Fishhook removal

Fishing accidents are the most common cause of fishhooks stuck in the skin.

A fishhook stuck in the skin can cause:

• Pain
• Localized swelling
• Bleeding

If the barb of the hook has not entered the skin, pull the tip of the hook out in the opposite direction it went in. Otherwise, you can use one of the following ways to remove a hook that is superficially (not deeply) embedded just beneath the skin.

Fish line method:

• First, wash your hands with soap and water or use a disinfecting solution. Then wash the skin surrounding the hook.
• Put a loop of fish line or string through the bend of the fishhook so that a quick jerk can be applied and the hook can be pulled out straight backward, directly in line with the shaft of the hook.
• Holding onto the shaft, push the hook slightly downwards and inwards (away from the barb) so as to disengage the barb.
• Holding this pressure constant to keep the barb disengaged, give a quick jerk on the fish line and the hook will pop out.
• Wash the wound thoroughly with soap and water. Apply a loose, sterile dressing. Do not close the wound with tape. Doing so can increase the chance of infection.
• Watch the skin for signs of infection such as redness, swelling, pain, or drainage.

Wire cutting method:

• First, wash your hands with soap and water or disinfecting solution. Then wash the skin surrounding the hook.
• If the tip of the hook lies near the surface of the skin, advance the tip up and through the skin. Then cut it off just behind the barb with wire cutters. Remove the rest of the hook by pulling it back through the way it entered.
• Wash the wound thoroughly with soap and water. Apply a loose sterile dressing and apply antibiotic ointment. Do not close the wound with tape. Doing so can increase the chance of infection.
• Watch skin for signs of infection such as redness, swelling, pain, or drainage.

Do not use any of the two methods above, or any other method, if the hook is stuck deeply in the skin, or in a joint or tendon, or located in or near an eye, eyelid, or artery. Get medical help right away.

A fishhook in the eye is a medical emergency, and you should go to the nearest emergency room right away. The injured person should lie down with the head slightly raised. They should not move the eye, and the eye should be protected from further injury. If possible, place a cup or soft patch over the eye but do not allow it to touch the hook or put pressure on it.

The main advantage to getting medical help for any fishhook injury is that it can be removed under local anesthesia. This means before the hook is removed, your health care provider numbs the area with medicine.

Contact your provider if:

• You have a fishhook injury and your tetanus immunization is not up to date (or if you are unsure)
• After the fishhook is removed, the area starts to show signs of infection, such as increasing redness, swelling, pain, or drainage

The following steps can help prevent fishhook injuries.

• Keep a safe distance between you and another person who is fishing, especially if anyone is casting.
• Keep electrician's pliers with a wire-cutting blade and disinfecting solution in your tackle box.
• Make sure you are up to date on your tetanus immunization (vaccine). You should get a booster shot every 10 years.

Fishhook removal from skin

Haynes JH, Hines TS. Fishhook removal. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 190.

Otten EJ. Hunting and fishing injuries. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 26.

Stone DB, Scordino DJ. Foreign body removal. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 36.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.