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Snake and Lizard Bites

Topic Overview

Poisonous snake or lizard bite

A bite from a poisonous (venomous) snake or lizard requires emergency care. If you have been bitten by a snake or lizard that you know or think might be poisonous, call 911 or other emergency services immediately. Do not wait for symptoms to develop.

If you are not sure what type of snake or lizard bit you, call the Poison Control Center immediately to help identify the snake or lizard and find out what to do next. Medicine to counteract the effects of the poison (antivenom) can save a limb or your life.

It is important to stay calm.

Poisonous snakes or lizards found in North America include:

Maine, Alaska, and Hawaii are the only states that don't have at least one poisonous snake species in the wild.

Poisonous snakebite

Symptoms of a pit viper snakebite often appear from minutes to hours after a bite. Severe burning pain at the site usually begins within minutes, and then swelling starts spreading out from the bite.

Things that affect the severity of a poisonous snake or lizard bite include the:

  • Type and size of the snake or lizard.
  • Amount of venom injected (if any).
  • Potency of the venom injected.
  • Location and depth of the bite.
  • Number of bites and where they occurred on the body.
  • Age, size, and health of the person who was bitten.

If you do not develop symptoms within 8 to 12 hours, it is possible that no venom was injected; this is called a dry bite. At least 25%, and perhaps up to 50%, of bites are dry. If poison is released in the bite, about 35% of the bites have mild injections of poison (envenomations), 25% are moderate, and 10% to 15% are severe.

It is important to remember that a snake only injects part of its venom with each bite, so it is still dangerous after the first strike. A bite from a young snake can be serious. And a dead snake, even one with a severed head, can still bite and release venom by reflex action for up to 90 minutes after it dies. Even if you do not develop symptoms within 8 hours, continue to watch for symptoms for 2 weeks or more.

Nonpoisonous snake or lizard bite

Most snakes and lizards in North America are not poisonous. Bites may be frightening, but most do not cause serious health problems. A bite from a small nonpoisonous snake might leave teeth marks, a minor scrape, or a puncture wound without other symptoms. Home treatment often relieves symptoms and helps prevent infection.

Although most nonpoisonous snakebites can be treated at home, a bite from a large nonpoisonous snake (such as a boa constrictor, python, or anaconda) can be more serious. In North America, these snakes are found in the Florida Everglades and zoos, but they may also be kept as exotic pets. The force of the bite can injure the skin, muscles, joints, or bones. Other problems can occur with a nonpoisonous snake or lizard bite even if the reptile is small. A snake or lizard's tooth may break off in a wound or a skin infection may develop at the site of the bite.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a snake or lizard bite?
Yes
Snake or lizard bite
No
Snake or lizard bite
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Could you be having a severe allergic reaction?
This is more likely if you have had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Do you have symptoms of shock?
The symptoms in an adult or older child are different than the symptoms in a young child.
Yes
Symptoms of shock
No
Symptoms of shock
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Are you having a severe reaction to the bite?
In a severe reaction, you may have sudden, severe swelling and sudden numbness and tingling.
Yes
Severe reaction to bite
No
Severe reaction to bite
Has there been a decrease in how alert or aware you are or how well you can think and respond?
Yes
Decreased level of consciousness
No
Decreased level of consciousness
Is the bite from a snake or lizard that you know is poisonous or think may be poisonous?
Yes
Bite from known or suspected poisonous snake or lizard
No
Bite from known or suspected poisonous snake or lizard
Is there any numbness or tingling?
Yes
Numbness or tingling
No
Numbness or tingling
Is the numbness or tingling near the bite or in the mouth, tongue, scalp, or feet?
Yes
Numbness or tingling near bite or in mouth, tongue, scalp, or feet
No
Numbness or tingling near bite or in mouth, tongue, scalp, or feet
Do you have numbness or tingling below the bite?
Yes
Numbness or tingling below bite
No
Numbness or tingling below bite
Are there any hives?
Hives are raised, red, itchy patches of skin. They usually have red borders and pale centers. They may seem to move from place to place on the skin.
Yes
Hives
No
Hives
Did the hives appear within the past 3 hours?
Yes
Hives appeared within past 3 hours
No
Hives appeared within past 3 hours
Is there any swelling?
Yes
Swelling
No
Swelling
Is there any pain?
Yes
Pain
No
Pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
Signs of pain in an adult or child are different than signs of pain in a baby or toddler.
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain lasted for more than 8 hours?
Yes
Pain for more than 8 hours
No
Pain for more than 8 hours
Is the pain getting worse?
Yes
Pain is getting worse
No
Pain is getting worse
For an arm or leg wound, is the skin below the wound (farther down the limb) blue, pale, or cold to the touch and different from the other arm or leg?
This may mean that a major blood vessel was damaged and that blood is not reaching the rest of the arm or leg.
Yes
Skin is blue, pale, or cold below an arm or leg injury
No
Skin is blue, pale, or cold below an arm or leg injury
Can you move the area below the injury normally, even though it may hurt?
Yes
Able to move limb normally below injury
No
Unable to move limb normally below injury
Are you nauseated or vomiting?
Nauseated means you feel sick to your stomach, like you are going to vomit.
Yes
Nausea or vomiting
No
Nausea or vomiting
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Do you think that a tooth from the snake or lizard may still be in the wound?
Yes
Snake or lizard tooth may still be in wound
No
Snake or lizard tooth may still be in wound
Do you think you may need a tetanus shot?
Yes
May need tetanus shot
No
May need tetanus shot
Do you still have symptoms more than 24 hours after the bite?
Yes
Symptoms more than 24 hours after bite
No
Symptoms more than 24 hours after bite

