Definition

• A foreign body (FB) is stuck in the skin
• Some examples are a splinter of wood or sliver of glass

Health Information

Symptoms

• Pain. Most tiny slivers in the top layer of skin do not cause much pain. An example of these tiny slivers are plant stickers. Foreign bodies that are deeper or go straight down are usually painful to pressure. FBs in the foot are very painful with standing or walking.
• Foreign Body Sensation. Older children may complain about something being in the skin. ("I feel something in there.")

Types of Foreign Bodies (FBs)

• Wood-organic FBs: splinters, cactus spines, thorns, toothpicks
• Metallic FBs: nails, sewing needles, pins, tacks
• Glass FBs
• Plastic FBs

Causes

• Tiny pain-free slivers near the surface that don’t need to be removed
• Tiny plant or cactus spines or fiberglass spicules that need to be removed
• Minor sliver, splinter or thorn that needs removal

Care Advice

1. Tiny, Pain-Free Slivers:
   • Tiny, pain-free slivers near the skin surface can be left in.
   • They will slowly work their way out with normal shedding of the skin.
   • Sometimes, the body also will reject them by forming a little pimple. This will drain on its own. Or you can open up the pimple with a clean needle.
2. Tiny Painful Plant Stickers:
   • Plant stickers or cactus spines are hard to remove. Fiberglass spicules may also be hard to get out. Reason: They are fragile. Most often, they break when pressure is applied with a tweezers.
   • Tape. First, try touching the spot lightly with tape. The stickers should attach to the tape. You can use packaging tape, duct tape or another very sticky tape.
   • Wax Hair Remover. If tape doesn’t work, use wax hair remover. Put a thin layer on. Let it air dry for 5 minutes. You can also speed up the process with a hair dryer. Then peel it off with the stickers. Most will be removed. The others will usually work themselves out with normal shedding of the skin.
3. Needle and Tweezers:
   • For large slivers or thorns, remove with a needle and tweezers.
   • Check the tweezers first. Be certain the ends (pickups) meet exactly. If they do not, bend them. Clean the tool with rubbing alcohol before using them.
   • Clean the skin around the sliver briefly with rubbing alcohol. Do this before trying to remove it. If you don’t have any, use soap and water. Caution: Don’t soak the spot if the foreign body is wood. Reason: Can cause swelling of the splinter.
   • Use the needle to uncover the large end of the sliver. Use good lighting. A magnifying glass may help.
   • Grasp the end firmly with the tweezers. Pull it out at the same angle that it went in. Get a good grip the first time. This is important for slivers that go straight into the skin. This is also important for those trapped under the fingernail.
   • For slivers under a fingernail, sometimes part of the nail must be cut away. Use a fine scissors to expose the end of the sliver.
   • Slivers (where you can see all of it) often can be removed at home. Pull on the end. If the end breaks off, open the skin with a sterile needle. Go along the length of the sliver and flick it out.
4. Antibiotic Ointment:
   • Wash the area with soap and water before and after removal.
   • Use an antibiotic ointment once after sliver is taken out. An example is Polysporin. No prescription is needed. This will help to decrease the risk of infection.

Call Your Doctor If

• You can’t get the FB out
• FB is out, but pain gets worse
• Starts to look infected
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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