Can a Topical Pain Reliever Be Used for Hair Removal?

Question

Can a topical pain reliever be such as a viscous lidocaine be applied to the skin, left on the skin for 20 minutes, and then washed off prior to the procedure?

Ron Shelton, MD · Answer

Advice for numbing cream must be given by a physician for you based on your treatment. There are risks with the application of numbing cream and the absorption into the blood stream if it is a wide spread area. The type of cream can make a difference. Please ask the physician who is responsible for your laser hair removal.

Andrew Miller, MD · