From the Guidelines
The recommended treatment for most spider bites involves cleaning the bite area with soap and water, applying a cold compress to reduce pain and swelling, elevating the affected limb if possible, and taking over-the-counter pain relievers like acetaminophen or ibuprofen as needed. For common non-venomous spider bites, these measures are usually sufficient, and symptoms typically resolve within a week 1. However, bites from venomous spiders like black widows or brown recluses may require medical attention. According to the 2024 American Heart Association and American Red Cross guidelines for first aid, emergency services should be called if a person bitten by a spider develops symptoms throughout the body such as difficulty breathing, muscle rigidity, dizziness, or confusion 1.
Some key considerations for treatment include:
- Monitoring for signs of infection, such as increasing redness, warmth, swelling, or pus
- Watching for allergic reactions, such as difficulty breathing or widespread hives
- Being aware of systemic symptoms, such as severe pain, muscle cramps, or fever, which may require immediate medical care 1
- Using over-the-counter acetaminophen and nonsteroidal anti-inflammatory agents to alleviate local pain, as recommended by the guidelines 1
It's essential to note that most spider bites heal without complications when properly cleaned and monitored, as the body's immune system effectively manages the small amount of venom or irritants introduced by the bite 1. However, if pain extends beyond the site of the bite, becomes severe, and is not controlled by over-the-counter pain medications, or if an open wound develops, medical care should be sought 1.
From the Research
Treatment Options for Spider Bites
- The recommended treatment for spider bites varies depending on the type of spider and the severity of the bite.
- For widow spider (Latrodectus) envenomation, treatment includes analgesics and benzodiazepines, with antivenom considered for severe cases 2.
- Recluse spider (Loxosceles) bites are often overdiagnosed and should be treated supportively, with curettage of the subcutaneous tissue in the necrotic area considered for early-stage lesions 3.
- Hyperbaric oxygen therapy (HBOT) may be effective in treating nonhealing wounds caused by brown spider bites, even in the late, chronic stage 4.
General Treatment Principles
- The current standard of care for brown spider bites includes analgesics, ice, compression, elevation, antihistamines, and surgical debridement 4.
- Anti-venom administration is considered the most useful treatment for spider bites, although it may not be widely available 5.
- Treatment with dapsone, brown recluse spider antivenom, or combination therapy, in addition to erythromycin, may be effective in healing wounds caused by brown recluse spider bites 6.
Important Considerations
- Spider bites can be difficult to diagnose due to nonspecific presentation, and physicians should be aware of the geographical distribution of dangerous spiders and their clinical manifestations 5.
- Keeping the diagnosis in mind and questioning patients about possible exposure to spiders is crucial for proper treatment 5.