Trick of the Trade: Hair tourniquet removal using depilatory cream

A hair tourniquet occurs when a strand of hair coils around a patient’s appendage. It can cause damage to the skin, nerves, or affect blood supply. It is more common in infants as their skin appendages are small which allows for hair or thread to trap inside. Because in some cases these pediatric patients can present with inconsolable crying, it is important to perform a thorough physical examination to evaluate for the presence of such a hair tourniquet. We present a simple trick for removing a hair tourniquet using depilatory cream!

Problem

Hair tourniquet removal can be challenging, as these cases can present with swollen appendages. This makes it difficult to use needles or scalpels to reach underneath the tightly-wound hair without injuring the underlying skin.

There are few methods described in the literature. We describe one trick of the trade using a cutting needle.

Trick of the Trade: Depilatory cream

Using over-the-counter depilatory cream is an easy and painless solution.

Cautionary points:

1. Avoid applying the cream to areas of skin that area damaged or bleeding. This might cause further irritation and pain.
2. This technique is limited to hair tourniquets. It will not remove synthetic material, such as a thread from a child’s clothing.

Equipment:

1. Gloves
2. Over-the-counter depilatory cream
3. Water to rinse

Technique:

1. Apply a small amount of the cream to one area of the tourniquet; if the knot is visible you can apply the cream there.
2. Wait for 30-60 seconds or however long the product company recommends.
3. Rinse area with water.

Consult your surgical or orthopedic team if there is an issue of neurovascular compromise or tourniquet release is unsuccessful.

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