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
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Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Symptoms of a severe allergic reaction (anaphylaxis) may include:

  • The sudden appearance of raised, red areas (hives) all over the body.
  • Rapid swelling of the throat, mouth, or tongue.
  • Trouble breathing.
  • Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused, or restless.

A severe reaction can be life-threatening. If you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. Even if the symptoms are mild at first, they may quickly become very severe.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

  • For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
    • You haven't had a tetanus shot in the past 5 years.
    • You don't know when your last shot was.
  • For a clean wound, you may need a shot if:
    • You have not had a tetanus shot in the past 10 years.
    • You don't know when your last shot was.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Symptoms of shock in a child may include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
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Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.
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Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Home Treatment

Poisonous snake or lizard bite

If you were bitten by a snake or lizard that you know or think is poisonous, call 911 or other emergency services immediately. Do not wait for symptoms to develop. Symptoms may progress from mild to severe rapidly.

If you are not sure what type of snake or lizard bit you, take a picture of it. But do not do this if it will delay treatment or put someone at risk for more bites. Do not waste time or take any risks trying to kill or bring in the snake. Only trap a poisonous snake if the chances are good that it will bite more people if you let it go. It is important to remember that a snake only injects part of its venom with each bite, so it can still hurt you after the first strike. And a dead snake, even one with a severed head, can bite and release venom by reflex action for up to 90 minutes after it dies.

Medicine (antivenom) to counteract the effects of the poison can save a limb or your life. Antivenom is given as soon as a doctor determines it is needed, usually within the first 4 hours after the snakebite. Antivenom may be effective up to 2 weeks or more after a snakebite.

Immediate home treatment

Immediate home treatment should not delay transport for emergency evaluation.

  • If you think the snake bite is an emergency, call 911.
  • Remain calm and try to rest quietly.
  • If you are not sure what type of snake or lizard bit you,call a Poison Control Center immediately to help identify the snake or lizard and find out what to do next.
  • Remove any jewelry. The limbs might swell, making it harder to remove the jewelry after swelling begins.
  • Use a pen to mark the edge of the swelling around the bite every 15 minutes. This will help your doctor estimate how the venom is moving in your body.

Avoid these treatment measures

Avoid doing anything that might cause more problems with the snake or lizard bite.

  • Do not cut the bite open.
  • Do not suck on the bite wound or use any kind of extraction device.
  • Do not use a constriction band, such as a tourniquet or bandage, on a bite.
  • Do not soak your hand or foot in ice water or pack your arm or leg in ice. This can increase damage to the skin and cause a cold-induced injury, such as frostbite.
  • Do not raise the bitten arm or leg above your head. This may increase the flow of venom into the bloodstream.
  • Do not drink alcohol.
  • Do not give any prescription or nonprescription medicines after a poisonous snake or lizard bite unless your doctor tells you to. Some medicines, such as aspirin, ibuprofen, or naproxen, may cause increased bleeding.

