title: Ingestion of caustic hair relaxer: is endoscopy necessary?
abstract: Hair relaxer, a commercially available alkaline product, is commonly the offending agent in caustic ingestion. These patients often experience oral cavity and facial burns; however, no clinically significant esophageal injuries have been reported. Therefore, we questioned the therapeutic and economic efficacy of the "standard treatment protocol" that includes hospitalization and endoscopic evaluation. Twenty-six patients over a 7-year period presented to our institution having ingested hair relaxer. Presenting signs and symptoms, esophageal findings, and cost of the standard treatment protocol were reviewed. Also, we analyzed the caustic potential and current packaging of hair relaxer. Our findings support modifications in the standard treatment protocol for hair relaxer ingestion including elimination of hospitalization and endoscopy in most patients. We also question compliance with childproof packaging laws and suggest avenues for prevention of hair relaxer ingestion.
authors.affiliation: Cardinal Glennon Children's Hospital, Department of Otolaryngology, Saint Louis, Missouri 63110-0250, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Cox
authors.forename: J F
authors.initials: JF
authors.lastname: Eisenbeis
mesh_terms: D002057:Burns, Chemical / Q000175:diagnosis / Q000209:etiology*; D002126:Calcium Hydroxide / Q000009:adverse effects; D002424:Caustics / Q000009:adverse effects*; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003679:Deglutition; D004945:Esophagoscopy; D004947:Esophagus / Q000293:injuries; D005151:Facial Injuries / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006146:Guanidines / Q000009:adverse effects; D006203:Hair Preparations / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008046:Lip / Q000293:injuries; D008297:Male; D009055:Mouth / Q000293:injuries; D010614:Pharynx / Q000293:injuries; D019064:Product Packaging; D012189:Retrospective Studies
chemical_list: D002424:Caustics; D006146:Guanidines; D006203:Hair Preparations; D002126:Calcium Hydroxide