Hair Tourniquet Syndrome in Pediatric Populations

Hair Tourniquet Syndrome (HTS) is a paediatric emergency in which a strand of hair or similar filament becomes tightly wrapped around a digit, toe, genital structure or, more rarely, other soft tissues. The incidence peaks in infants under two months, coinciding with maternal postpartum hair shedding, although older children may present with genital involvement. Pathophysiologically, the constrictive band impedes lymphatic and venous return, leading to progressive oedema, arterial occlusion, ischaemia and, if unrelieved, necrosis or even autoamputation. Clinical features include persistent crying, local swelling, erythema and, in some cases, visible or embedded hair rings. A high index of suspicion is essential, particularly when there is no history of trauma. Diagnosis relies on meticulous physical examination—often aided by magnification—and, occasionally, imaging to assess deep tissue involvement. Management requires prompt removal of the constricting strand, by simple unwinding or surgical release under appropriate anaesthesia if the hair is buried. Post-release care encompasses wound cleaning, antibiotic prophylaxis when indicated and, in severe cases, reconstructive intervention. Preventive strategies focus on caregiver education, routine inspection of infants’ digits and use of mittens or socks. Early recognition and standardised management protocols have markedly reduced complication rates and improved long-term functional outcomes.

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Hair Tourniquet Syndrome in Pediatric Populations publication trend

The graph below shows the total number of articles in hair tourniquet syndrome in pediatric populations across all publications each year (not limited to Nature Index journals).

Technical terms

Tourniquet syndrome: Constriction of an appendage by a hair or fibre causing circulatory compromise.

Ischaemia: Inadequate blood supply to tissue leading to oxygen deprivation.

Oedema: Accumulation of fluid in tissues resulting in swelling.

Necrosis: Irreversible tissue death due to prolonged ischaemia.

Autoamputation: Spontaneous detachment of a body part following severe vascular injury.

References

1. Hair-Thread Tourniquet Syndrome: A Comprehensive Review. Cureus (2024).
2. Hair-thread strangulation syndrome in childhood: a systematic review.. Swiss Medical Weekly (2023).
3. The First Report of Isolated Clitoral Hood Hair-Thread Tourniquet Syndrome: A Study of Six Patients. Cureus (2022).