Outlook

The majority of brown recluse bites cause little permanent skin damage, although, in some cases, moderate to severe tissue destruction is possible. The full extent of damage to tissues is not known for days. It may take many months for the wound to completely heal.

• Brown recluse bites are noted for somewhat slow development and often take up to 12 hours to reveal themselves. Necrosis of skin (death of the skin), if it occurs, does so in the first 96 hours. Bites older than this that do not display tissue death have not been reported to worsen.

• Necrotic lesions can be difficult to manage, and early surgery to remove dead tissue has not been shown to improve outcomes. Necrotic lesions with careful cleaning are allowed to mature for weeks until spreading stops and healing appears to begin. Then a wide area of tissue around the wound is removed and skin grafting may be done once all evidence of skin necrosis has subsided.