Looking for advice – ongoing skin redness/spots on my 13-year-old Maltese Shih Tzu 🐶

Hi everyone, I'm hoping someone may have experienced something similar or can offer some advice.

My dog is a 13-year-old Maltese Shih Tzu, and she's been dealing with an ongoing skin problem for approximately 2 years now.

She develops red spots/areas on her body (photo attached). We've taken her to the vet multiple times. Initially, we were told it could be an allergy, but the problem has continued.

She also constantly licks and attacks/chews her paws, sometimes to the point where they bleed. The vet prescribed medication to try to stop the itching/licking, but we still haven't been able to get to the bottom of what's actually causing it.

It's been really upsetting to watch, especially because this has been going on for so long.

Has anyone had a dog with similar red skin spots, allergies, constant itching, or obsessive paw licking/chewing? Were you ever able to find the underlying cause?

I'm not looking to replace veterinary advice—we will continue working with our vet—but I'd really appreciate hearing about other people's experiences and anything we could potentially ask the vet about.

Thank you ❤️