From the Guidelines
For a brown recluse spider bite wound, clean the area gently with mild soap and water, then apply a clean, dry dressing and change it daily, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When managing a brown recluse spider bite, it is essential to prioritize wound care to prevent infection and promote healing.
Key Recommendations
- Clean the wound gently with mild soap and water to remove any debris or foreign matter 1.
- Apply a clean, dry dressing and change it daily to promote wound healing and prevent infection 1.
- Keep the wound elevated if possible to reduce swelling and pain.
- Apply a cold compress intermittently during the first 24-48 hours to reduce pain and swelling.
- Take over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as needed for discomfort.
Monitoring for Complications
- Watch for signs of infection such as increasing redness, warmth, swelling, or drainage.
- Seek immediate medical attention if you develop severe pain, fever, rash, or if the wound begins to blacken or form an ulcer, as these may indicate tissue necrosis requiring medical intervention.
- Brown recluse venom contains enzymes that can destroy skin tissue, potentially causing a slow-healing wound that may require weeks or months to heal completely 1.
Additional Considerations
- Avoid home remedies like cutting the wound or applying heat, as these can worsen tissue damage.
- Most brown recluse bites heal well with proper wound care, but medical evaluation is strongly recommended, especially for children, elderly individuals, or those with compromised immune systems 1.
From the Research
Wound Care Instructions for Brown Recluse Spider Bites
- The current standard of care for brown spider bites includes:
- Analgesics
- Ice
- Compression
- Elevation
- Antihistamines
- Surgical debridement 2
- For nonhealing wounds, hyperbaric oxygen therapy (HBOT) may be considered as a valuable therapeutic tool, even months after the bite 2, 3
- Treatment of brown recluse spider bites may also include:
- Wound care should include thorough cleansing and tetanus status update as needed 5
- Surgical excision of skin lesions is indicated only for lesions that have stabilized and are no longer enlarging 5
General Principles
- Most brown recluse spider bites are asymptomatic, but envenomation can result in systemic symptoms and necrotic skin ulcers 5
- Patients who develop systemic symptoms require hospitalization 5
- The brown recluse spider bite is a relatively common problem treated by family physicians, and most bites are not serious 6