Hair Tourniquet

Overview

What is hair tourniquet syndrome?

Hair tourniquet syndrome occurs when a piece of hair wraps around a small appendage of your baby’s body. A thread from a blanket or a piece of clothing can also cause the condition. Hair tourniquets most commonly coil around your baby’s toes, fingers or penis. They can also affect their other body parts such as genitals, nipples, ear lobes, tongue or belly button (navel).

When a hair or thread becomes so tightly wrapped around an appendage, it can cause pain and swelling. The hair is essentially acting as a tourniquet. In severe cases, the blood supply to your baby’s appendage can be disrupted. Delay in treatment can cause serious complications such as tissue death or bone erosion, which can lead to the need for amputation.

Who does hair tourniquet syndrome affect?

Most cases of hair tourniquet syndrome occur in babies and young children. The average age of diagnosis is five months. The average age that finger hair tourniquets occur is 3 weeks old. The average age that toe hair tourniquets occur is 4 months old. When genitals are involved in hair tourniquets, the average age of diagnosis is 2 years old. Hair tourniquet syndrome is very rare in adults.

Symptoms and Causes

What are the symptoms of hair tourniquet syndrome?

The first symptoms of hair tourniquet syndrome may include excessive crying and irritability. You may notice redness or swelling on a finger, toe or another body part. The area may be tender and cause your baby pain and discomfort.

Upon further inspection, you may see a groove within the area. It may look like a normal crease in your baby’s folds. In more severe cases, the groove may be filled with fluid and have a foul smell.

What causes hair tourniquet syndrome?

One of the most common reasons hair tourniquet syndrome occurs in infants and young children is postpartum hair loss (telogen effluvium). Due to hormonal changes after giving birth, up to 90% of birthing parents experience excessive hair loss. This exposes your infant to more loose hair, causing an increased risk of the condition. Telogen effluvium can last from two to six months after giving birth.

In addition, when your hair is wet, it stretches out. When it’s dry, it constricts back to its normal size. So if your hair is wet when it coils around your baby’s finger or toe, it can tighten around their appendage when it dries. Since human hairs are so thin, you may not see that one has wrapped around your child’s body part.

Certain infant clothing can also cause hair tourniquet syndrome. If your baby repeatedly moves their fingers or toes around in a confined area, such as in mittens, socks or pajamas, the condition can occur.

Diagnosis and Tests

How is hair tourniquet syndrome diagnosed?

Your baby’s healthcare provider will diagnose hair tourniquet syndrome after doing a physical examination. They'll ask you about your baby’s symptoms. They’ll examine your baby’s appendages closely to look for any signs of the condition.

Management and Treatment

How is hair tourniquet syndrome treated?

Your baby’s healthcare provider can remove a hair tourniquet by dissolving, unwrapping or cutting the hair. The type of hair tourniquet removal method will depend on the severity of your baby’s condition.

For mild cases where your child’s provider can see the hair, they may use a hair removal cream (depilatory agent) to dissolve the hair. This is the least invasive and most effective method of treating the condition. It only works if a strand of hair is causing the condition. It won’t work on threads from clothing or blankets.

Your child’s provider will apply the cream onto the affected area. Within 10 minutes, the hair should break, releasing the tension around your child’s appendage. You should avoid this method if your child has broken skin or has an allergy to the ingredients in the cream.

If your child’s provider can’t use a hair removal cream, they may try unwinding the hair or thread. If they can’t unwind it, they may cut the hair or thread directly. First, they’ll place a blunt probe between the thread and your baby’s skin to protect it. Then they’ll cut the hair or thread using a pair of scissors or a blade.

For severe cases where a hair or thread is deeply embedded in your baby’s skin, a pediatric surgical specialist may need to perform surgery. They’ll give your child anesthesia and make a cut (incision) as far as necessary to get through the hair or thread.

Prevention

How can I prevent hair tourniquet syndrome?

You can prevent hair tourniquet syndrome by being aware of the condition. If you’ve recently had a baby, you may notice an increase in hair loss. You can take steps to reduce your baby’s contact with loose hairs. These steps include:

  • Brushing your hair often to make sure loose strands don’t fall out near your baby.
  • Tying your hair back with an elastic band while you’re taking care of your baby.
  • Checking your baby’s fingers, toes and other appendages frequently to check for hairs and threads.

In addition, avoid dressing your baby in mittens and older clothing that may have loose threads. If your baby likes to pull on your hair, gently direct their attention to a toy or another object.

Outlook / Prognosis

How long does a hair tourniquet take to heal?

The healing process depends on the severity of your baby’s condition. After your child’s healthcare provider removes the hair or thread, they’ll examine their appendage. More than likely, any swelling and tenderness will decrease significantly within 10 minutes.

In most cases with early treatment, the appearance of your child's finger or toe should go back to normal almost immediately. You should see complete recovery within a month of treatment.

What is the outlook (prognosis) of hair tourniquet syndrome?

With early diagnosis and treatment, hair tourniquet syndrome has a very good prognosis. Your baby’s wound should heal quickly and they shouldn’t need any additional treatment.

If left untreated, hair tourniquet syndrome can cause severe complications. These complications may include:

  • Excessive swelling.
  • Nerve injury.
  • Lack of blood flow to the appendage.
  • Tissue death (necrosis).
  • Bone erosion.

In the most serious cases, a pediatric surgical specialist will need to remove their appendage through amputation.

Living With

How do I take care of my baby after hair tourniquet removal?

After your baby’s hair tourniquet removal, your baby’s healthcare provider will send you home with specific instructions. You may need to apply an antibiotic ointment to the affected area to encourage healing. Cover the wound with a dressing and change it regularly.

Keep your baby’s appendage clean and dry for the first few days after treatment. Avoid baths or swimming pools. You can apply petroleum jelly or a baby lotion to the area. If pain continues, ask your child’s healthcare provider about giving your baby a mild pain reliever.

When should my baby see their healthcare provider?

After your baby’s hair tourniquet removal, the affected area should start to heal quickly. If your baby develops any symptoms of an infection, call their healthcare provider immediately. These symptoms may include:

A note from Cleveland Clinic

If your baby is crying inconsolably and you can’t figure out why, they may have a hair tourniquet. This painful condition occurs when a strand of hair or thread of clothing coils around a finger, toe or another appendage. The condition is easily treatable, but early diagnosis and treatment are vital. Without prompt treatment, the condition can worsen and cause complications. Call your baby’s healthcare provider right away if your baby has symptoms of hair tourniquet syndrome.

Last reviewed by a Cleveland Clinic medical professional on 06/23/2022.

References

  • Alruwaili N, Alshehri HA, Halimeh B. Hair tourniquet syndrome: Successful management with a painless technique. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372396/) Int J Pediatr Adolesc Med. 2015;2(1):34-37. Accessed 6/23/2022.
  • Gottlieb M, Holladay D, Spearman D. Current Approach to the Evaluation and Management of Hair-Thread Tourniquets. (https://pubmed.ncbi.nlm.nih.gov/31045982/) Pediatr Emerg Care. 2019;35(5):377-379. Accessed 6/23/2022.
  • Hussin P, Mawardi M, Masran MS, et al. Hair tourniquet syndrome: revisited. (https://pubmed.ncbi.nlm.nih.gov/26712259/) G Chir. 2015;36(5):219-221. Accessed 6/23/2022.
  • Özçift B, Ağras K. Hair tourniquet syndrome of penis: A rare situation in boys with serious complications if not recognized. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619851/) Turk J Urol. 2018;45(4):322-324. Accessed 6/23/2022.

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