Hair tourniquet is a condition where

hair Hair is a protein filament that grows from follicles found in the dermis. Hair is one of the defining characteristics of mammals. The human body, apart from areas of glabrous skin, is covered in follicles which produce thick terminal and fi ...

or thread becomes tightly wrapped around most commonly a toe, and occasionally a finger,

genitals A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female, a ...

, or other body parts. This results in pain and swelling of the affected part. Complications can include

tissue death Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated diges ...

due to lack of blood flow. It occurs most commonly among children around 4 months of age, though cases have been described in older children and adults. Most cases occur accidentally. Risk factors may include

autism The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...

and

trichotillomania Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is remov ...

. The mechanism is believed to involve wet hair become wrapped around a body part and then tightening as it dries. Diagnosis involves examination of the entire child. Prevention is by keeping the parent's hair from contact with the baby such as by the parent keeping their hair brushed and back and washing the baby's clothing separately. Treatment is with a substance that breaks down hair or cutting through the hair. The condition is rare. Males and females are equally frequently affected. The first medical description dates from 1832. In some cultures thread is tied around the penis of children with

bedwetting Nocturnal enuresis, also informally called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can include urin ...

or for luck.

Signs and symptoms

As this is a condition primarily of young children, symptoms are rarely reported. The child will become suddenly uncomfortable and miserable. As the digit is often inside a sock, the cause may not be clear. The affected toe can no longer receive an adequate blood supply via the

arteries An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pu ...

, nor can blood be drained via the

veins Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated ...

. The toe will therefore swell and turn blue, indicating

ischemia Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems w ...

. The ligature will not stretch in response to the toe swelling and will therefore cut into the skin in more severe cases, like a cheese-wire.

Treatment

The ligature is cut or dissolved as quickly as possible. Often it is possible to lift a portion of it to enable cutting, but in a severe case the ligature must be cut through the skin. This is, of course, injurious to the child, but may prevent loss of the digit. It must take place on the side of the toe, where there are no nerves or tendons. Other treatment not requiring minor surgery includes use of a chemical depilatory, such as the over-the-counter product

Nair The Nair , also known as Nayar, are a group of Indian Hindu castes, described by anthropologist Kathleen Gough as "not a unitary group but a named category of castes". The Nair include several castes and many subdivisions, not all of whom hist ...

, to dissolve or weaken the hair. This option is not indicated if the hair tourniquet has cut into the skin. Use of depilatory products such as Nair is not an effective treatment on nylon or other fibers that are not human hair.

Prognosis

Despite the distressing nature of the condition, outcomes are excellent. Loss of the toe is extremely rare, as is any residual disability. In rare cases the loss of a digit is possible. Rubber bands can have the same effect.

References

{{Infants and their care Injuries Infancy Safety

Signs and symptoms

Treatment

Prognosis

See also

References