answer:That’s an inflammatory reaction with a possible (probable) secondary bacterial infection. The cause is the hard part of the equation, and you might not ever figure out exactly what’s causing it, but you should be able to control it. The hydroxizine is a very mild antihistamine, and masks the symptom, but does nothing to deal with the issue itself. Using steroids will help with the inflammation and itching, but as you seem to be aware, there are some serious health risks associated with long term use. And again, if the root cause of the problem is environmental (which it probably is), then the problem will return once the steroids wear off. (Folks love to blame food allergies, but it’s not nearly as common as people think, and yours doesn’t look typical at all.) Ideally, if you have the funds, I would recommend that you ask your vet for a referral to a veterinary dermatologist. They may recommend allergy testing, a skin scraping to check for parasites, or even a biopsy. But at the very least, he/she will be able to get you more comfortable. After all, that’s all they do – skin! If that’s not an option, then I would talk to your vet about a course of antibiotics and steroids. Some “old-timey” vets rely too heavily on steroids, but if used correctly, they can be a very powerful tool. Since it functions in a completely different way, you can also keep giving antihistamines, too. Continued chewing and licking just makes things worse – wet skin is the perfect petri dish for growing bacteria. If the meds don’t control the itchy, then the cone of shame will be necessary. In the meantime, clean all of the bedding with a hypoallergenic laundry detergent, make sure to use flea and tick control year round (not Hartz or any other cheap over the counter crap), and put up a barrier to keep the wee-wee away from the scratchy bush.