My Baby Has Toe Tourniquet Syndrome? What’s That?

What is Toe Tourniquet Syndrome?


We know that new parents have a lot to be worried about. At the risk of adding to that inevitable overload, here’s one more infant safety item to bear in mind. As noted in PubMed, toe tourniquet syndrome is a common condition in pediatric emergency medicine, even though it is relatively under-reported. 

If your baby constantly cries for no apparent reason, and you’ve exhausted all other possibilities, take a close look at your baby’s feet. It’s just possible that a long strand of hair has become tightly, and painfully, wrapped around a toe. 

The result? A condition known medically as hair tourniquet syndrome, hair-thread tourniquet syndrome, or in the case of baby toes, toe tourniquet syndrome.  

It’s weird and rare, but a hair tourniquet is also dangerous

A hair tourniquet occurs when a strand of long hair wraps around a protruding appendage. It can affect multiple body parts, including fingers, external genitalia, and an umbilical stump, but the most common site by far is a baby’s toe. 

Literature reviews show that hair tourniquets have sometimes been reported as evidence of child abuse, but it’s clear the vast majority of such cases are completely accidental.

What causes a hair tourniquet?

When a woman becomes pregnant, the hormonal changes that occur lead to the growth of fuller, more luxuriant hair. Those hormonal alterations reverse themselves postpartum, which usually leads to maternal hair loss.  

And new mothers naturally spend a lot of time hovering over their very young children. So it’s easy for a long strand of hair to become accidentally twined around a baby’s toe. 

What makes the tourniquet tighten?

Human hair lengthens when it’s wet and shrinks when it dries. Sometimes it shrinks a lot. So if a loose strand of wet hair accidentally becomes draped around an infant’s toe, it tends to constrict as it dries, until it turns into what doctors call appendage strangulation.

What are the symptoms of hair tourniquet?

The primary result of a hair tourniquet is pain, so the most noticeable symptoms will be whatever methods a baby uses to signify discomfort.

Because hair tourniquets usually occur in infants under six months, they don’t have the vocabulary to verbally explain the problem. So the primary symptom is going to be constant, inconsolable crying.

Once alerted by the incessant and inexplicable crying, parents should check for a discolored and/or swollen finger, toe, or another appendage. If no hair is visible, look for an indentation or groove that might be hiding the tourniquet itself. Case reports describe deep, circumferential grooves with severe swelling.

What are the hair tourniquet dangers?

The constriction caused by a hair tourniquet can cut off blood circulation. The veins are affected first because they are closer to the surface.

If the condition isn’t promptly corrected, the deeper, arterial blood flow can be impeded. This can lead to tissue necrosis, i.e., death of the flesh surrounding the constriction. 

If the constriction continues unabated, the hair may cut into the skin. The skin can in turn grow over the strangulating hair, making the tourniquet virtually undetectable. In extreme cases, a process called autoamputation ensues. In cases where the condition is long neglected, the hair can actually contact the bone and erode it. 

Hair tourniquet removal at home

  1. If you can visually locate the hair, either with the naked eye or using a magnifying glass, you may be able to simply remove it with a pair of tweezers.
  2. If the hair is too firmly embedded to be easily removed, but the baby’s skin is still unbroken, apply a depilatory agent, such as Nair, that contains calcium hydroxide, sodium hydroxide, or calcium thioglycolate.
  3. Wait 10 minutes.
  4. Wash the depilatory cream off with warm water.
  5. Make absolutely sure that no hair residue is left in the indentation.
  6. Apply a disinfectant, like hydrogen peroxide, to the affected area.

If the baby’s skin is broken, do not use the depilatory cream. It contains alkali and is not meant for use on an open wound.

If the hair tourniquet has resulted in a laceration, it’s a pediatric emergency. Take your baby directly to an emergency department for immediate medical treatment.

How long does a hair tourniquet take to heal?

The time necessary for complete recovery is highly variableIt can be from a few minutes to weeks before a complete resolution is achieved. In severe cases, resulting in bony erosion or even amputation, the residual damage may last for a lifetime.

Hair tourniquet prevention

  • Brush your hair frequently, to eliminate loose hairs that might fall on your baby.
  • Keep your hair tied back when you are changing, bathing, or playing with your child.
  • Frequently check your baby’s toes and fingers for signs of constricting hairs. 

 Why choose University Foot and Ankle Institute for your family’s foot and ankle care?

If you or your family are experiencing foot pain, we’re here to help. Our specialists offer the most advanced podiatric care and the highest success rates in the nation. We are nationally recognized foot and ankle specialists and leaders in researching, diagnosing, and treating all foot and ankle conditions for adults, babies, and children.

At University Foot and Ankle Institute, we take our patients’ safety seriously. Our facility’s Covid-19 patient safety procedures exceed all CDC recommendations. Masks are required in our institutes at all times.

For more information or to schedule a consultation in the greater Los Angeles area, please call (877) 736-6001 or make an appointment now.

University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area as our foot doctors are available at locations in or near Santa Monica (on Wilshire Blvd.), Beverly Hills, West Los Angeles, Manhattan Beach, Northridge, Downtown Los Angeles, Westlake Village, Granada Hills, and Valencia California, to name a few.

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