From the Guidelines
To treat a spider bite, first clean the area with soap and water, then apply an ice pack for 10 minutes at a time to reduce swelling and pain, and take over-the-counter pain relievers like acetaminophen or ibuprofen as directed on the package. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, most spider bites cause self-limited local symptoms, but some species like the black widow and brown recluse can cause more severe symptoms. The guidelines recommend seeking medical care if pain extends beyond the site of the bite, becomes severe, and is not controlled by over-the-counter pain medications; if an open wound develops; or if the person experiences symptoms throughout the body 1.
Some key points to consider when treating a spider bite include:
- Cleaning the area with soap and water to prevent infection
- Applying an ice pack to reduce swelling and pain
- Taking over-the-counter pain relievers like acetaminophen or ibuprofen as directed on the package
- Elevating the affected area if possible to reduce swelling
- Seeking immediate medical attention if severe symptoms occur, such as difficulty breathing, muscle cramps, fever, or if the bite is suspected to be from a black widow or brown recluse spider
It's also important to note that some studies have shown that topical lidocaine and ice can be useful for local pain relief from scorpion stings 1, but the evidence for spider bites is limited. However, given the potential for severe reactions, it's always best to err on the side of caution and seek medical attention if symptoms persist or worsen. For children and elderly individuals, medical evaluation is recommended even for seemingly minor bites due to their potentially stronger reactions to venom.
From the Research
Treatment Options for Spider Bites
- Symptomatic treatment is usually the approach for spider bites, with a combination of opioid analgesics and muscle relaxants used to manage symptoms such as muscle pain, diaphoresis, tachycardia, flushing, and hypertension 2
- In cases where symptom resolution fails, an equine IgG antiserum may be available for treatment, particularly for black widow spider bites 2
- For spider bites that cause dermonecrosis, secondary infection, neuromuscular damage, and allergic reactions, intensive medical management may be required, including the use of antivenin for black widow bites 3
Diagnosis and Management
- Spider bites can be difficult to diagnose as the spider is often not seen at the time of the suspected bite, and such cases should be labeled as arthropod bites, vector unknown 3
- A high index of clinical suspicion coupled with a knowledgeable patient history is crucial for successful treatment, especially when the treating physician is aware of the type of bite and its usual course and possible complications 2
Types of Spider Bites
- At least 60 species of spiders have been implicated in human bites, with most causing minimal medical importance and requiring little treatment 3
- Some species, such as the brown recluse and Hobo spider, can cause severe cutaneous and systemic reactions requiring intensive medical management 3
- Black widow spider bites can cause severe neurologic problems and may require the use of antivenin 3