What is the treatment for a spider bite?

Treatment for Spider Bites

For spider bites, treatment should focus on wound care, pain management, and monitoring for severe symptoms that require emergency services, with specific interventions based on the type of spider involved. 1, 2

Initial Assessment and Management

• Clean the wound with soap and water and apply a sterile dressing 2
• Remove rings and other constricting objects from the affected extremity 2
• Rest and immobilize the bitten extremity 2
• Monitor for severe symptoms that require emergency medical attention:
  • Difficulty breathing
  • Muscle rigidity
  • Dizziness or confusion
  • Pain extending beyond the bite site
  • Severe pain not controlled by over-the-counter medications
  • Development of an open wound
  • Systemic symptoms 1

Treatment Based on Spider Type

Black Widow Spider (Latrodectus) Bites

• Characterized by severe crampy pain, muscle rigidity, diaphoresis, and hypertension 1
• Treatment options:
  • Over-the-counter pain medications for mild symptoms 1
  • For moderate to severe symptoms:
    • IV opioid analgesics with benzodiazepines for muscle relaxation 2, 3
    • Calcium gluconate may be helpful 4
    • Antivenom for severe cases (though limited availability in the US) 3, 4
  • Cardiac monitoring may be necessary as myocarditis can occur in rare cases 5

Brown Recluse Spider (Loxosceles) Bites

• Can cause painful ulcerated wounds that progress over days to weeks 1
• Treatment options:
  • Rest and ice compresses 6
  • Antibiotics to prevent secondary infection 6
  • Dapsone may be considered 6
  • Delayed surgical intervention (several weeks later) for necrotic tissue 6
  • Systemic corticosteroids may help for systemic loxoscelism with hemolysis 6

Pain Management

• First-line options:
  • Over-the-counter acetaminophen and nonsteroidal anti-inflammatory drugs 1
  • Ice application for local pain relief (with a barrier between ice and skin) 1, 2
  • Topical lidocaine (if skin is intact) 1

When to Seek Emergency Care

Call emergency services immediately if the person:

• Develops systemic symptoms (difficulty breathing, muscle rigidity, dizziness, confusion) 1
• Has severe pain not controlled by over-the-counter medications 1
• Develops an open wound 1
• Has a black widow spider bite to the face 2
• Shows signs of severe envenomation (respiratory difficulty, altered consciousness) 2

Important Cautions

• Avoid inappropriate treatments:
  • Suction
  • Tourniquets (except temporarily for severe bleeding)
  • Electric shock
  • Direct pressure immobilization bandages 2
• Most lesions attributed to spider bites are actually caused by other conditions 7
• Spider bites are relatively uncommon medical events, as most spiders cannot pierce human skin 7

Special Populations

• Higher risk individuals requiring closer monitoring:
  • Children
  • Elderly (age >60)
  • People with hypertension 4
  • Individuals with compromised immune systems

For suspected black widow or brown recluse spider bites with significant symptoms, medical evaluation is strongly recommended rather than home treatment alone.