Accidents involving pencils are becoming less common as school-aged children (and the rest of us) navigate to a digital world. But there are still cases of children and adults getting punctured by a pencil. If this accident occurs to you or to someone in your home, you may become concerned about pencil lead getting stuck in the skin.
Some pencil puncture wounds may heal and fade over time, but if a fragment of pencil lead enters the dermis (middle layer) of the skin, it can leave a black or blue-grey mark that remains for years. These are medically known as "traumatic tattoos" and informally as "pencil tattoos." Fortunately, there are ways to safely remove pencil lead marks from under the skin.
Is Pencil Lead Toxic?
Pencil lead is not made of the type of naturally-occurring metal that causes lead poisoning. In fact, pencil leads are not made from lead at all. The "lead" in pencils is actually a non-toxic form of carbon called graphite. According to the American Chemical Society, modern pencil leads are made by mixing graphite and clay.
The history of pencils dates back to 1565, when a large deposit of graphite was discovered in England. Farmers in the area began using the material to mark sheep, but it was difficult to write with pure graphite because it is soft and malleable. Eventually, pencil "leads" were cased in wood to make it easier to write and draw with the material.
Over 200 years later, French painter and inventor Nicolas Jacques Conte mixed powdered graphite with clay and discovered that by changing the ratio of graphite to clay, the hardness of the graphite rods could be altered. To this day, most pencil leads are created using Conte's method.
The graphite pencil scale is used to grade pencils according to the hardness of the lead and the darkness of the marks it produces on paper. The more clay in the mixture, the harder the pencil will be. Number one pencils (#1 pencils) are softer and leave darker marks on paper, and #4 pencils are harder and leave lighter marks. In the United States, most people are familiar with #2 pencils since they are commonly used in elementary schools.
How to Get Pencil Lead Out of Skin
The procedure to remove pencil lead stuck in the skin varies depending on how long the pencil fragment has been under your tissue. Removal may be as simple as removing a splinter. But if the lead has been there for a while, you may need professional help.
Simple Pencil Splinter Removal
If a piece of pencil lead has broken off and become lodged under the skin recently, it may be possible to remove the fragment as if it were a splinter, according to the American Academy of Pediatrics. But these steps should only be followed when the sliver is minor.
- Wash your hands with soap and water.
- Sterilize tweezers and/or a needle with isopropyl alcohol.
- Sterilize the wound and surrounding skin with isopropyl alcohol (or with soap and water if the alcohol is not available).
- Use the pin to carefully remove any skin covering the pencil piece/splinter.
- Use tweezers to grasp the pencil piece and carefully remove it at the same angle it went in.
- After removing the pencil fragment, wash the area with soap and water. Pat dry.
- Apply antibiotic ointment to the wound and place a bandage over the area.
If you are unable to remove the pencil splinter with tweezers and a needle, seek the guidance of a healthcare professional. You will also want to watch for signs of infection - even if the splinter was removed.
Any time skin has an open wound, there is always a small risk of infection if bacteria enters the puncture or cut. Remember to keep the wound covered with a bandage until it has healed to reduce the risk of infection. The risk of infection is highest in the first 24 to 72 hours after sustaining a wound on the skin. According to the Centers for Disease Control and Prevention, signs of skin infection to look out for include:
- Pain, tenderness, and/or warmth when touching the affected area
- Redness and/or red streaks around the wound
See your healthcare provider if you have one or more signs of infection.
Delayed Pencil Splinter Removal
If pencil lead has been lodged under your skin for a long period, you may need the help of a medical professional to remove it. It is generally advised that traumatic tattoos are best removed by laser treatment. Research shows that Q-switched ruby lasers are an effective way to remove them, although there is very limited information regarding the removal of pencil lead specifically. Q-switched ruby lasers use short, high-energy pulses of light to break up graphite particles that are then absorbed and eliminated by the body.
When to Call Your Doctor
While pencil lead is typically harmless, there are times that it may be necessary to see your healthcare provider. See your healthcare provider for a pencil lead wound if:
- The pencil tip is logged in a vulnerable area of the body (e.g., eye, head, knee, elbow, or other joints)
- The puncture wound appears infected and/or you have symptoms of an infection
- You have not had a tetanus shot in the past five years
Your healthcare provider will examine the affected area and determine the best course of treatment or removal.
What If You Can't Remove Pencil Lead Stuck in Skin?
Pencil lead in the skin is generally not a cause for concern. People can have pencil fragments under their skin for years without any issue. Poison control experts say that the condition is generally not harmful. But you may end up with a permanent blue-grey mark.
In rare cases, a pencil-core granuloma may form even decades after a pencil tip has been embedded in the skin. A pencil-core granuloma is caused by the body's delayed reaction to pencil lead fragments lodged in the skin. These granulomas may cause pain, tenderness, and swelling. You may feel a hard, thickened bump under the skin.
In one case study, a patient presented with a pencil fragment that had been under their skin for 31 years. When that area was accidentally hit 31 years later, a pencil-core granuloma formed. This suggests that additional trauma to the area may have caused a delayed tissue reaction and subsequent growth of the granuloma.
Research shows that pencil-core granulomas may be mistaken for malignant melanoma (skin cancer), as the dark-pigmented lesions can appear similar to melanoma spots. Pencil-core granulomas can be removed by incision (cut) to remove the pencil lead. This is a procedure that is performed at a hospital, doctor's office, or medical clinic by a trained professional.
How to Prevent Pencil Lead Under Your Skin
Though getting poked by a pencil used to seem like a rite of passage for many school children, particularly at the elementary school age, these injuries have become far less common as pencils are used less and less. Still, it is important to be mindful when using pencils and make safety a priority to prevent injury. To prevent pencil pokes:
- Store pencils in a bag or pencil case when walking or traveling.
- Use pencil caps to cover the tips when not in use.
- Carry pencils with the tips pointed down.
- Teach children that pencils are writing instruments and are not to be used as a toy or weapon at school or home.
Lastly, remember that if a pencil poke occurs, it is probably not cause for serious concern. But if you are unsure about a wound, reach out to your healthcare provider or to your local poison control center for further guidance.