From the Guidelines
The treatment for a spider bite typically involves cleaning the bite area with soap and water, applying a cold compress to reduce swelling and pain, and taking over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) as needed. 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, and may require advanced medical care.
For local pain relief, over-the-counter acetaminophen and nonsteroidal anti-inflammatory agents can be used 1. Additionally, topical lidocaine and ice can be useful for relieving local pain from scorpion stings, which may also be applicable to spider bites 1. It is essential to monitor symptoms, as some spider bites can cause systemic effects, and seek immediate medical attention if symptoms worsen or include difficulty breathing, muscle rigidity, dizziness, or confusion 1.
Some key considerations for treatment include:
- Cleaning the bite area with soap and water
- Applying a cold compress to reduce swelling and pain
- Taking over-the-counter pain relievers as needed
- Elevating the affected limb to reduce swelling
- Monitoring symptoms for potential systemic effects
- Seeking immediate medical attention if symptoms worsen or include severe pain, spreading redness, fever, muscle cramps, or difficulty breathing.
From the Research
Treatment for Spider Bites
The treatment for spider bites can vary depending on the severity of the bite and the type of spider. For brown recluse spider bites, the following treatments have been suggested:
- Thorough cleansing of the bite area and updating tetanus status as needed 2
- Hospitalization for patients who develop systemic symptoms 2
- Surgical excision of skin lesions, but only for lesions that have stabilized and are no longer enlarging 2
- Use of steroids for bites associated with severe skin lesions, loxoscelism, and in small children 2
- Use of dapsone for adult patients who experience necrotic arachnidism, but only after screening for glucose-6-phosphate dehydrogenase deficiency 2
- Topical nitroglycerin to decrease the enlargement of necrotic skin ulcers 2
Additional Treatment Options
Other treatment options that have been reported include:
- Resting, local cooling, systemic antibiotics to prevent infection, and mild anti-inflammatory drugs 3
- Oral corticosteroids added to antibiotics in the first 72 hours, especially for massive bites with necrotic centers greater than 2 cm in diameter, or when there is systemic loxoscelism 3
- Use of Avlosulfon (dapsone) to cure necrotic cutaneous ulcerations 3
- Hyperbaric oxygen therapy (HBOT) for nonhealing wounds caused by brown spider bites, even in the late, chronic, nonhealing stage 4
- Curettage of the subcutaneous tissue in the necrotic area of the lesion to prevent the local destructive actions of the toxin 5
Management of Soft Tissue Infections
For spider bites that result in soft tissue infections, the following management strategies have been suggested: