Pink Prescriptions - July 2025
When the Lowcountry Bites Back: What to Know About Bites, Venoms, Stings & Poisonous Vines
July 2025 Issue — Pink Prescriptions
When the Lowcountry Bites Back
What to Know About Bites, Venoms, Stings & Poisonous Vines
We’re taking a “bite” out of those scary, sneaky crawlers
with fangs, teeth, tentacles, and stingers to learn all
about staying safe this season!
It’s summertime, and as we walk through tall grasses, swim in the ocean, and sit on picnic blankets, our not-so-friendly biting insects and other crawling atrocities are ready to claim their territories on us—literally! Following, not only will you read a real-life story about being bitten by a copperhead snake—everyone’s nightmare, you will also read what our experts best advice to avoid summer sabotage when it comes to snakes, insects, jellyfish, spiders and poison ivy and oak.
By Kayo Perley, MD | Novant Health Arley Way Primary Care
Help! I was bitten by a snake.
Do I need to look for it to know what kind bit me? What should I do next?
Snake venom may cause moderate to severe toxicity that requires immediate medical attention. If you are bitten by a snake, call 911 or go to the nearest emergency room. Although tempting, do not delay treatment by looking for the snake. After calling for help, minimize movement and keep the limb at chest level to prevent the venom from spreading. Remove clothing, jewelry, and accessories near the bite in case there is swelling. Do not apply excessive pressure to the wound as this may cause further damage. Stay calm and await health professionals to administer first aid and antivenom, if needed.
What should I do if I get bitten by red bugs?
“Red bugs” is a colloquial term for chiggers, which are small red insects that can be found in grassy areas, forests, and water banks. Once bitten, you may notice clusters of raised skin or blisters that are intensely itchy and inflamed. Chiggers have detached by the time symptoms arise, so attempts to eradicate or suffocate the bug (such as with clear nail polish) are unnecessary. You may treat symptoms with topical steroids or anti-itch creams, such as calamine or pramoxine. If severe, try an antihistamine like Claritin or Zyrtec.
What should I do if a tick bites me? If it’s still on me, should I remove it or have a doctor remove it?
Ticks may carry dangerous diseases such as Lyme disease, babesiosis, and rocky mountain spotted fever. The Ixodes (black-legged) tick transmits Lyme disease and is endemic to South Carolina.
If you find a tick on your body, remove it immediately with tweezers. Do not squeeze, burn, or attempt to suffocate the tick. You can also secure the tick in a clear plastic bag and bring it to your doctor’s office for inspection. Your physician may decide to start a preventative antibiotic. If you start to notice any joint aches, muscle pain, fever, chest pain, numbness, or shortness of breath, contact a health professional immediately.
Dr. Kayo Perley is a Primary Care Physician with a passion for helping patients change their lives for the better. Dr. Perley is with Novant Health Arley Way Primary Care in Bluffton and is taking new patients—call (843) 706-2523 to schedule an appointment.
This month's Pink Prescriptions theme was inspired by Hilton Head Island native
Elizabeth Acuff's harrowing story.
Snakebitten: Watch Your Step
By Lesley Kyle
Photography by Lindsay Pettinicchi Photography, LLC
Sometimes you remember every detail of a day you won’t soon forget. And May 15, 2025, was one of those days for Hilton Head Island native, Elizabeth Acuff.
Without a maternity ward on the Island back then, Elizabeth was born in Savannah to Yvette and Lamar Acuff. Her family first lived on North Forest Beach Drive before moving to a home in Sea Pines. Elizabeth, along with her sister and parents, call real estate a family business. Her mother started the multiple listing service (MLS) that her sister now manages, and her father built more than 400 custom homes on Hilton Head and in Bluffton. Elizabeth loves her family’s Lowcountry roots. “I’m surrounded by water and people who have a strong sense of community,” she said. “I love the lifestyle, and my family and friends are all here!”
On a sunny day in mid-May, Elizabeth rose and dressed for a normal workday, donning a skirt and top, paired with her favorite flip-flop sandals adorned with rhinestones. She was scheduled to meet with a contractor to review the punch list on a home a day before the real estate closing. Elizabeth and the contractor entered the service yard and moved the trash cans to get a better view of the electrical box when she felt what she thought was a wasp sting. She turned and spotted a juvenile copperhead snake coiled in the sandal she had flung off, prepared to strike her a second time.
The contractor froze, and Elizabeth kept her wits about her, asking the contractor to kill or remove the snake. The snake was positioned in front of the service yard gate, making a speedy departure impossible. The contractor killed the snake while Elizabeth sat to try and manage her blood pressure while calling 911. An ambulance soon arrived to take her to the hospital, and the EMTs marked her foot so medical professionals could gauge her body’s inflammatory response to the venom. Elizabeth’s blood pressure spiked over 200 as she endured intense pain. The dead snake was removed and placed in a jar for identification purposes. It was approximately 18-20 inches in length and deemed a juvenile from the tell-tale yellow markings on its tail. Elizabeth was asked if she wanted the snake to ride with her to the hospital. “It’s riding up front with y’all,” she replied and gratefully never saw that snake again.
