What is the treatment for a spider bite?

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. For most spider bites, these simple measures are sufficient as the majority of spiders in North America aren't dangerous to humans. Elevating the affected limb can help reduce swelling. An antihistamine like diphenhydramine (Benadryl) at a dose of 25-50mg every 6 hours may help with itching, as suggested by general medical practice, although specific guidelines for spider bites may vary 1.

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. Additionally, a person bitten by a spider should seek 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 in the treatment of spider bites include:

• 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) as needed
• Elevating the affected limb to reduce swelling
• Seeking medical attention if the bite appears infected or if symptoms worsen or spread
• Considering antihistamines for itching, although this is more of a general medical practice than a specific guideline for spider bites

It's also important to note that for bites from potentially dangerous spiders like black widows or brown recluses, medical attention should be sought immediately as these may require specific antivenom treatment, especially if symptoms like severe pain, muscle cramps, fever, chills, nausea, or a spreading rash develop 1. These more serious bites can cause tissue damage or systemic reactions that require professional medical intervention beyond home care.

From the Research

Treatment Overview

• The treatment for spider bites varies depending on the type of spider and the severity of the bite 2.
• Most spider bites are not life-threatening and can be treated with minor first aid, such as cleaning the wound and applying a cold compress.

Medically Relevant Spiders

• In the United States, there are two medically relevant spiders: the widow spider (Latrodectus) and the recluse spider (Loxosceles) 2.
• Widow spider envenomation can cause muscle spasm and severe pain, and should be treated with analgesics and benzodiazepines 2.
• Recluse spider bites are often overdiagnosed, and should be treated supportively, with rare cases causing skin necrosis 2, 3, 4, 5, 6.

Treatment Options

• For brown recluse spider bites, treatment options include:
  • Local care, such as curetting the subcutaneous tissue in the necrotic area of the lesion 4.
  • Hyperbaric oxygen therapy (HBOT) 3, 5.
  • Analgesics, ice, compression, elevation, antihistamines, and surgical debridement 5.
• For nonhealing wounds caused by brown spider bites, HBOT may be considered as a valuable therapeutic tool, even months after the bite 5.

Prevention

• Prevention strategies for arthropod bites and stings include avoiding high-risk areas, covering exposed skin, and wearing permethrin-impregnated clothing 2.
• N,N-diethyl-m-toluamide (DEET) 20% to 50% is the most studied and widely recommended insect repellent 2.