Cactus splinter: urgent care worthy?

March 5, 2019 4:20 PM

I have a cactus splinter. How can I tell if it's infected?

Last Friday, I was hiking in Saguaro National Park, and what I believe was a Teddy Bear Cholla cactus bit me in the leg. We managed to get most the the prickers out, but apparently one small one remained. I tried to pull it out with tweezers when I got home, but it just broke off. I put Neosporin on it. Now (4 days later) it's itchy, red, and swollen a little. Is this thing infected? Do I need to go to urgent care? How will they get it out? I'm a little squeamish of someone digging it out, TBH. Pulling out the other spines hurt like a MF.

posted by libraryhead to Health & Fitness (14 answers total)

Relax. You’re fine. It will most likely take care of itself if you can avoid irritating it, picking at it, rubbing it, etc for the next few days.
posted by SaltySalticid at 4:52 PM on March 5, 2019 [6 favorites]

I would take that to urgent care, personally. They might tell you to keep putting neosporin on it and keep an eye on it, or they might dig out the splinter (I bet you could ask for a numbing agent, at least). Either way, I would consider that a more positive option than getting a worse infection. No point in putting yourself through more of an ordeal than you have to.
posted by Autumnheart at 4:54 PM on March 5, 2019 [4 favorites]

A cholla attacked my ankle when I went to Joshua Tree a while ago. I pulled most of it out but some spine bits remained--it's not always comfy but I've found that letting them eventually work their way out was preferable to digging around for them.
posted by sprezzy at 5:03 PM on March 5, 2019 [3 favorites]

Best answer: any foreign body under the skin will cause an irritation that will raise, get red, itch and so forth. an infection will develop pus and enlarge, sometimes draining.

most small slivers will work themselves to the surface, but on the other hand they do carry bacteria with them into the wound, so keep an eye out and go to urgent care if pus develops.
posted by OHenryPacey at 5:08 PM on March 5, 2019 [2 favorites]

Best answer: Circle the red area with sharpie or ballpoint, so you can see if it's getting significantly larger.
posted by The corpse in the library at 5:14 PM on March 5, 2019 [4 favorites]

Best answer: Urgent care worthy? No.

How to tell if it’s infected? Pus.
posted by MountainDaisy at 5:46 PM on March 5, 2019 [1 favorite]

Best answer: If there's a pink line going from the site towards your heart, go to urgent care. Otherwise draw a circle around it in sharpie, and if it's bigger tomorrow go then.
posted by bile and syntax at 5:54 PM on March 5, 2019 [5 favorites]

Best answer: itchy, red, and swollen a little does not indicate an infection; it indicates your immune system being annoyed by a foreign object.
posted by DarlingBri at 5:57 PM on March 5, 2019 [6 favorites]

Best answer: If you grind equal parts by weight Epsom salts and dry bentonite clay to a fine powder with a mortar and pestle, then add just enough water to make a paste with a texture something like poster paint, then paint some over the red and itchy spot and let it dry to a white crust, you will probably find that it does a pretty good job of both calming down the irritation and drawing out the remaining plant material.
posted by flabdablet at 7:29 PM on March 5, 2019 [5 favorites]

Best answer: If you don't have Epsom salts or bentonite clay, baking soda works as well.
posted by I claim sanctuary at 3:57 AM on March 6, 2019 [2 favorites]

The point of the bentonite ingredient is to make the resulting paint cohere and stick quite hard to skin even when it appears to have dried out completely. If you use a soluble crystal like Epsom salt or baking soda by itself, the resulting paste tends to be quite powdery after drying and falls off easily. Glycerin can help with that if you've got no bentonite.

If you can put aside the instinctive ick-by-association factor, clumping cat litter is a very cheap source of bentonite that you might already have in the house. Though it tends to stay a little gritty even after having had a good go at it with the mortar and pestle, it's always done the job for me.

Baking soda is quite alkaline, unlike Epsom salt, and therefore more likely to act as an irritant to sensitive skin with extended contact. So if you're trying baking soda and your redness gets worse, wash it off. On the other hand, that very alkalinity makes baking soda paste a good first aid for bee, ant and wasp stings: the venom in all of these is based on formic acid, which the baking soda tends to neutralize.

Epsom salt is good at reducing irritation and drawing out assorted kinds of muck on its own, as long as you can keep it in good contact with the skin for at least a day. On parts of me where the clay paint won't stick or won't dry out or wears off too fast, I've had good results from slapping on a bandaid, then temporarily pulling up one edge and stuffing a pinch of fine-ground Epsom salt into the resulting pocket between the pad and the skin. This is good for boils as well as splinters.

Epsom salt can be had very cheaply in bulk from farm supplies stores, which sell 20kg bags of it as a fertilizer (it's typically labelled "magnesium sulphate heptahydrate" rather than "Epsom salt" but it's the same thing).
posted by flabdablet at 5:08 AM on March 6, 2019 [2 favorites]

When I had a similar run in with some briars I discovered something called ichthammol, aka "drawing salve" if you prefer an old-timey name. It's black and oily, smells like coal tar and will stain clothing but does a good job bringing stuff up to the surface (it's also popular for treating boils). Should be available at most drug stores, OTC. Note that there are also many versions of homeopathic drawing salves available but I wouldn't vouch for any of them (your tolerance for homeopathy may vary).
posted by Jemstar at 8:14 AM on March 6, 2019 [1 favorite]

All the "homeopathic" drawing salves I've seen have been based on ichthammol, which is a perfectly respectable medicine. A perfectly respectable medicine with undetectable quantities of magic added is still a perfectly respectable medicine. If you want to try a drawing salve and stuff labelled "homeopathic" is all you can find, it will hit your wallet far harder than it ought to but as long as ichthammol is high on the ingredients list it should work fine.

Ichthammol is black, and it's a drawing salve, so it sometimes gets called "black salve". It's important not to confuse it with other substances also called by that name, which range from harmless if not particularly effective mixtures of honey, oils and charcoal to quack cancer "cures" deliberately formulated to inflict severe chemical burns. Always check your ingredients lists.

The main reasons I prefer the Epsom salt and clay paint to any of the greasy or tarry salves are that once dried it doesn't stain clothes, it washes off skin and out of fabrics very easily with plain water, and it costs next to nothing to make up.
posted by flabdablet at 8:45 AM on March 6, 2019

Response by poster: Thanks for the reassurances and the home-remedy tips. It's already starting to calm down, so I think I can get through this :)
posted by libraryhead at 10:00 AM on March 6, 2019