If you garden without gloves, or are partial to going barefoot in the backyard, chances are you've managed to collect a splinter.For most of us, it's a non-event. With tweezers or even your fingernails, you can pull the splinter from the skin's surface and there is no cause for alarm.But sometimes a splinter isn't easily removed.Is it safe to assume it will come out by itself, or can you leave it alone regardless?It depends on several factors, says Dr Adam Sheridan, dermatologist and spokesman for the Australasian College of Dermatologists. Horror stories aren't common but when they do occur, generally the splinter has come from plant material.'

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Nine times out of 10, splinters are trivial things. But the classic scenario where things go wrong and end up in our clinic relates to vegetable matter,' Dr Sheridan says.' They are the ones that most often cause infection and an immune reaction. The splinter is seen as a living foreign body and we're designed to reject that.' A splinter of inert, non-living material like metal or glass is less likely to trigger an immune reaction, Dr Sheridan says. Close'We'll see people presenting with a painful nodule — like a non-healing lump — on their finger and it all goes back to them getting pierced by a rose thorn or a bit of mulch when they were working in the garden,' Dr Sheridan says.' Twenty to 30 days later, they can get this line of red inflamed lumps right up their arm.'

The lumps occur in a pattern known as sporotrichoid spread, which follows the line of vessels in your body's lymphatic system, which has a role in fighting infection.These sores do not heal unless they are treated with anti-fungal medicine. (Pixabay: sophieja23)Are noisy joints a sign of arthritis? Will going vegetarian reduce your cancer risk?

Splinters can carry bacteria and fungi that can cause nasty reactions.

If you garden without gloves, or are partial to going barefoot in the backyard, chances are you've managed to collect a splinter.

For most of us, it's a non-event. With tweezers or even your fingernails, you can pull the splinter from the skin's surface and there is no cause for alarm.

But sometimes a splinter isn't easily removed.

Is it safe to assume it will come out by itself, or can you leave it alone regardless?

It depends on several factors, says Dr Adam Sheridan, dermatologist and spokesman for the Australasian College of Dermatologists.

Horror stories aren't common but when they do occur, generally the splinter has come from plant material.

'Nine times out of 10, splinters are trivial things. But the classic scenario where things go wrong and end up in our clinic relates to vegetable matter,' Dr Sheridan says.

'They are the ones that most often cause infection and an immune reaction. The splinter is seen as a living foreign body and we're designed to reject that.'

A splinter of inert, non-living material like metal or glass is less likely to trigger an immune reaction, Dr Sheridan says.

What is the infection risk?

While anything that pierces the skin can create a point of entry for microbes from outside the body, organic splinters are themselves likely to be carrying bacteria and fungi that can cause infections. The result can be pain, swelling and redness - or sometimes worse.

Rose thorns, for instance, may be coated with a fungus called Sporothrix and many a gardener has discovered the pitfalls of pruning the popular flower.

Red lumps in a line on the skin after a splinter can indicate fungal infection.

'We'll see people presenting with a painful nodule — like a non-healing lump — on their finger and it all goes back to them getting pierced by a rose thorn or a bit of mulch when they were working in the garden,' Dr Sheridan says.

'Twenty to 30 days later, they can get this line of red inflamed lumps right up their arm.'

The lumps occur in a pattern known as sporotrichoid spread, which follows the line of vessels in your body's lymphatic system, which has a role in fighting infection.

These sores do not heal unless they are treated with anti-fungal medicine. They may last for years and can sometimes drain small amounts of pus.

Splinters from plants are also more likely to carry bacteria like Staphylococcus aureus or golden staph, Dr Sheridan says.

If this is the case, a splinter in the foot might result in a visible red streak up the leg around 24 hours later — again a result of inflammation in the lymph vessels.

If you develop fever and chills, that's likely a sign of a severe bacterial infection.

Leave a thorn or splinter of wood in your body for a few months, and it's likely to disintegrate and further stimulate your body's immune response.

And any infection left untreated can spread and cause septicaemia or blood poisoning.

So leaving a splinter alone isn't without risks.

To remove or not

While it's hard to be definitive, Dr Sheridan's general rule of thumb is that if a splinter is easy to get out, you should get it out, regardless of what it's made of.

'You wouldn't want someone digging around with dirty pliers,' he warns. But if it's in the surface, and you can get it out fairly easily without breaking it up, 'go for it'.

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If you can't get it out, it's in deep, or you think the splinter is vegetable matter, Dr Sheridan advises seeing your GP — ideally within 48 to 72 hours, before any infection has time to take hold.

You can probably be a bit more relaxed if you think the splinter is a bit of glass, metal or plastic, Dr Sheridan says, but it's a good idea to keep an eye on it.

And bear in mind that splinters of any kind can be risky for anyone with medical conditions including diabetes, lowered immunity or diseased blood vessels.

Whatever the cause, a deep splinter that's caused infection may need to be cut out under local anaesthetic, followed by careful washing of the area.

You may also require medication to ensure the infection doesn't continue to spread, even after the splinter is gone.

Can splinters come out by themselves?

Movement of your body can see a splinter 'work its way out'. The action of immune cells migrating to the area also achieves this result, although this can cause localised pain.

'You get a build-up of pus under pressure, an abscess, and if it bursts, the splinter can float out,' Dr Sheridan says.

Popular 'natural' splinter removal remedies

Home remedies for splinters

These common methods for removing splinters may increase infection risk.

• Place a piece of eggshell lining over affected area
• Soak the area in vinegar
• Place banana skin on the area
• Use baking soda paste on the area
• Place a piece of potato skin on the affected area

*If you want a natural treatment, Dr Sheridan suggests a dab of petroleum jelly to keep the area moist (which makes it easier for the splinter to come out by itself) and cover with a dressing if needed.

The natural process of cells in the surface skin layer being pushed out and replaced can eject a splinter too.

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'Often when a splinter's perceived as working its way out, it's more that your skin's turned over and the splinter's ridden the escalator out, so to speak,' Dr Sheridan says.

If the body can't get rid of a splinter, it may 'wall it off' to form an internal lump known as a granuloma.

The splinter can re-emerge at the surface, sometimes years later, or remain encased and 'dormant', Dr Sheridan says.

'I've had patients who do angle grinding, or something like that, and when you do surgery to remove an unrelated skin cancer, you can find little metal splinters within their exposed skin.'

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