After arriving at the Hilton Head Hospital emergency room, Elizabeth first approached her injury by requesting regular pain medication. An hour later, she needed much stronger meds as the inflammation spread up her leg. “The pain was terrible,” she said, “I couldn’t walk on it because it was so swollen, and I couldn’t flex my foot.” She received the antivenom medication within four hours of the bite incident, and the hospital kept her overnight for observation. A second dose of antivenom was administered the next morning. The swelling had not improved very much by the time she was discharged late that afternoon. She felt woozy from the pain medication and also received a tetanus shot. Another 10 days crept by before she began to feel more like herself.
Weeks later, Elizabeth’s big toe on her right foot, the location of the bite, is still swollen. She can only wear flip-flops because traditional shoes are too restrictive and painful to wear. She still experiences brain fog and fatigue as she continues follow-up visits with her primary care physician. “I have good and bad days; I’ve had to slow down,” she said. She refrains from alcohol, eats clean and healthy foods, elevates her foot, and gets plenty of rest to assist with her recovery.
Growing up here, Elizabeth always knew she shared the Island with snakes and could easily spot a copperhead. “I was a barefoot kid,” she said. “That day, I was standing on concrete: not in pine straw. I don’t know where it came from. Copperheads are sneaky and can be anywhere.” Elizabeth encourages readers to watch where they are walking, be aware of their surroundings, and wear close-toed shoes. She also says to make noise and carry a stick in the yard for defense. “And don’t assume they won’t be on concrete.”
Elizabeth is still understandably shaken by the experience, especially since she had a major snake phobia before the bite occurred. “I feel very lucky I was able to receive the antivenom treatment so quickly, and I have a greater appreciation for good health and safety now,” she said. She is most grateful for the skilled, attentive, and supportive care she received from the first responders: the community security officers, firefighters, and EMS personnel.
Up Close:
By Day: Managing Partner in COAST brokered by eXp Realty, Bluffton Office
Phobias: Heights and snakes
Fun Fact: As a kid, Elizabeth won the International Science Fair Award, Biochemistry Division, raising chickens in Sea Pines.
Being Brave: Means showing up during the most difficult times, facing the unexpected, and moving through challenges with grace.
The More You Know: The Center for Disease Control’s (CDC) website has resources for snake identification, bite prevention, and first aid. Visit their website to learn more: www.cdc.gov/niosh/outdoor-workers/about/venomous-snakes.html.
By Dr. Michael Kaup
Beaufort Memorial Express Care & Occupational Health
What are the step-by-step actions I should follow if I’m stung by a jellyfish? When should I see a doctor?
There are several types of stinging jellyfish in this region, including
sea nettles, which are responsible for the largest number of stings in
South Carolina.
• If stung, exit the water as quickly as possible.
• A common myth is that urinating on the sting can offer relief and aid recovery, but this can increase pain and cause further skin reactions. Instead, remove the irritating tentacles still on the skin by loosely placing dampened sand on the skin and rinse with ocean water. Do not use tap water.
• This can also be accomplished with shaving cream scraped off the skin with a credit card or something similar. Then, place a vinegar compress on the affected skin for 30-60 minutes. Finally, use an over-the-counter steroid cream two to three times daily on the affected skin.
• If swelling or extreme pain persists, it’s time to seek medical attention.
What are the step-by-step actions I should follow if I get poison ivy or oak? When should I see a doctor?
Most mild cases of poison ivy, oak, and sumac resulting in itching, burning, and blistering can be treated at home.
• Remove any clothing that has touched the plant and wash your hands thoroughly. Avoid scratching; cool compresses can help relieve itching, as can applying calamine lotion to the skin.
• If isolated to a small area, you can treat the rash with an over-the-counter steroid cream two or three times daily, with an antihistamine for the itching.
• If the rash covers a large portion of your body or your genitals, appears infected or does not clear up after home treatment, it may be time to see a healthcare provider.
How should I identify a spider bite? What should I do if I have one? When should I see a doctor, and should I try to bring the spider with me?
First, know how to recognize brown recluse and black widow spiders—the two species whose bites are most likely to cause a reaction. Fortunately, brown recluse spiders are not common in the Lowcountry, so their bite would be unlikely.
Symptoms of these bites differ but can include two pinprick-sized fang marks, sharp pain (during the bite), severe muscle cramping, swelling, soreness, sweating, chills, and a red or purplish circle around the bite.
If you think you have been bitten by a brown recluse or black widow spider, contact your healthcare provider. If you can capture the spider, it may help your provider in administering the proper treatment.
Most other spider bites can be treated at home by cleaning the bite thoroughly, applying antibiotic cream, a cool compress to reduce swelling, and over-the-counter pain relievers.
Michael R. Kaup, M.D., is a board-certified emergency medicine specialist who sees patients of all ages at Beaufort Memorial Express Care & Occupational Health in Bluffton, Port Royal, and Okatie.