The injury resulting from a centipede encounter is often mistakenly called a bite. Centipedes do not possess true jaws; instead, they use a pair of modified front legs called forcipules to inject venom. These hollow, pincer-like appendages are located just behind the head and pierce the skin to deliver a complex mix of toxins. While the experience is immediately painful, most centipede envenomations result only in localized symptoms that resolve without serious complication. The severity of the reaction depends largely on the centipede’s size and the volume of venom delivered.
What You Feel Right Away
The moment the forcipules penetrate the skin, the primary sensation is an immediate, sharp pain often described as a burning or searing feeling. This intense localized discomfort is the direct result of the venom, which contains a diverse mix of peptides and small molecules. The site is visually distinct, typically appearing as two small puncture marks that may form a chevron or V-shape due to the paired nature of the centipede’s venom delivery system.
Within minutes, the area around the puncture marks begins to exhibit localized redness and swelling. The severity of the pain and inflammation is directly correlated with the amount of venom injected, with larger centipedes generally causing a more pronounced reaction. Some individuals may also experience a tingling sensation or localized numbness around the wound.
Some people report mild, temporary systemic effects in addition to the immediate localized symptoms. These can include tenderness in the lymph nodes closest to the injury site. On rare occasions, a person might also experience slight nausea or a mild headache, though these are typically minor and pass quickly.
Immediate Care and First Aid Measures
The first action after a centipede envenomation should be to clean the injury thoroughly to prevent secondary bacterial infection. The area must be washed gently with soap and running water. Applying a topical antibiotic ointment after cleaning offers protection against pathogens entering the small puncture wounds.
To manage the pain and localized swelling, apply a cold compress or ice pack wrapped in a cloth to the site. Applying the compress for 10-minute intervals, followed by a 10-minute break, helps to constrict blood vessels and reduce inflammation. Cold application can also help elevate the pain threshold and soothe the burning sensation associated with the venom.
Over-the-counter pain relievers such as acetaminophen or ibuprofen can be taken to help control the systemic pain. For persistent itching, which is a common reaction, a topical corticosteroid cream, such as hydrocortisone, can be applied. Oral antihistamines are also effective for reducing swelling and itchiness caused by the body’s reaction to the toxins.
Because the forcipules create small puncture wounds, ensure your tetanus vaccination status is current. If more than ten years have passed since your last shot, consult a healthcare provider. Symptoms for most centipede envenomations generally begin to resolve within 24 to 48 hours with basic home care.
When to Seek Professional Medical Care
Immediate professional medical attention is necessary if signs of a severe systemic reaction, such as anaphylaxis, begin to develop. These serious allergic reactions can manifest quickly and include difficulty breathing, wheezing, or swelling of the face, tongue, or throat. Other acute signs requiring urgent care include widespread hives, dizziness, or a rapid, irregular heartbeat.
Medical consultation is warranted if localized symptoms fail to improve or worsen after the initial 48 hours of home care. Persistent or escalating pain beyond two days suggests a need for professional evaluation. A healthcare provider can assess the wound and potentially prescribe stronger pain management options or prescription-strength topical treatments.
Monitor the site for signs of a secondary bacterial infection in the days following the event. Indicators of infection include increasing warmth around the wound, the development of pus or foul-smelling discharge, or red streaks extending away from the site. The onset of a fever also signals that the body may be fighting a more significant infection.
Bites from very large or tropical centipede species, such as those in the Scolopendra family, often warrant a medical assessment regardless of initial symptoms. These larger centipedes inject a greater volume of potent venom, which may cause more intense and prolonged symptoms. People with pre-existing health conditions, especially those with circulatory issues or compromised immune systems, should also seek medical advice proactively.