Foot Burn Injuries Associated with Hair Braiding

An increasing number of burns are associated with a popular hair braiding trend incorporating synthetic hair extensions. These burns occur predominantly in young African American females and across all age groups. The hair technique involves the ends of the braid being dipped in scalding water to prevent unwinding. This process requires the installer to place the attached hair in hot water behind the client to seal the ends of the braid. This burn injury is most frequently reported on the back, shoulder, arm, forearm, thigh, and leg. The reported cases of this burn injury occurred most frequently in the client. We present a case of a burn injury involving the foot and ankle of the hairstylist installing the braids, a first-ever reported case of this kind. The review focuses on evidence-based management of foot and ankle burns to promote wound healing and prevent limb loss. Standard of care makes education and prevention necessary for lower-extremity burns because these injuries pose a risk to patients with underlying diseases. The review emphasizes the importance of better understanding the mechanism of this burn injury and the necessity to continue treating these injuries as major burns, as well as education about prevention strategies. Lower-extremity thermal injuries challenge physicians due to their unique anatomical and histologic components that affect ambulation. Strategies to prevent these burns in at-risk populations are needed. Hair braiding with scalding water to seal the ends of the braids and other thermal burns can lead to hospitalizations and the need for surgical intervention, driving up health-care costs.