Hair Tourniquet Syndrome

Hair Tourniquet Syndrome

Author: Dr S Knapp & Dr R Rowlands

From: Leicester Royal Infirmary

Presented as a Poster at #RCEM15 (Manchester)


To assess the effectiveness and safety of our hair depilatory cream protocol in the treatment of hair tourniquet syndrome. 

(click to view full size)

(click to view full size)


The use of depilatory cream has been previously described to aid the removal of hair tourniquet in children [1].

We have introduced a nurse led protocol to allow treatment to begin at triage.

This is the first case series in the literature describing the use of hair depilatory cream.


All children coded with diagnosis of ‘Hair Tourniquet Syndrome’ were obtained from the Emergency Department Information System (EDIS) since the introduction of the protocol.

All staff were asked to email details of patients they treated to attempt to capture those who may have incorrect coding.

Table 1


There were 21 cases of Hair Tourniquet Syndrome between December 2012 and May 2015 (Table 1).

Hair depilatory cream was successful 71% of the time.

Hair depilatory cream was well tolerated and caused no documented side effects

Instrumentation removal was equally effective but there were 2 examples of failure resulting in iatrogenic tissue damage requiring theatre and further follow up.


  • Hair Depilatory Cream is safe, cheap and effective

  • It can be safely implemented with a nurse led protocol

  • Why risk unnecessary iatrogenic injury?


Special thanks to Julia Bragg, Paediatric ENP who helped in the original data collection

Photo: James Heilman, MD / CC-BY-SA-3.0


  1. O’Gorman, A. Ratnapalan, S. Hair Tourniquet Management. Pediatr Emerg Care 2011;27:203-204
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