Pop star-turned-newscaster Asami Konno has shone a public spotlight on a little-known syndrome that she didn't care about until it hit close to home. 

She became concerned when her newborn son's toes became tangled in hair to the point where their tips became swollen.

“I heard that hair and other objects that tighten around joints and elsewhere and restrict blood flow is known as hair tourniquet syndrome,” Konno, who has three children, said in an entry on her blog on Oct. 16.

A tourniquet is a bandage used to stop bleeding, and hair tourniquet refers to a phenomenon where blood flow is impeded by hair or a string wound tightly around some part of the body.

Whereas Konno could remove the hair at home, she visited a medical center with her son in the event that his “blood flow was being blocked by remaining hairs.”

It was confirmed there that no hairs remained and his health began improving. But Konno recalled her feeling when she found out, writing, “The moment was really terrifying for me.”

Konno encountered a grave issue for parents and physicians, when infants' fingers, toes and other parts of the bodies get tangled with hair or string.

Hair tourniquet syndrome is little known even among doctors.

Due to the lack of awareness, scars and traces of the syndrome could now mistakenly be deemed as signs of parental abuse.

UNKNOWN CAUSE, RISK OF NECROSIS 

In the worst cases of hair tourniquet, the affected appendages may die and need to be amputated. As it is difficult for infants to complain about their own pain and other conditions, the syndrome can go undetected in the early stages.

In 2019, Hirokazu Takei, an emergency pediatrician at the Hyogo Prefectural Kobe Children’s Hospital, examined eight hair tourniquet cases reported at the Tokyo Metropolitan Children’s Medical Center, his workplace at the time.

In five of the cases, hairs were found wrapped around the toes of babies several months old.

While cases of hair tourniquet were confirmed outside Japan as early as the first half of the 19th century, few instances have been identified in the country. For that reason “even doctors are not well aware of the syndrome,” according to Takei.

It remains unknown why hair tourniquet occurs.

Takei noted that mothers often have hair fall out after giving birth due to hormonal changes, and that infants unconsciously and reflexively are prone to grab things coming into contact with their hands and feet. Those factors are believed to be linked to the syndrome.

Ryugo Hiramoto, head of the pediatric center of Matsudo City General Hospital in Chiba Prefecture, provided tips to parents on how to detect their offspring suffering from hair tourniquet.

“Babies who do not stop crying or are in a foul mood for prolonged periods indicate the possibility of hair tourniquet,” said Hiramoto. “Remember to check their fingers and toes in such instances.”

At the same time, Hiramoto advised mothers not to worry about the syndrome too much.

“Women immediately after giving birth tend to develop mental instability,” he said. “Being extremely alarmed at the possibility of hair tourniquet could lead to postnatal depression.”

MISTAKEN FOR ABUSE

The reason hair tourniquet is especially problematic is that it can leave scars resembling those caused by parental abuse. In a suspected child abuse case, the marks on a child turned out to be the result of hair tourniquet.

In December 2019, a woman in Sakai in her 20s was suddenly told at a day care facility by an official from the city’s child consultation center that her then 2-year-old eldest son must be removed from her custody. 

“We will give protection to the child for the time being until his safety is assured,” the official was quoted as saying.

The reasoning was that the mother was suspected of abusing her son.

The night before, the woman heard her son, who was sleeping with her, abruptly start crying and she felt her hair being pulled by something. A red, thin linear mark was discovered on the left side of his neck the following morning.

The injury was regarded as a sign the boy was being abused. Though the woman explained that “my hair wrapped itself" around the child’s neck, a medicolegal expert commissioned by the consultation center decided that it was “unlikely” the cause. 

As the children’s welfare center decided to keep her eldest son at a home for orphans and abused children, the mother took the case to court.

She and her husband contacted more medicolegal specialists, and Koichi Suzuki, a professor emeritus of Osaka Medical College, accepted their request to carry out a survey.

His experiment to replicate the condition as well as other kinds of evidence suggested the woman’s son was turning over in bed when her hair was caught in the fastener of his nightclothes, resulting in strong pressure being applied to his neck.

Suzuki’s conclusion was that the child “likely suffered from hair tourniquet syndrome.”

Referring to Suzuki’s opinion and other data, the Osaka High Court in April 2020 pointed out that “no signs of possible abuse were confirmed,” and allowed the oldest son to return home in December that year for the first time in a year.

Upon his return home, the woman regretted the incident as her first son did not call her "Mommy" and knowing that he "had to live while being so lonely."

In his research, Suzuki learned of an overseas report about a child’s neck tangled in hair and left with a similar scar.

He urged parents to be cautious to prevent a similar occurrence.

“Child consultation center officials and physicians need to know that such a phenomenon can occur,” he said.