SPLINTER OR SLIVER

Injury Definition

  • A splinter or sliver (thin fragment) is a foreign body (FB) embedded in the skin. Most commonly, splinters or slivers are made of wood. Sometimes they may be glass, metal or plastic. This definition also includes thorns or cactus needles.
  • Most slivers are in the superficial skin and do not cause much pain. Deep or perpendicular slivers are painful to pressure.

General Information

  • Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are nontoxic. They will cause a tattoo, however, and should be scrubbed out.
  • Organic slivers (e.g. wood or thorns) usually become infected if they are not removed. Non-organic slivers (e.g. metal or glass) generally do not become infected.
  • If slivers need to be removed in a medical setting, it's better to do so quickly before they become hidden by swelling or are pushed in more deeply. Also, the physician can numb the area before removal.

WHEN TO CALL YOUR DOCTOR FOR SPLINTER OR SLIVER

Call Your Doctor Now (night or day) If:

  • You feel weak or very sick
  • FB is deeply embedded (e.g. needle or toothpick in foot)
  • FB has a barb (e.g. fish hook)
  • FB is a BB
  • Dirt or pencil pigment is left in skin after FB removed and scrubbing
  • FB is causing severe pain
  • You are reluctant to take out FB or can't get it out

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If:

  • You think you need to be seen
  • Diabetic and splinter is in foot
  • Deep puncture wound and last tetanus booster was over 5 years ago

Call Your Doctor During Weekday Office Hours If:

  • You have other questions or concerns

Self Care at Home If:

  • Tiny, pain-free slivers that don't need removal
  • Tiny plant stickers or spicules (small fragments) of fiberglass
  • Minor slivers that need removal and you don't think you need to be seen

HOME CARE ADVICE FOR MINOR SPLINTERS OR SLIVERS

  1. Tiny, Pain-Free Slivers: If superficial slivers are numerous, tiny, and pain-free, they can be left in. Eventually they will work their way out with normal shedding of the skin or the body will reject them with a minor skin infection.
  2. Tiny Plant Stickers:  Plant stickers (e.g. stinging nettle), cactus spines, or fiberglass spicules are difficult to remove. Usually they break when pressure is applied with tweezers.
    • Wax Hair Remover: Warm up wax in your microwave for 10 seconds, and apply a layer over the skin containing the stickers. Cover it with the cloth strip that came with hair remover. Let it air dry for 5 minutes or accelerate the process with a hair dryer. Then peel it off. It will remove most of them. The others will usually work themselves out with normal shedding of the skin. You can also try all-purpose white glue, but it is far less effective.
    • Tape: Another option is to lightly touch the area with packaging tape or another very sticky tape.
  3. Needle and Tweezers: Remove larger slivers with a needle and tweezers.
    • Check the tweezers beforehand to be certain the ends (pickups) meet exactly. (If they do not, bend them.) Sterilize the tools with rubbing alcohol or a flame.
    • Wash the skin surrounding the sliver briefly with soap and water before trying to remove it. Don't soak the area if FB is wood. (Reason: can cause swelling of the splinter)
    • Use the needle to completely expose the large end of the sliver. Use good lighting. A magnifying glass may help.
    • Then grasp the end firmly with the tweezers and pull it out at the same angle that it went in. Getting a good grip the first time is especially important with slivers that go in perpendicular to the skin or those trapped under the fingernail.
    • For slivers under a fingernail, sometimes a wedge of the nail must be cut away with fine scissors to expose the end of the sliver.
    • Superficial horizontal slivers (where you can see all of it) usually can be removed by pulling on the end. If the end breaks off, open the skin with a sterile needle along the length of the sliver and flick the rest out.
  4. Antibiotic Ointment:  Wash the area with soap and water before and after removal. Apply an antibiotic ointment to the area once after removal to reduce the risk of infection.
  5. Call Your Doctor If:
    • You can't get it all out
    • FB is removed, but pain becomes worse
    • Starts to look infected (e.g. redness, pus, increasing pain)
    • You become worse or develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Adult HouseCalls Online. Copyright © 2000-2004 David Thompson, M.D. FACEP

Reviewed 8/2004

Revised 8/2003

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