Hair tourniquet syndrome is most common in young infants, but can affect older children too. Ahead, find out more about what hair tourniquet syndrome is, how to spot it, and advice on how to safely respond.
What Is Hair Tourniquet Syndrome?
Hair tourniquet syndrome is sometimes also referred to as “hair and thread tourniquet syndrome” or “toe-tourniquet syndrome.” “It is the swelling of an appendage, normally a finger, toe or even the genitals, caused by a tightly wound strand of hair or thread,” explains Eric Hoppa, MD, FAAP, a board certified pediatrician who specializes in pediatric emergency medicine at Connecticut Children’s Hospital. If caught and removed early, any swelling and skin discoloration may subside after a few hours with no lasting ill effects. However, as an untreated hair tourniquet tightens, blood flow and oxygen are constricted to the affected area. “This can lead to tissue death and even loss of that area in a very extreme circumstance,” explains Dr. Hoppa.
Who Is at Risk for Hair Tourniquet Syndrome?
Hair tourniquet syndrome can affect babies at any age, but most commonly affects infants. “In young babies, this often occurs as a result of maternal postpartum hair loss, but it can be seen in toddlers and older children as well,” explains Krupa Playforth, MD, FAAP, a pediatrician from Northern Virginia who shares parenting advice on social media under the handle The Pediatrician Mom. “In older children, it is often the result of intentionally winding a constricting object, such as an elastic, around the body part.” It is imperative to remove and treat a hair tourniquet as quickly as possible in order to reduce the risk of long-term injury.
Signs and Symptoms of Hair Tourniquet Syndrome
Often the first sign associated with hair tourniquet syndrome is a baby’s sudden and prolonged crying. If this seems unusual for your child, remove their clothes and diaper and check for any redness, swelling, or discoloration of the fingers, toes, or genitalia. “The most common presentation of hair tourniquet syndrome is fussiness,” explains Dr. Playforth. “But when examined, parents will see a circumferential indentation–sometimes very tight–along with swelling and sometimes discoloration of a finger, a toe, or genitalia." In severe cases, as the tourniquet becomes tighter and the swelling becomes more pronounced, you may not be able to see the hair or the thread. This can be because the tourniquet has cut through the skin and is buried beneath it. This requires immediate medical assistance to prevent any long-term damage.
How to Safely Remove a Hair Tourniquet
Unless it is very superficial and you can clearly see and remove the tourniquet at home, hair tourniquet syndrome requires rapid medical evaluation by a qualified healthcare provider. “Time is of the essence; there’s a risk of permanent tissue necrosis if the tourniquet is not addressed,” explains Dr. Playforth. “For superficial hair tourniquets, or those on digits, we sometimes use a depilatory agent [hair removal cream] in the office for removal, but this cannot be used on female genitalia, and it does not always work,” explains Dr. Playforth. “Tweezers can also be used, but you must be careful to avoid pinching the skin. In some cases, patients need to have forceps or scalpel removal, and even may need sedation depending on the severity of the tourniquet.” If your child had a hair tourniquet associated with swelling, pain, or discoloration of the skin, you should seek an assessment with a healthcare provider, even if you think you safely removed it at home.
How to Prevent Hair Tourniquet Syndrome
You can help prevent hair tourniquet syndrome by keeping your hair safely tied back when in close contact with your baby, particularly if it’s long. This is especially important for parents who might be suffering from postpartum hair loss and shedding more hair than usual. Brushing your hair often to remove and dispose of any loose strands of hair will help reduce the amount of hair that could find its way into your baby’s grasp. However, hair isn’t the only thing that may cause a tourniquet injury to your infant. Be mindful of any object that could potentially wrap itself tightly around your baby’s fingers, toes, or genitalia, such as a loose piece of thread from a towel, cotton from a sock, or yarn from a pair of mittens. You can catch and potentially prevent hair tourniquet syndrome by regularly checking your infant’s fingers, toes, and genitalia, and removing any pieces of hair or threads before they become tightly wound.
A Word from Verywell
Not only can hair tourniquet syndrome be incredibly painful for infants, it can also lead to permanent nerve and tissue damage if left untreated. In extreme cases, hair tourniquet syndrome can even result in amputation of the affected body part. Regularly check your baby’s fingers, toes, and genitalia for signs of circumferential constriction, swelling, or discoloration, and seek immediate medical assistance to avoid long-term damage.
