What is the recommended therapy for non-venomous spider bites?

Therapy for Non-Venomous Spider Bites

For non-venomous spider bites, thoroughly irrigate the wound with copious amounts of clean water, apply antibiotic ointment, and cover with a clean occlusive dressing. 1

Initial Management

• Thoroughly irrigate the bite wound with a large volume of warm or room temperature potable water until there is no foreign matter in the wound 1
• Apply a clean barrier (such as a thin towel) between ice and skin when applying ice for pain relief 1
• Cover the wound with antibiotic ointment or cream and a clean occlusive dressing to improve healing and reduce infection risk 1

Pain Management

• Over-the-counter acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for managing local pain 2
• Ice application to the bite site provides local pain relief (with a barrier between ice and skin) 1, 3
• If skin is intact, topical lidocaine can be applied for pain relief 4

When to Seek Medical Care

• Seek medical attention if:
  • Pain extends beyond the bite site or becomes severe 4
  • Pain is not controlled by over-the-counter medications 4
  • An open wound develops 5
  • Signs of infection appear (progressive erythema, purulent discharge, fever) 5
  • Systemic symptoms develop (difficulty breathing, muscle rigidity, dizziness, confusion) 5, 4

Common Pitfalls to Avoid

• Do not apply suction to the bite site as this is ineffective and potentially harmful 3
• Do not apply tourniquets or pressure immobilization bandages as these may worsen tissue injury 3
• Do not place objects in the mouth of someone having a seizure (if severe envenomation occurs) as this may cause dental damage or aspiration 1
• Do not assume antibiotics are needed for swelling around the bite site, as swelling is typically caused by mediator release, not infection 5

Special Considerations for Specific Non-Venomous Spider Bites

• Most non-venomous spider bites cause limited swelling, itching, pain, and redness 2
• Remove rings and other constricting objects from the bitten extremity as swelling may occur 3
• For persistent or non-healing wounds (though rare with non-venomous spiders), hyperbaric oxygen therapy may be considered in select cases 6

Follow-up Care

• Most patients with local symptoms only will recover completely within 24-48 hours 5
• Continue pain management with over-the-counter medications as needed for several days 5
• Monitor for signs of secondary infection, which would require prompt medical attention 5