Splinter or Sliver

DEFINITION

  • A splinter or sliver is a foreign body (FB) embedded in the skin.

Symptoms

  • Most slivers are in the superficial skin and do not cause much pain. Deep or perpendicular slivers are painful to pressure.
  • If slivers need to be removed in a medical setting, it is better to see them quickly before they become hidden by swelling or pushed in more deeply by the parent or child.

Causes

  • 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.
  • Organic slivers (e.g., wood or thorns) usually become infected if they are not removed.  Nonorganic slivers (e.g., metal or glass) generally do not.
  • Pencils contain graphite (harmless), not poisonous lead. Even colored graphite leads are nontoxic. They can cause a tattoo, however, and should be scrubbed out.

WHEN TO CALL YOUR DOCTOR

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
  • 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
  • Site of sliver removal looks infected (redness, red streaks, swollen, pus)
  • Fever occurs

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

  • You think your child needs to be seen
  • Deep puncture wound and last tetanus shot was over 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, cactus spines or fiberglass spicules
  • Minor sliver or thorn that needs removal and you think you can remove it

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 with normal shedding of the skin or the body will reject them by forming a little pimple which will drain on its own.
  2. Tiny Plant Stickers: Plant stickers (e.g., stinging nettle), cactus spines or fiberglass spicules are difficult to remove because they are fragile. Usually they break when pressure is applied with a tweezers.
    • Wax Hair Remover: Apply a layer of wax hair remover. Let it air dry for 5 minutes or accelerate the process with a hair dryer. Then peel it off with the spicules. Most will be removed.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 or thorns 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.
    • Cleanse the skin surrounding the sliver briefly with rubbing alcohol before trying to remove it. If you don't have any, use soap and water but don't soak the area if foreign body 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:
    • Can't get it all out
    • Removed, but pain becomes worse
    • Starts to look infected
    • Your child becomes worse

And remember, contact your doctor if your child develops 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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 7/15/2007

Last Revised: 10/1/2006

Content Set: Pediatric HouseCalls Online

Copyright 1994-2007 Barton D. Schmitt, M.D.