Hair tonic poisoning

Ethanol (ethyl alcohol) is the harmful ingredient in hair tonic.

Most symptoms are from the alcohol in these products. They are similar to the feeling of being drunk. Symptoms may include:

• Coma (decreased level of consciousness and lack of responsiveness)
• Diarrhea
• Increased urination
• Lack of alertness (stupor)
• Painful urination
• Slowed breathing
• Slurred speech
• Unsteady walk
• Vomiting, possibly bloody 

Seek medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to. If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the person swallowed the hair tonic, give them water or milk right away, unless a provider tells you not to. DO NOT give anything to drink if the person has symptoms that make it hard to swallow. These include:

• Vomiting
• Convulsions
• A decreased level of alertness

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients, if known)
• Time it was swallowed
• Amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.

The person may receive:

• Blood and urine tests
• Breathing support, including a tube through the mouth into the lungs, and a breathing machine (ventilator)
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Endoscopy -- camera placed down the throat to look for burns in the esophagus and the stomach.
• Fluids through a vein (by IV)
• Laxatives
• Medicines to treat symptoms

How well someone does depends on how much hair tonic they swallowed and how quickly they receive treatment. The faster medical help is given, the better the chance for recovery. Swallowing a large amount of hair tonic can cause liver failure.

Finnell, JT. Alcohol-related disease. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 137.

Jansson PS, Lee J. Toxic alcohol poisoning. In: Parsons PE, Wiener-Kronish JP, Stapleton RD, Berro L, eds. Critical Care Secrets. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 76.

Theobald JL, Kostic MA. Poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 77.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.