What Happens to Foreign Objects Under the Skin?

Symptoms of foreign objects under the skin include: 

• Pain
• The sensation of something being under the skin

See a doctor if you have a foreign object under the skin and:

• Signs of infection, such as: 
  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
  • Increased or severe pain 
  • Redness, red streaks, or swelling in the area
  • Pus draining from the wound 
• It is a deep puncture wound and your last tetanus shot was more than 5 years ago
• It is deeply embedded
• It has a barb (e.g., fish hook)
• It is a BB
• You are reluctant to take out the foreign object
• You are unable to remove the foreign object

Foreign objects under the skin can be diagnosed with a patient history and physical examination of the injury. 

Topical lidocaine may be used to help examine a painful wound, particularly in children. 

Imaging is not always needed if the object can be seen or if it does not need to be removed. 

If the object is not visible or if it needs removal, tests used to determine the location of the object and the severity of the wound may include: 

• X-rays wounds
• Ultrasound 
• Computed tomography (CT)

Depending on the foreign object and the nature of the injury, not all foreign objects under the skin need to be removed. 

Small, superficial slivers that don’t cause pain or other symptoms may be left in place in some cases. They usually work their way out as the skin sheds or the body will form a small pimple around them that will drain on its own. 

• Keep the wound clean and dry
• Over-the-counter (OTC) antibiotic ointment such as bacitracin zinc and polymyxin B sulfate (Polysporin) may be applied 

First aid and home care for minor slivers that need to be removed includes: 

• Tiny plant stickers, cactus spines, or fiberglass spicules may be difficult to remove because they are fragile:
  • They often break when tweezers are used
  • Attempt to touch the area lightly with packaging tape, duct tape, or another very sticky tape
  • If tape doesn’t work, try applying a layer of wax hair remover
    • Let the wax air-dry for 5 minutes and peel it off, which will remove most of the stickers
    • Any that are not removed will usually work themselves out with normal skin shedding 
• For large slivers or thorns:
  • These may be removed with a needle and tweezers  
  • Sterilize the tools with rubbing alcohol
  • Clean the skin surrounding the sliver with rubbing alcohol (if there is no rubbing alcohol available, soap and water will work, but do not soak an area that has wood embedded as the water can cause the wood splinter to swell)
  • Using the needle, completely expose the large end of the sliver and then grasp the end firmly with the tweezers, pulling it out at the same angle that it entered the skin
  • Over-the-counter (OTC) antibiotic ointment such as bacitracin zinc and polymyxin B sulfate (Polysporin) may be applied after removal

If the foreign object causes pain, over-the-counter (OTC) pain medicines may be used. 

For foreign objects under the skin that are unable to be removed at home, medical removal includes: 

• Splinter removal
  • A doctor may need to use specialized tweezers 
  • An incision may be required in order to access the object
  • Surgery by a specialist may be necessary if initial attempts to remove the object are not successful
• Fish hook removal
  • There are so many kinds of fishhooks so it is helpful to bring an identical hook to the doctor for them to visualize how the hook might be embedded into the skin
  • Depending on the patient, the location of the wound, and how the hook is embedded, a digital block (used on fingers and toes) or anesthesia of the area may be needed
  • Hooks that are not barbed may be backed out following the curve of the hook
  • Barbed hooks may need to be pushed all the way through to the other side and the barbed end is cut with a wire cutter so the shank of the hook can then be backed out
  • Other methods may be used depending on the patient, the location of the wound, and how the hook is embedded

Other treatments may include: 

• Stitches or staples may be used to close the wound, depending on how large it is
• Antibiotics may be prescribed to treat or help prevent infection
• Patients whose last tetanus shot was more than 5 years ago should be given a tetanus shot

Complications of foreign objects under the skin include:

• Risk of infection
• Scarring
• Need for surgical intervention
• Pigment tattooing if the foreign object is pencil lead or graphite