Definition

Hair bleach poisoning occurs when someone swallows hair bleach or splashes it on their skin or in their eyes.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call the local emergency number (such as 911), or the 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.

Alternative Names

Hair lightener poisoning

Poisonous Ingredient

The harmful ingredients in hair bleach are:

• Ammonium persulfate
• Ethyl alcohol
• Hydrogen peroxide

Where Found

The above ingredients are used in different kinds of hair bleach.

Symptoms

Symptoms of hair bleach poisoning can include:

• Abdominal pain
• Blurred vision
• Breathing difficulty
• Mild lung irritation when vapors from household strength hydrogen peroxide (3%) are inhaled
• Severe lung irritation when vapors from industrial strength solutions (higher than 10%) are inhaled
• Burning pain in the throat
• Burns to the eye, redness, and tearing
• Collapse
• Coma (decreased level of consciousness and lack of responsiveness)
• Diarrhea (watery, bloody)
• Low blood pressure
• Inability to walk normally
• No urine output
• Rash
• Slurred speech
• Stupor
• Vomiting

Home Care

Get 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 bleach, 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

Before Calling Emergency

Have this information ready:

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

Poison Control

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.

What to Expect at the Emergency Room

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 breathing machine (ventilator)
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Endoscopy -- camera placed down the throat to see burns in the esophagus and the stomach
• Fluids through a vein (by IV)
• Medicines to treat the effects of the poison
• Surgery to remove burned skin (if needed)
• Washing of the skin (irrigation), perhaps every few hours for several days 

If the poisoning is severe, the person may be admitted to the hospital.

Outlook (Prognosis)

How well someone does depends on how severe the poisoning is and how quickly they receive treatment. The faster medical help is given, the better the chance for recovery.

Extensive damage to the mouth, throat, and stomach is possible. The outcome depends on how much of this damage there is. Damage to the esophagus and stomach can continue to occur for several weeks after the product is swallowed. A hole can develop in these organs, and that can lead to bleeding and severe infection. Surgery may be needed to treat these and other complications.

References

Holstege CP, Borek HA. Decontamination of the poisoned patient. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 42.

Hoyte C. Caustics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.