From the Guidelines
For most spider bites, the best treatment involves cleaning the bite area with soap and water, applying a cold compress to reduce swelling and pain, taking over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as directed on the package, and elevating the affected limb if possible. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, bites from black widow and brown recluse spiders can cause severe symptoms, including crampy pain, muscle rigidity, and hypertension. 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 1.
Some key considerations for treatment include:
- Cleaning the bite area with soap and water to prevent infection
- Applying a cold compress to reduce swelling and pain
- Taking over-the-counter pain relievers like acetaminophen or ibuprofen as directed on the package
- Elevating the affected limb if possible to reduce swelling
- Using an antihistamine such as diphenhydramine (Benadryl) at 25-50mg every 6 hours to reduce itching
- Applying an antibiotic ointment like bacitracin or Neosporin to prevent infection
It is essential to monitor symptoms and seek immediate medical attention if severe symptoms develop, such as intense pain, spreading redness, difficulty breathing, severe swelling, or flu-like symptoms 1. The guidelines also recommend calling emergency services if a person bitten by a spider or stung by a scorpion develops symptoms throughout the body, such as difficulty breathing, muscle rigidity, dizziness, or confusion 1.
From the Research
Treatment Options for Spider Bites
- The treatment for spider bites depends on the type of spider and the severity of the bite. For brown recluse spider bites, treatment may include rest, ice compresses, antibiotics, dapsone, and surgery delayed for several weeks 2.
- Systemic corticosteroids may be helpful in treating systemic loxoscelism, a rare condition caused by brown recluse spider bites that has minimal skin changes but produces massive hemolysis 2.
- For black widow spider bites, treatment typically includes pain control, muscle relaxants, and calcium gluconate, although a specific antivenin is available 2.
- In some cases, hyperbaric oxygen therapy may be used to treat brown recluse spider bites, particularly those that result in necrotic wounds 3.
- It's essential to note that many spider bites are not medically significant and do not require treatment beyond minor first aid 4.
Diagnosis and Management
- Diagnosing spider bites can be challenging, as the spider is often not seen at the time of the bite, and symptoms may not appear immediately 3, 4.
- A clinical approach to diagnosis and management is necessary, taking into account the patient's symptoms, medical history, and the likelihood of a spider bite based on the location and time of year 4.
- In cases where the spider is identified, capture of the offending spider can be helpful in diagnosis and proper treatment 3.
Epidemiology and Risk Factors
- Black widow and brown recluse spider bites have different epidemiological characteristics, with black widow spider bites more commonly occurring among males and brown recluse spider bites more commonly occurring among females 5.
- The majority of reported spider bites occur at the patient's own residence, although the percentage is lower for black widow spiders 5.
- Seasonal trends and geographic variations in spider bite incidence can help identify populations at greatest risk for spider bites 5.