What is the treatment for a spider bite?

Treatment for Spider Bites

The treatment for a spider bite includes cleaning the area with soap and water, applying ice to reduce pain and swelling, using over-the-counter pain relievers, and seeking medical attention for severe symptoms or if the bite is from a venomous spider like black widow or brown recluse. 1

Initial Assessment and First Aid

1. Identify the spider if possible (particularly important to distinguish between venomous and non-venomous species)

   • Black widow spiders (Latrodectus): cause severe crampy pain, muscle rigidity, diaphoresis, and hypertension
   • Brown recluse spiders (Loxosceles): cause painful ulcerated wounds that progress over days to weeks
   • Most other spider bites cause only minor local symptoms

2. Immediate first aid measures:

   • Clean the bite area thoroughly with soap and water 1
   • Apply ice with a thin barrier between ice and skin to reduce pain and swelling 1, 2
   • Elevate the affected limb if significant swelling is present 2
   • Take over-the-counter pain medications (acetaminophen or NSAIDs) 1
   • Apply calamine lotion to relieve itching if present 3

When to Seek Medical Care

Emergency medical services should be called immediately if: 1

• The person develops systemic symptoms such as:
  • Difficulty breathing
  • Muscle rigidity
  • Dizziness or confusion
  • Widespread hives
  • Severe pain not controlled by over-the-counter medications

Seek medical care if: 1

• Pain extends beyond the bite site
• Pain becomes severe and is not controlled by over-the-counter medications
• An open wound develops
• Signs of infection appear (increasing redness, warmth, purulent drainage)

Treatment Based on Spider Type

Black Widow Spider Bites

• Focus on pain management with acetaminophen or NSAIDs 1
• In severe cases, medical treatment may include:
  • Muscle relaxants
  • Calcium gluconate
  • Black widow antivenom for severe cases 4

Brown Recluse Spider Bites

• Apply ice compresses 5
• Rest and elevate the affected area
• Antibiotics may be prescribed to prevent secondary infection 5
• For necrotic wounds:
  • Wound care with regular cleaning
  • Possible surgical intervention, though typically delayed for several weeks 5
  • In chronic non-healing wounds, hyperbaric oxygen therapy may be beneficial 6

Special Considerations

• Children: Treatment principles are similar to adults, but dosing of medications should be adjusted appropriately
• Pregnant women: Require prompt medical evaluation for black widow bites as antivenom may be indicated 4
• Secondary infection: Monitor for signs of infection for 48-72 hours after the bite 2

Common Pitfalls to Avoid

1. Misidentification: Many "spider bites" are actually caused by other insects or medical conditions. When the spider is not seen, the lesion should be labeled as an "arthropod bite, vector unknown" 7

2. Delayed treatment: Particularly for brown recluse bites, delayed treatment can lead to extensive tissue necrosis requiring reconstructive surgery 8

3. Overtreatment: Most spider bites are minor and require minimal intervention; avoid unnecessary antibiotics or aggressive treatments for non-venomous bites

4. Underestimating severity: Black widow and brown recluse bites can cause serious systemic effects and should be monitored closely

5. Home remedies: Unproven treatments like applying meat tenderizer or attempting to "suck out" venom are ineffective and may delay proper treatment

Remember that while most spider bites are not medically significant, prompt identification and appropriate treatment of venomous spider bites can significantly improve outcomes and prevent complications.