Hair-grooming syncope, expert decodes viral phenomenon

A Tennessee woman took to social media to raise awareness about the condition that caused her 10-year-old sister to collapse while getting her hair done last week.

The results? A now-viral Facebook post that has garnered more than 45,000 comments, 222,000 shares and countless questions about hair-grooming syncope (pronounced SIN-kuh-pee), a fainting disorder associated with combing or brushing one’s hair.

It all started when Alicia Brown Phillips was curling her little sister Gracie’s hair for church. In “one of the scariest moments” of her life, Phillips shared that she was about “five minutes in” when Gracie started to “gag a little” and look “kind of pale.”

“I asked her if she was going to get sick and she shook her head yes,” Phillips said in the July 7th Facebook post. “30 seconds later… she looks at me. She is extremely pale with blue lips and starts to pass out.”

Courtesy: Facebook

After a trip to a local, unaffiliated children’s hospital, the family was given the “all clear” and the hair-grooming syncope diagnosis.

Katherine Meddles, MD, a pediatric neurologist at HealthONE’s Rocky Mountain Hospital for Children, an affiliate of HCA Healthcare in Denver, Colo., explains that syncope is the medical term for fainting or passing out.

“This particular condition is a form of ‘vasovagal syncope’ – the most common form of syncope caused by stimulation of the nerve that regulates blood pressure and heart rate. The stimulation can result in a sudden drop in blood pressure, affecting blood flow to the brain, and causing a child to pass out and wake up after blood flow is restored.”

Dr. Katherine Meddles is a pediatric neurologist at HealthONE’s Rocky Mountain Hospital for Children, an affiliate of HCA Healthcare in Denver, Colo.

Even though hair-grooming syncope occurs mostly in children, it is similar to people who faint when they have their blood taken or in stressful situations.

Dr. Meddles shares more on the little-known seizure-like condition triggered by hair grooming here.

How is it caused?

Some individuals are more sensitive and can pass out when their scalp is stimulated.  There are other triggers for vasovagal syncope including:

• straining during a bowel movement
• urination
• hot showers
• coughing

What are the symptoms leading up to hair-grooming syncope?

Fainting is the cardinal symptom. However, many people will feel an episode coming on with signs like lightheadedness, nausea, warmth, sweaty palms, and then “tunnel vision” before passing out.

Bystanders may notice jerky movements, a weakened pulse and dilated pupils.

In most instances, syncopal episodes last less than one minute and are considered non-epileptic.

How common is it?

It’s not uncommon. Estimates vary but possibly as high as 40% of individuals will have some type of syncope (hair-grooming or other) by the time they reach college-age. Also, a 2009 study of fainting among adolescents found that of more than 1,500 kids who fainted over a nine-year period, 111 of them had a hair-grooming trigger determined as the cause.

Hair-grooming syncope typically affects girls between 5 and 13 years old.

Who does it most commonly affect?

It typically affects girls who range in age from 5 to 13 years old.

Can children outgrow it?

Yes, though individuals who are susceptible may continue to be so throughout adulthood.

Are there ways to prevent it?  

Have your child sit down when brushing their hair. And, if they begin to feel lightheaded, lie them down and elevate their feet to help prevent a fainting episode.

How is it diagnosed? 

It’s diagnosed by medical history and a doctor’s exam, which can include laboratory tests and an electrocardiogram or EKG. Less commonly, an electroencephalogram (EEG) or MRI may be performed if the patient is not waking up or there are unstable vital signs. (According to the viral Facebook post, Gracie had an “EKG and a head scan”.)

How is it treated? 

Hydration can usually preempt fainting episodes, so make sure the child has had plenty of fluids before combing or brushing their hair. Regular exercise can be helpful as well.

What should parents do if this happens to their child? 

Lie them down flat on the floor to return blood to the head.  If they wake up and act normally within a few seconds to minutes, they are probably OK to stay home, but if there is any concern at all, it is reasonable to seek care from a medical provider. Syncope during exertion such as running or other exercises should be investigated by a doctor.

Is a trip to the emergency room recommended?   

The American Academy of Pediatrics notes that when kids and teens faint, they usually recover quickly and without lasting harm. From a neurologic standpoint, if they are back to normal immediately after the event, they typically do not need urgent neurologic evaluation.  But, any time your child faints, especially if they’ve never had one before, be sure to tell your pediatrician. Repeat fainting might be a sign of something else, such as a heart or brain disorder.

When brushing, braiding, curling and drying your child’s hair, keep an eye out for syncope symptoms and consult a physician if there is any cause for concern.

One of HCA Healthcare’s 185 affiliated hospitals, HealthONE’s Rocky Mountain Hospital for Children (RMHC) system of pediatric care offers six pediatric locations throughout the Denver metro area, along with five pediatric emergency rooms and more than 300 pediatric specialists. By extending pediatric care to all its affiliated hospitals RMHC ensures the highest quality emergency, inpatient and outpatient services for children.