Nonpoisonous snake or lizard bite

If you are certain the snake or lizard was not poisonous, use home treatment measures to reduce symptoms and prevent infection.

  • Use direct pressure to stop any bleeding.
  • Look at the wound to make sure a snake or lizard tooth is not in the wound. If you can see a tooth, remove it with tweezers, taking care to not push it farther into the wound.
  • Clean the bite as soon as possible to reduce the chance of infection, scarring, and tattooing of the skin from dirt left in the wound. Wash the wound for 5 minutes with large amounts of clean warm water.
  • Do not use rubbing alcohol, hydrogen peroxide, iodine, or Mercurochrome, which can harm the tissue and slow wound healing.
  • Soak the wound in warm water for 20 minutes, 2 to 4 times a day, for the next 4 to 5 days. The warmth from the water will increase the blood flow to the area, which helps reduce the chance of infection.
  • Puncture wounds usually heal well and may not need a bandage. You may want to use a bandage if you think the bite will get dirty or irritated.
    • Clean the wound thoroughly and cover it with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
    • Apply a clean bandage when it gets wet or soiled.
  • Determine whether you need a tetanus shot.
  • An ice or cold pack may help reduce swelling and bruising. Never apply ice directly to a wound or the skin. This could cause tissue damage.
Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your fever or pain:

  • Acetaminophen, such as Tylenol
  • Do not use a nonsteroidal anti-inflammatory drug, such as Advil, Motrin, Aleve, or aspirin.
Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

Prevention

Snakebites are more likely to occur in warm-weather months when both snakes and people are more active outdoors. Most snakebites occur on the fingers, hands, and arms when someone is working with or trying to catch a snake. The legs and feet are also common bite sites; these bites usually occur when a person (especially a child or a hiker) accidentally disturbs a snake.

Snakes and lizards are popular exotic pets, so the risk for being bitten has increased.

Many snake and lizard bites can be prevented.

  • Find out what local snakes and lizards are found in your area. Learn what they look like, whether they are poisonous, and where you are most likely to see them.
  • If you see a snake or lizard, do not bother it. Keep in mind that the striking range of a snake is about two-thirds of its length.
  • Do not pick up or handle snakes. Even a dead snake can bite and release venom through reflexes for 90 minutes or more after it dies.
  • Watch for snakes around wood or rock piles or caves. Wear protective shoes, boots, and clothing when you are hiking, camping, fishing, and hunting.
  • Do not drink alcohol or use illegal drugs while doing outdoor activities where you might encounter a snake. The effects of the alcohol and drugs may slow your judgment and reflexes.
  • If you have a pet snake or lizard or are thinking about getting one, learn how to handle it safely to avoid being bitten. Find out what first aid supplies you will need if you are bitten, and have them handy.

If you are often in an area where there are poisonous snakes, consider carrying a first aid kit. Carry a cellular phone, if you have one, to call for help if you are bitten.

Preparing For Your Appointment

Questions to prepare for your appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • Do you know what type of snake or lizard bit you? What did the snake or lizard look like? How big was the snake or lizard? Did it rattle?
  • When did the bite occur?
  • Where were you bitten?
  • How many times were you bitten?
  • What are your main symptoms? How long have you had your symptoms?
  • What home treatment measures have you tried? Did they help?
  • What nonprescription medicines have you tried? Did they help?
  • Have you been treated for a snakebite in the past? If yes, what type of treatment did you receive?
  • What prescription and nonprescription medicine do you take?
  • How long ago was your last tetanus shot?
  • Do you have any health risks?

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Sean P. Bush, MD, FACEP - Emergency Medicine, Envenomation Specialist

Current as ofNovember 20, 2017

Current as of: November 20, 2017

Author: Healthwise Staff

Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Sean P. Bush, MD, FACEP - Emergency Medicine, Envenomation Specialist