I don't see why you couldn't just try using a supplement such as Derm Caps with Zinc or Linatone with Zinc which are formulated to help with such skin problems to see if that works for your dog.
If your dog is not on flea prevention that could be the issue also.
Food or inhalant allergies also can cause serious skin problems in dogs.
But if you don't want to play around with guessing and are not comfortable with your vet saying 'hot spots' without any solutions. I'd suggest seeing a veterniary dermatologist to work with someone experieced with all kinds of skin issues in dogs.
This site may help you find one
http://www.acvd.org/site/view/55607_FindADermatologistAlphabetical.pml
Hope this helps you!
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