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So what do you do when your toddler has found the discarded remnants of a hair relaxer product and has the cream smeared all over his hands, face, eyes, and mouth?
First, get the product off of the skin, face, eyes, and mouth right away by rinsing the exposed areas with water. Do not make him throw up! Then call Poison Control at 1-800-222-1222 for further treatment advice.
Children can become sick from ingesting caustic agents. Caustics are products that have either a very low pH (acids) or very high pH (alkalis). Caustics include drain cleaners, toilet bowl cleaners, and hair relaxers. Hair relaxers are among the caustic products most commonly swallowed by children. These products often have pleasant smells and colorful packaging, which make them interesting to children.
In 2013, there were 949 hair relaxer exposures reported to US poison control centers. About 75% were children younger than 6 years of age. Almost half of these children received treatment in a healthcare facility.
Hair relaxer kits for home use are one- or two-step systems involving a cream relaxer with calcium, lithium, or sodium hydroxide and an activator. Both components are very caustic. A second type of hair relaxer is referred to as "thio" relaxers and is made with ammonium thioglycolate (ATG). Thio relaxers are usually less caustic and are used primarily in permanent waving. You will also notice "lye" or "no lye" relaxers. "No lye" relaxers do not have the active ingredient sodium hydroxide and instead have other hydroxides, like calcium hydroxide. "No lye" relaxers are marketed as being milder although there is still a considerable risk of caustic injury.
Swallowing hair relaxer can cause burns to the lips, mouth, throat, and stomach. Kids will quickly vomit and have swelling, redness, and even blistering of their lips and mouth. If there is a burn to the throat, the child cannot swallow and often will drool excessively and refuse to eat or drink. Anyone with these symptoms should be evaluated in an emergency room immediately. There can burns even past the throat into the lining of the esophagus and stomach. Do not make the person throw up! Vomiting can make the problem worse.
Hair relaxers can also cause moderate to severe burns of the skin and scalp. A first-degree burn looks and feels like a sunburn. It only affects the uppermost layer of the skin. There is burning and pain, and the skin becomes reddened. Second- and third-degree burns affect the deeper layers of the skin. The skin will break down, blisters can form, and bleeding can occur. These burns can become very painful and possibly infected. Depending on the extent of the burn, a doctor may have to provide specific burn therapy.
Hair relaxers can cause burns to any part of the eye they come in contact with. This often occurs when treated hair strands fall over and into the eye. Chemical burns to the eye are considered a medical emergency and need immediate evaluation in an emergency room. If left untreated, injury to the eye can be permanent.
The extent of caustic injury or burn from hair relaxers is directly related to the duration of exposure. This means that the sooner the substance is removed from the skin, eyes, or mouth, the better the outcome. The key is to immediately rinse the mouth, skin, or eyes with lots of water. Then call Poison Control right away for further treatment advice.
To prevent poisoning from hair relaxers:
- Read and follow the directions for home hair relaxer kits carefully before each use.
- Discard unused hair relaxers safely.
- Never store hair relaxer in an unmarked containers for later use.
- Keep hair relaxers out of reach of children or pets.
- Avoid any direct contact with the product, being sure to keep it away from the mouth, eyes, and skin.
- Rinse off the product as soon as possible.
- Never make a person throw up after swallowing hair relaxer. Give a small amount of water instead.
If you suspect someone has been exposed to hair relaxer, call Poison Control at 1-800-222-1222 right away.
Serkalem Mekonnen, RN, BSN, MPH
Certified Specialist in Poison Information
Aronow SP, Aronow HD, Blanchard T, et al. Hair relaxers: a benign caustic ingestion? J Pediatr Gastroenterol Nutr. 2003;36:120-5.
Babl FE, Edelberg LH, Shannon M. Oral and airway sequelae after hair relaxer ingestion. Pediatr Emerg Care. 2001;17:36-7.