Puncture Wound

Is this your symptom?

  • Skin is punctured by a narrow sharp object (a nail, pencil, toothpick)

Some Basics...

  • Punctures are a type of skin wound made by a narrow sharp object.
  • Puncture wounds can become infected, so need proper care.
  • A tetanus shot is often needed after a puncture wound.

Types of Puncture Wounds

  • Needlestick: If the wound is from a used or discarded needle, call a doctor right away. In some cases, medicines need to be started to stop the spread of HIV/AIDS.
  • Foot Punctures: Punctures into the bottom of the foot have a 4% risk of infection. This risk is higher in people with puncture wounds that go through a shoe. Pain lasting 4-5 days after the injury may be a sign of infection.
  • Pencil Lead Punctures: Pencil lead is made of graphite, which is harmless. Pencils are not made of poisonous lead. Colored lead pencils are also nontoxic. However, the graphite will cause a tattoo if it is not scrubbed out.

When to Call for Puncture Wound

Call 911 Now

  • Deep puncture on the head, neck, chest, back, or stomach
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Severe pain
  • Puncture over a joint
  • Tip of the object is broken off and missing
  • Feels like something is still in the wound
  • Cannot stand, put weight on the injury, or walk
  • Needlestick from used injection needle (may have been exposed to another person's blood)
  • Sharp object was very dirty
  • Setting was dirty and puncture happened to bare foot
  • Dirt in the wound is not gone after 15 minutes of scrubbing
  • Wound looks infected (redness, red streaks, swollen, or tender to touch)
  • Fever
  • You think you have a serious injury
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Diabetic and puncture wound of foot
  • Last tetanus shot was over 5 years ago
  • No past tetanus shots
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Puncture through shoe (athletic shoe) and into bottom of foot
  • Pain is not better after 3 days
  • You have other questions or concerns

Self Care at Home

  • Minor puncture wound

Care Advice for Minor Puncture Wound

  1. What You Should Know:
    • Punctures are a type of skin wound made by a narrow sharp object.
    • Puncture wounds can become infected, so need proper care.
    • You can treat minor puncture wounds at home.
    • Here is some care advice that should help.
  2. Cleansing: Wash the wound with soap and warm water for 15 minutes. Scrub the wound with a washcloth to remove any dirt.
  3. Trimming:
    • Gently trim off any flaps of loose skin that cover the wound. These can keep the wound from draining.
    • Use small sharp scissors.
    • Clean the scissors with rubbing alcohol before and after use.
  4. Antibiotic Ointment: Put on an antibiotic ointment covered with an adhesive bandage (Band-Aid) to reduce the risk of infection. Re-soak the area and put on more antibiotic ointment every 12 hours for 2 days.
  5. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  6. Expected Course: Puncture wounds seal over in 1-2 hours. Pain should get better within 2 days.
  7. Call Your Doctor If:
    • Dirt in the wound is still there after 15 minutes of scrubbing
    • It begins to look infected (redness, red streaks, pus, or tender to touch)
    • Fever
    • Pain becomes severe
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to 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.


Last Reviewed: 7/22/2017 1:11:23 AM
Last Updated: 5/7/2017 1:36:16 PM

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Puncture Wound - BB Gun

This photo shows a puncture wound from a BB gun in left upper arm. Note the small hole in the arm where the BB struck and entered the skin.

First Aid - Removing a Fishhook

This is method of fishhook removal is sometimes referred to as the Advance and Cut Method.

There are four steps in removing a fishhook using this method:

  1. Step 1. Using pliers (or needle drivers) firmly grasp the hook.
  2. Step 2. Push (advance) the hook until the tip of the hook pops out through the skin.
  3. Step 3. Cut off the tip of the hook (and the barb).
  4. Step 4. Pull (back out) the hook out.

Important Note:

  • These instructions assume that you can not get into see a doctor right away. In most circumstances it is best to have a physician (or other licensed health care provider) remove an embedded fishhook.
  • The hook in this drawing has only a single barb at the tip, and thus the tip of the hook (with the barb) can be cut off and the hook pulled backwards through the skin.
  • Some hooks can have more than one barb along the shaft of the hook. In such cases, it is better to cut off the ring at the bottom of the hook and push the hook all of the way through the skin.
First Aid - Wound - How to Clean
  • Wash the wound with soap and water for 5 minutes.
  • Gently scrub out any dirt with a washcloth.
  • Cover the wound with a sterile gauze or a clean cloth.
  • Apply direct pressure for 10 minutes to stop any bleeding.

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