks and the upper thighs are closely connected to the rear (caudal) portion of the spine.
    • The metatarsal bones (the shins), the heels and the hind feet are related to the caudal and the lumbar regions. 
    • The hips, the tail and the area around the anus are supplied by the sacral-lumbar area of the spine. 

    Examples of the most common neck and back injuries and related pathology:

    • Cervical spine => Forepaw hot spots or licking.
    • Cranial thoracic and mid-thoracic spine => Forearm licking, shoulder and armpit hot spots or scratching.
    • Thoracic spine => Hot spots and skin lesions on the chest.
    • Cranial lumbar spine => Abdominal skin lesions and licking.
    • Caudal lumbar => Hind legs and groin and genital region.
    • Tail base => Anal gland abscesses, anal region.

    IMPORTANT: remember that a local muscle injury or skin irritation may also be the cause of hot spots and must be ruled out first. To say this, a spinal segment-related injury is a much more common cause.

    Conventional treatment overview

    The problems with antibiotic ointments and creams

    A large majority of people reach for an antibiotic cream when they have a cut or a wound. This is an ingrained habit and most people do not realize that they are putting a crude oil based chemical directly on the wound such as petroleum jelly that is the base for most antibiotic ointments.

    Also, the overuse of antibiotics has led to the propagation of resistant bacteria and superbugs which is a serious and sometimes life-threatening problem. 

    Even if we were to use the most natural creams, most dogs would lick the greasy cream off, which would cause additional trauma to the wound and a prolonged healing process.

    Should antibiotics be used to treat hot spots?

    In most situations, antibiotics are not needed if the underlying cause of hot spots is addressed. Bacteria surrounding hot spots is mostly from the group of opportunistic pathogens and spreads only if the skin is scratched or weakened by decreased blood and energy flow due to a local or spinal injury. It is extremely unlikely that hot spot infections would spread systemically. 

    Generally, antibiotics as a treatment for hot spots are only rarely needed in cases where there is evidence of bacterial infection. Some people mistake inflammation and redness with an infection. It is best to see your veterinarian if you are concerned. 

    Important information about chlorhexidine

    Chlorohexidine comes under many commercial names, hence, I suggest that you read the ingredient label every time you use any disinfectant solution. Based on the safety data sheet, chlorhexidine is very hazardous when ingested and it is also a skin, eye and respiratory tract irritant. It is also toxic to lungs and mucous membranes. Strangely, it continues to be readily used in veterinary medicine for wound cleaning and in surgical scrubs.

    Repeated or prolonged exposure to chlorhexidine soap can produce target organ damage which is a real concern in dogs because they often lick their incisions and wounds. 

    It is hard to believe that this toxic substance is very frequently used in mouthwashes and rinses for humans and dogs too!

    How about steroids?

    Steroids are frequently added to antibiotic creams and ointments used for the treatment of hot spots such as Panalog, Surolan or Otomax. It is also common practice to put dogs with chronic recurrent hot spots and scratching on steroids. 

    While steroids may give your dog temporary relief, both topical and oral preparations have a serious negative effect on your dog’s health and the overall ability to heal without the continuous reoccurrence of hot spots. 

    It is my experience that even one course of steroids leads to a long term inability to generate a proper healing response. Steroids are also absorbed in the body and suppress the normal function of the adrenal glands. 

    Steroids could be compared to “a credit card loan with high interest”; they deliver a quick fix with high, long term costs! The most common side-effects are liver disease, obesity, muscle weakness, excessive thirst and urination, adrenal gland problems and more itching in the long run. 

    Why do antibiotics and steroids work temporarily?

    The reason is that there is a secondary bacterial infection after the skin gets scratched and the inflammation gets suppressed with steroids. Unfortunately, such an approach only gives us the illusion of recovery. The overuse of antibiotics and steroids for skin comes with the hefty price of long-lasting side-effects that lower your dog’s ability to heal and thrive.

    How to treat hot spots naturally - 8 step first aid
    1. Assess the size and location of the hot spot.
    2. Unless the area is very sensitive, examine the surrounding muscles for pain, swelling, heat and other signs of injury. 
    3. Clip all hair in and around this area. This is important as hair and discharge cause the ideal environment for bacterial overgrowth and deeper infection. 
    4. If your pet is too sensitive to touch, use an ice pack to numb the region first. Sometimes sedation and/or topical anesthesia may be needed.
    5. If the skin appears sore and crusty, use a face cloth or gauze to soak and soften the scabbing. Gently wash the whole scab off and continue doing so for two to three days. Thick crusty scabs harbor bacteria, delay healing and cause deeper scars.
    6. Dry the area gently with gauze and spray on Herbal Skin Spray two to three times daily for two to four days.
    7. Clean and soak the scabs for the next three to five days until a very thin scab forms. Thin scab formation is usually a good sign of healing; continuous oozing and discharge may be cause for a visit to your veterinarian.
    8. To prevent your dog from licking and making the problem worse, you have either an option to put a T-shirt on your dog or use the Elizabethan collar to prevent licking. 

