We recently had a young baby girl present after her parents could not settle her. During a thorough assessment by one of our nurses, the cause of the girls unhappiness was identified.
A single human hair had wrapped itself tightly around her toe.
What is it?
Hair Tourniquet syndrome is a relatively (although often unreported) common occurrence in the hospital setting.
It requires high vigilance as it can quickly lead to ischaemia and loss of the digit or toe.
Often the tourniquet results from a single hair that becomes wrapped around the appendage.
Fingers and toes are the most commonly effected areas but there are reports of tourniquets occurring on the penis and even the clitoris.
Following pregnancy a mother may experience increased hair shedding known as ‘telogen effluvium‘ due to hormonal changes.
Loose strands of hair may become wrapped around the babies fingers or toes or other appendages.
As it dries out it shrinks, slicing into the skin and quickly becoming undetectable in the resulting inflammation.
Another potential cause to be aware of (and I have seen this on two occasions now ), is cotton strands from dressings around IV sites or other areas.
Many cotton bandages have easily fraying edges, and some of the ‘netting’ type dressings can easily trap-and-wrap around a finger or toe.
Increased irritability may be the only symptom, and therefore Hair-Tourniquet syndrome should always be considered in an irritable baby with no obvious cause of distress.
Once swelling occurs, removal of the tourniquet can become increasingly difficult.
- Keep your eyes peeled when ever you are examining an unwell child. Check fingers, toes etc.
- Always be vigilant for problems with IV dressings (particularly when they are over the hands or feet).
Happily in this case the baby settled for a solid sleep after after a liberal application of hair removal cream which successfully dissolved the hair after 2 applications (over about 30 minutes). There was no permanent damage to the toe.
Toe-Tourniquet Syndrome: A Diagnostic Dilemma!
(Ann R Coll Surg Engl. 2006 July; 88(4)
Toe Tourniquet Syndrome in Association With Maternal Hair Loss
( Journal of the American Academy of Paediatrics)