What kind of hotspots and where ?. I get them under the smallest toe in the joint. In my case it's an inflammation caused by lack of support to the middle of the foot, seems as you age (my podiatrist tells me) the ligaments and tendons in the middle of the foot where the toes meet the main foot, stretch and thus provide less support, thus the pressure migrates to the outer toe area. I found using a shoe with a carbon mid sole (or a full carbon sole) provides the support I needed and my inflammation went away mostly.

So one solution is a sole with better support as found on a carbon shoe. I use Shimano XC-7's, in wide, very comfortable. Not cheap but worth it.