I use benadryl in the gel form on the hot spots, it numbs the area so it can heal. My Saint used to get REALLY bad hot spots ...once I started using benadryl in the gel form , she no longer would tear them open or spread them from the constant rubbing/licking or irritating the area.
I alternated the benadryl with a antibacterial gel ( comes in a tube) and have had the best success . I no longer have to go to the vet at every oocurance. My current Saint had the start of a hot spot and it only took two application of the benadryl to stop it.