Removal of hair tourniquet, thread tourniquet, or other constricting band of the digits or genitalia

* Apply chemical depilatory lotion, spray, or cream (eg, Nair, Magic Shave, or Veet) for three to six minutes according to specific product package instructions. Do not leave on longer than 10 minutes. Gently wipe off the depilatory with clean gauze and rinse with lukewarm water. The treatment can be reapplied in 10 to 15 minutes if the first treatment is unsuccessful. Do not use near mucosa (eg, tourniquets of the labia or clitoris) or on tourniquets associated with significant skin breakdown.
¶ Superficial tourniquets typically show prompt return to normal perfusion but decrease in swelling may be delayed for 1 to 2 days. Deeply embedded tourniquets show improvement in perfusion and decrease in pain soon after release but timing to normalization of appearance depends on the degree of necrosis or skin breakdown present.
Δ Depending on the site, regional anesthesia (eg, digital or dorsal penile block) with sedation or general anesthesia in the operating room may be warranted. Some physicians may prefer to consult a gynecologist for removal of tourniquets of the labia or clitoris.
◊ Deeply embedded tourniquets with ischemia or necrosis of external genitalia (penis, labia, or clitoris) require excision and warrant consultation with a surgical specialist (ie, urologist for penile tourniquets or gynecologist for tourniquets of the vulva). Some experienced physicians may feel comfortable excising embedded digital tourniquets without surgical consultation. Otherwise, prompt consultation with a general surgeon, plastic surgeon, or orthopedic surgeon, depending upon local availability and practice is warranted.