Use of Hair Removal Cream in Hair Tourniquet Syndrome

Use of Hair Removal Cream in Hair Tourniquet Syndrome

I found the discussion of “Hair Tourniquet Syndrome” in the Photoclinic section of your September issue (CONSULTANT FOR PEDIATRICIANS, 2012, Vol. 11, No. 9, pages 284-285) very interesting. In most cases, the hair can be removed with fine forceps. I thought that the authors’ suggestion for treatment with a nerve block and surgical intervention a little aggressive in that there is an intermediate effective option.

We use a depilatory (hair remover) cream, like Nair, which is applied to the wound. Within a few minutes, this dissolves the constricting band and relieves the obstruction. I have used this treatment successfully multiple times over the 35 years I’ve been in practice without ever having to resort to surgical intervention.

——David H. Wisotsky, MD
CEO and Medical Director
Tenafly Pediatrics P. A.
www.TenaflyPediatrics.com

We thank Dr Wisotsky for his correspondence regarding our Photoclinic case on “Hair Tourniquet Syndrome.” My coauthors and I appreciate his comments and insight.

The use of depilatory cream is well-reported in the literature. It provides a simple, easy alternative for removal of superficial hair tourniquets. On the other hand, its use is not recommended for deeply embedded hair tourniquets with extensive inflammation or swelling.¹ The constriction band in the infant described cut through the ventral aspect of the fourth toe. This led to extensive swelling and tissue damage, which limited the ability to see the tourniquet. Surgical intervention is indicated in such cases to prevent more tissue damage or loss of digit.^2,3

——Ameer Hassoun, MD
Assistant Clinical Professor of Pediatrics and Emergency Medicine
Kings County Hospital Center
SUNY Downstate Medical Center
New York, NY