Depends on the breed and weight of your dog, so CHECK WITH YOUR VET FIRST to determine the severity of the hot spot is, (ie: just seeing red blotchiness or full blown raw open skin)

With this said, I have a 10 lb rat terrier/chihauhau mix that my vet has told me with the beginnings of a patch to put his neck cone on, give him 25 mg Children's Benedryl PILL FORM until it clears. This has worked in some instances, however, if this doesn't work, and you see it staying or getting worse, CALL YOUR VET IMMEDIATELY as this is no picnic for your dog which can not only be itchy, but very painful. :((

When a severe patch has occurred, My vet gave him a shot to expedite the process quickly and help him to become more comfortable immediately seeing results of healing within 12-24 hrs in which it healed very fast. This was the one without steriods.

In the meantime, I found out alot about the foods and chemicals/crap in them that can cause this as well. Feed your dog (s) lamb or beef, vegetable food, NO CHICKEN. Secondly, if you can afford to pay price point, look into feeding him/her "JUST FOOD FOR DOGS" http://www.justfoodfordogs.com. Again, this is just a suggestion to think about as it's what I discovered and am passionate about for our sweet little pooches.

Good luck! :)