When a Small Splinter Becomes a Big Problem

While a splinter in your hand or fingers are generally just an annoyance, some slivers can escalate into larger health issues if left untreated. Splinters, slivers, and other material in the hand are generally easy to remove, but if you find you are unable to safely pull out the material, you may want to consult a medical professional. A hand doctor specializes in treating conditions, such as foreign bodies, that affect the hand and upper extremity. They can provide expert advice and treatment if necessary. A splinter is a foreign body that can become lodged in the hand or fingers, causing injury and potentially leading to infection or other complications if not removed. Most foreign bodies in the hand are small — a wood splinter, thorn, or metal sliver. However other plant or animal barbs are also possible.

All splinters have the potential to be dangerous if they are not removed properly. Splinters that are left in the skin can cause infection, inflammation, and other complications. Some types of splinters are more likely to be dangerous than others. Splinters from certain types of wood, such as poison oak or poison ivy, can cause an allergic reaction. Splinters from glass, metal, or other sharp objects can also cause more serious injuries, such as cuts or puncture wounds. If you are unsure whether a splinter is dangerous, it is best to see a doctor for removal.

Removing a Splinter by Yourself

Some small, superficial splinters in your hand can be removed without seeing a doctor, and they should be removed as soon as possible to prevent infection or further injury. To remove a splinter, you will need a pair of tweezers, a sterilized needle, or a splinter remover tool. First, clean the area around the splinter with soap and water to reduce the risk of infection. Then, use the tweezers, needle, or splinter remover tool to gently remove the splinter.

Attempting to remove a deep splinter yourself can lead to further issues and can cause the splinter or foreign body to break, making it even harder to remove. If you feel the splinter is too deep, or you are not comfortable removing it yourself, consult a doctor.

If the splinter is deep, you are unable to remove it yourself, it appears to be infected, or if you have any other concerns, you should see a doctor or hand surgeon. A hand surgeon will have the tools and expertise to remove the splinter safely and effectively. Many times, a superficial foreign body can be found during physical examination by a doctor and removed without difficulty. If you are seeing any of these signs near the area of the foreign body, which may indicate that a splinter is too deep for home removal:

• Altered sensation

• Tingling

• Signs of color changes

• Swelling

• Throbbing

• Loss of motion or catching when the hand or finger is moving

In these situations, a hand doctor should be called as soon as possible to prevent further injury. Splinters and slivers can sometimes cause trauma to the skin, and it is possible for them to contribute to the development of an inclusion cyst. What may have begun as a small inert splinter can now be a hard lump that grows and grows as the body layers more tissue around it. Inclusion cysts can develop from blocked hair follicles or sweat glands, and they can also be caused by other factors such as infection or inflammation. The hard lump itself is annoying and the removal will now include the offending foreign body and the cyst or mass of tissue itself. There are some tools your hand surgeon may use to detect a foreign body in the hand:

• X-rays can be used to detect some wood splinters in the hand if there is a subtle shadow, and they are much better at detecting metal slivers. Glass typically only shows on an x-ray if it is leaded.

• An ultrasound can be used to detect the location and size of the object.

• CT scan or MRI: These imaging studies can be used, but they are rare and only used in severe cases.

These imaging studies will help guide the removal of the splinter for your doctor.

Can my foreign body come out on its own? What happens if it stays? Yes, a foreign body can potentially come out on its own if it is superficial. This is called ‘spitting.” Foreign bodies that are deeper below the skin can sometimes sit for years without being noticed. Either it eventually spits, in which the skin pushes it out as it grows, or it is walled off by tissue in an area that you never notice. This is not always the case, so you should consult with a hand surgeon if you think there may be a splinter or sliver stuck beneath your skin.

Source: American Society for Surgery of the Hand