Splinter or Sliver

Symptom Definition

• A splinter or sliver is a foreign body (FB) embedded in the skin. Most of these are slivers or splinters of wood. Others are slivers (thin fragments) of glass, metal or plastic. A few are thorns or cactus needles.
• Most slivers are in the superficial skin and do not cause much pain. Deep or perpendicular slivers are painful to put pressure on.
• 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.
• If slivers need to be removed in a medical setting, it's better to see them quickly before they become hidden by swelling or pushed in more deeply by the parent or child. Also, the physician can numb the area before removal.

Call Your Doctor Now (night or day) If

• Deeply embedded FB (e.g. needle or toothpick in foot)
• FB has a barb (e.g. fish hook)
• FB is a BB from a pellet gun
• FB is clear (glass or plastic)
• Pencil lead or other pigment left in skin after FB removed
• 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 and 4) If

• You think your child needs to be seen
• Deep puncture wound and last tetanus booster was > 5 years ago

Call Your Doctor during Weekday Office Hours If

• You have other questions or concerns

Parent Care at Home If

• Tiny, pain-free slivers that don't need removal
• Tiny plant stickers or fiberglass spicules
• Minor slivers that need removal and you don't think your child needs to be seen

Home Care Advice for Minor 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 either 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 a tweezers.
   • Facial Gel: Apply a layer of facial gel or wax depilatory (hair remover). Let it air dry for 5 minutes or accelerate the process with a hair dryer. Then peel it off with the spicules. The others will usually work themselves out with normal shedding of the skin.
   • 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 it 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
   • was Removed, but pain becomes worse
   • it Starts to look infected
   • your child becomes worse or develops any of the "Call Your Doctor Now" symptoms