From the Guidelines
Topical corticosteroids can be considered to help alleviate symptoms of arachnid bites, particularly for large local reactions.
Treatment Options
- Symptomatic treatment: Cold compresses, oral antihistamines, and oral analgesics may help reduce local pain, swelling, and itching associated with cutaneous reactions 1.
- Corticosteroids: Although definitive proof of efficacy through controlled studies is lacking, many physicians use oral corticosteroids for large local reactions, and topical corticosteroids may be considered as an alternative or adjunct treatment.
Important Considerations
- Infection: Antibiotics are not indicated unless there is evidence of secondary infection, as the swelling is caused by mediator release and not by infection 1. It is essential to note that the provided evidence primarily focuses on insect stings, but the principles of treatment may be applicable to arachnid bites as well. However, more specific guidance on the use of topical corticosteroids for arachnid bites is not available in the provided study 1.
From the Research
Topical Corticosteroids for Arachnid Bites
- There is limited evidence to suggest that topical corticosteroids are effective in treating arachnid bites 2, 3.
- One study suggests that steroids may be indicated in bites associated with severe skin lesions, loxoscelism, and in small children 3.
- However, another study found that systemic corticosteroids were associated with slower healing in suspected brown recluse spider bites 4.
- It is unclear whether topical corticosteroids would have a similar effect, as the study only examined systemic corticosteroids.
Treatment of Arachnid Bites
- The treatment of arachnid bites remains controversial, with multiple options but little evidence of their effectiveness 4.
- Other treatments that have been suggested include dapsone, topical nitroglycerin, and surgical excision 5, 3, 6.
- However, the evidence for these treatments is limited, and more research is needed to determine their effectiveness.
Specific Spider Bites
- Brown recluse spider bites can cause severe skin lesions and systemic symptoms, and treatment may involve rest, ice compresses, antibiotics, and surgery 2.
- Black widow bites primarily produce muscle cramping, pain, and other neuromuscular-related symptoms, and treatment may involve pain control, muscle relaxants, and calcium gluconate 2.
- The treatment of bites from other spiders, such as the Loxosceles spider, is largely unsatisfactory, and more research is needed to determine the most effective treatment 6.