Background Hair-thread tourniquet syndrome (HTTS) is the constriction of an appendage or tissue by a hair thread, which can cause ischemia and necrosis of distal tissues. Depilatory agents have the potential to release the hair tourniquet without exposing the patient to the risks of surgery. Objectives: This review aims to evaluate the effectiveness, benefits, complications, and contraindications of depilatory agents in HTTS. Methods: Relevant terms to HTTS and depilatory agents were used to search for articles on MEDLINE and EMBASE databases using the NHS Healthcare Databases Advanced Search engine. Results: In total, 19 of the 295 articles identified in the primary search were included in the final review. Articles described the benefits of depilatory agents as painless, well tolerated, and non-invasive. Contraindications described include use on mucosal membranes, non-hair tourniquet, and allergy. Sixty-four percent (n = 55) of patients had resolution of their HTTS after one or two cycles of depilatory agent treatment. Conclusions: The use of depilatory agents has multiple potential benefits. The authors propose a treatment algorithm for the use of depilatory agents in HTTS and recommend that all acute centers should store and train staff in their use.
