While it is true that compounded topical anesthetics are not FDA approved, over-the-counter numbing creams are not FDA approved either. They have varying degrees of quality and should be used with caution. Over the counter numbing creams that contain lidocaine are numerous and widely available in stores and online. The higher strength numbing creams provide a more potent anesthesia that can improve the patient experience, especially for skin and cosmetic procedures performed in dermatology offices. These higher-strength numbing creams are available only with a prescription. A compounding pharmacy can make creams with higher percentages including a 10% lidocaine cream. Availability of 10% Lidocaine CreamĬommercially available lidocaine creams that are sold over-the-counter generally are made in strengths between 2-5%. Since lidocaine is metabolized in the liver and excreted by the kidneys, patients with liver or kidney problems may also have different reactions to elevated serum levels. ![]() A patient with broken skin may also absorb more of the anesthetic ingredients. Each individual’s skin can absorb topically applied drugs differently based on the patient’s unique physiology. There are also significant differences between individuals when it comes to absorption of lidocaine and reactions to high serum concentrations. Some studies have shown that over-the-counter products result in higher serum concentrations of lidocaine compared to prescription compounded products with lidocaine. Read this article for more tips on using compounded numbing creams. A technique called occlusion, where the cream is applied and then covered with plastic, has resulted in many of the severe adverse reactions associated with topical lidocaine when it is done by individuals at home. ![]() That is why it is important for numbing creams to be used only as prescribed or be applied by a trained healthcare provider. All anesthetics have the ability to cause toxicity. However incorrect use, including the use of extended application times and occlusion, can raise serum concentrations significantly.Ĭlinical symptoms of lidocaine toxicity include lightheadedness, “pins and needles” sensation, nausea, and vomiting, which can progress to seizures, arrhythmias, and cardiorespiratory depression. It would be difficult to reach this serum concentration under normal use of topical lidocaine. The toxic serum concentration of lidocaine is 5ug/mL. Lidocaine Toxicity and PrecautionsĪlthough an allergic reaction is rare, lidocaine can cause adverse events when serum concentrations become excessively high. In most cases it should only be used under the supervision of a trained healthcare provider. While some may want to use this high-strength cream for getting a tattoo or daily pain relief, it is important to remember that this product is available by prescription only. A true sensitivity may be discovered through a test but usually this is outside the scope of what is done in a practice.Ī 10% lidocaine numbing cream may be used before skin procedures like laser treatments, injections, microneedling, and more. Instead some patients may have hypersensitivities to ingredients in a formulation – for example the preservative methylparaben. In fact, only about 1% of reported allergies to local anesthetics are actually related to an immune response. ![]() While patients may report allergies to local anesthetics, in the majority of cases the reactions are not immune-mediated. It is now used both as an injection and topically for numbing before procedures and for pain relief. When lidocaine was introduced in 1948, it quickly became the go-to anesthetic for a variety of procedures. Lidocaine is an amide local anesthetic – a class that also includes bupivacaine and ropivacaine. This inhibition produces local anesthesia. In more accurate terms it binds to and inhibits voltage-gated sodium channels, which inhibits the ionic fluxes required for the initiation and conduction of impulses. Lidocaine 10% cream works by blocking pain signals in the nerve endings in the skin. What is Lidocaine and How Does Lidocaine 10% Work? Lidocaine has been made in patches, gels, sprays, ointments, creams and more for providing pain relief and numbing for a variety of medical procedures and health conditions. In general there is a low incidence of side effects when it is used correctly but there are some important contraindications. The onset of action of lidocaine is rapid and compared to other topical anesthetics it has an average duration of action. Lidocaine is one of the most commonly used anesthetic ingredients in topical anesthetic creams.
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