We have a very allergic cat and Cetirizine Hydrochloride 5 mg/ half of a 10 mg pill works wonders. We tried the cone of shame for him but he was tortured using it.
Oh man hot spots are the worst! My Berner Kyla used to get those. The vet had me stop feeding her commercial canned food & make it from scratch. Her 2 faves were salmon, oatmeal, kale & carrots, & chicken, rice, spinach & sweet potato. It was cheaper too. No more hot spots after that.
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Have you figured out the root cause? Food or environmental allergies?