    7 steps to prevent hot spots from coming back!

    After you take care of the acute hot spots on your dog’s skin, follow these steps to prevent them from coming back:

    1. Examine your dog’s spine and look for a spinal segment injury, inflammation and tightness. You can do so by pushing down on both sides of the spine and note any signs of discomfort to touch, heat or skin twitching. These are all signals of decreased spinal energy flow, injury or congestion. Note that you have to apply a significant amount of pressure to see the different reactions between a healthy and an inflamed spinal segment. 
    1. Use the chart below to determine if a “twitchy” and tight spinal segment relates neurologically to the region of the hot spot occurrence. If it does, it is very likely part of the problem. If there is no sensitivity or inflammation in the spine, I suggest you still see a chiropractor, physical therapist, acupuncturist or a veterinarian with a background in these disciplines to be sure an injury is not missed.

    1. Examine the musculature, skin and joints beneath and surrounding a hot spot area. It may be that the source of discomfort is due to a joint or muscle sprain on the periphery and not related to the spinal segment. 
    1. In either case, I suggest you find either a good, gentle animal chiropractor, physiotherapist, acupuncturist or IMS (intramuscular needle stimulation) practitioner in your area to have a look at your dog. Several sessions are usually required.
    1. If your dog is middle-aged or senior, see if you can work with a rehabilitation practitioner to work on strengthening and core work. Weak dogs get injured and have hot spots more frequently 
    1. In severe, recurrent hot spot cases, back X-rays may be needed to determine the degree of bone changes and the degenerative disc disease of the spine. Other more serious problems may also be present. The more chronic your dog’s hot spots are, the more frequent and longer term the treatment needs to be. The fewer changes, the better the prognosis.
    1. Ensure your dog does not have a collar injury which can also lead to hot spots.   
     What to do if hot spots continue to reoccur or don’t heal?
    • Re-examine the spine and the surrounding muscles.
    • Make sure that your dog doesn’t overdo activities like sprinting, swimming, ball retrieving, or running behind a bike. These can be aggravating factors. Read more here.
    • If the spine continues to be sore, check with your practitioner or ask for a second opinion if you are unsure.
    • Get back X-rays done to check for chronic changes such as disc disease, arthritis, and spondylosis. If they are present, put your dog on mobility and joint support and make sure you avoid NSAIDs (non-steroidal anti-inflammatory drugs).  
    • The more chronic the injury is, the longer the treatment takes. Be patient and see your dog’s “mobility” practitioners regularly for maintenance treatment to prevent hot spot recurrence.
    • Ensure that other causes, such as hormonal issues, food allergies or fungal disease are not present. 
    Dietary recommendations

    To ensure your dog heals well, she or he must not be nutrient deficient. Ideally, feed your dog a raw or cooked diet and avoid kibble if possible.

    Click the button below to receive complimentary access to our Natural Diet Course for dogs. 

    Supplements and products for better health and faster healing 

    Naturally, healing can only happen if the body has all the building blocks it needs. There are four groups of essential nutrients that the body can’t make on its own and they are also absent in food mainly due to soil nutrient depletion. 

    This is why so many dog lovers see very positive transformations when they use the Healthy Dog Tool and explore the benefits of natural supplements for dogs.

    Here is also a link to the Skin Spray info page. 

    Spread the word and help us make a difference! 

    Now that you have a deeper understanding of hot spots, I hope you will share this information with others via social media or email.  And when you see a dog in a T-shirt or shaven like a punk, sharing what you just learned with the dog’s guardian will make a huge difference in the dog’s life! 

    Thank you for caring.

    © Dr. Peter Dobias, DVM 

    Product Reference

    Items referenced in this article.

    Dr. Peter Dobias, DVM has 30 years of experience as a veterinarian. He graduated as a Doctor of Veterinary Medicine in 1988 in the Czech Republic and obtained the Canadian Certificate of Qualification in 1995. He is currently licensed in the European Union, and his unique approach to healing and nutrition helps holistically minded dog lovers worldwide.

    Dr. Dobias strongly believes that disease prevention, natural nutrition and supplements, the right exercise and a drug free approach to medicine can add years to your dog's life.

    As a formulator of his all-natural vitamin and supplement line and co-inventor of natural, chemical free flea and tick control, FleaHex® and TickHex® his unique healing system and products currently hold the highest independent five star customer rating. For more information click here.

    Any general recommendations that Dr. Dobias makes are not a substitute for the appropriate veterinary care and are for informational and educational purposes only.