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Hair/Thread Tourniquet Syndrome occurs when a hair or fiber becomes wrapped around an appendage (usually a finger or toe, although cases involving external genitalia have been reported), restricting blood flow and potentially damaging or amputating the appendage. More than one hair or fiber can form an encircling band as well.

This medical condition occurs more often in infants, although it can occur at any age (particularly in individuals of limited mental capacity). Most often it is recognized as an accidental occurrence; although, since cases of child abuse have been known to involve Hair/ Thread Tourniquet Syndrome, the possibility of child abuse must be considered by medical professionals. It is a relatively common condition in infants.

Redness and swelling may call attention to the problem. Babies may fuss or cry for several hours, with no other signs of illness. Among all the conditions that may cause a baby to cry for several hours, a hair or tourniquet strangulation should always be considered as well. Visually examining all of the baby's appendages may reveal a hair or fiber ligature. For this reason, babies' hands and feet should not be covered for long periods of time, without opportunity to see the fingers and toes.

It is the third finger and third toe that are most commonly affected by Hair/Thread Tourniquet Syndrome. When it occurs in a finger a thread is more often involved. When a toe or external genitalia are involved hair is more often the culprit.

An association has been made between the hair loss that mothers experience in the months following delivery and Hair/Thread Tourniquet Syndrome. In Pediatrics, Official Journal of the American Academy of Pediatrics, R. Scott Strahlman, M.D. points out that making new mothers aware of this association could help reduce the incidence of Hair/Thread Tourniquet Syndrome. Mittens and fabrics that have been washed frequently have also been associated with the condition. Since babies' feet may be in socks and/or shoes, an encircling fiber or hair could easily go unnoticed for quite a while.

Detecting and removing the ligature early is important When an appendage becomes strangulated increased swelling can make detection of the hair or fiber difficult. Swelling can contribute to the hair's or fiber's cutting through skin. The hair or thread may then become deeply embedded in subcutaneous tissue. Skin may then re-epithelialize (grow over) the subcutaneous hair. When this occurs the hair or fiber becomes obscured, making detection particularly difficult.

The damage that can result from the restriction of blood flow to an appendage is extremely serious. If an appendage has become strangulated it is a medical emergency. Removing the ligature may be as simple as using fine scissors or a depilatory agent to dissolve hair fibers, or, in the case of deeply embedded hairs/fibers, treatment may require surgery under general anesthesia. It is always vital that the appendage be carefully examined in order to be certain that the ligature has been complete removed.
In addition to not leaving booties, socks, or mittens on a baby for long periods of time, parents/caregivers can reduce the chances of fibers encircling fingers or toes by turning booties, socks, and mittens inside out and looking for signs of too many loose fibers. The fabric in blankets used on the baby is something else to consider.

Being aware of the possibility that a hair/fiber tourniquet can occur, and frequently checking to make sure your baby's appendages are free of hairs and fibers, is one way to reduce the possibility this extremely serious condition will occur.

Learn more about this author, Lisa H Warren.
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