Numbing cream – Topical anesthetic

Pre-procedure topical anesthetics like BLT cream are effective in the numbing of the epidermis prior to laser, cosmetic, and dermatological procedures. Some procedures that these anesthetics are used for include laser hair removal, dermal filler and Botox injections, and laser tattoo removal.

Triple anesthetic creams can provide effective cutaneous anesthesia as early as 15 minutes after application. BLT cream contains three active ingredients: benzocaine, lidocaine and tetracaine. Patients almost always prefer a topical anesthetic. Topical anesthesia helps improve patient outcomes by making procedures easier for both the patient and the practitioner.

• Compounded topical anesthetics are to be applied by TRAINED PRACTITIONERS ONLY. They are not intended for patients to use at home. Compounded topical anesthetic creams are significantly stronger than commercially available numbing creams. The most frequent cause for systemic toxicity from topical anesthetics is when patients apply the cream themselves under occulsion prior to laser hair removal of the legs. Patients should never be given a compounded topical anesthetic to take home. In addition, all compounded topical anesthetics are for patients and NOT FOR RESALE.
• Compounded topicals are not for use on extended areas of the body. For large treatment areas either break treatment up into multiple sessions, or limit application of the cream to select areas that are most sensitive and forgo application to less sensitive areas.
• NEVER occlude the area where you apply any compounded topical anesthetic. This method is sometimes used with lower-potency anesthetic creams, but can elevate serum concentrations of anesthetic to dangerous levels. Occlusion is not necessary with compounded topical anesthetics.
• Topical anesthetics should only be applied to intact skin. Disruption of the stratum corneum significantly enhances transepidermal absorption of BLT cream. This may be beneficial in some situations but will increase systemic levels of the anesthetics. Contact with broken skin can lead to increased systemic absorption of the anesthetic ingredients and result in toxicity.
• Early recognition of the warning signs of toxicity is essential. These warning signs may include numbness of the tongue, lips, and mouth, a metallic taste, light-headedness, tinnitus, slurred speech, muscle twitching, restlessness, and anxiety. Once it is suspected that a patient is experiencing any of these signs or symptoms, the topical anesthetic must be immediately washed off and appropriate measures taken to treat anesthetic overdose.
• Methemoglobinemia: Some local anesthetics have been associated with methemoglobinemia. The risk is greater for patients with congenital or idiopathic methemoglobinemia. Very young patients, especially infants under twelve months old, are more susceptible. Certain drugs besides local anesthetics also increase the risk of methemoglobinemia. Signs of methemoglobinemia may occur immediately or may be delayed hours after exposure, and are characterized by a brownish, cyanotic skin discoloration and/or abnormal coloration of the blood.
• Contact with Eyes: Always make sure to avoid topical anesthetic coming in contact with the eyes. Contact can cause severe irritation. Immediately wash eyes if contact is made with the anesthetic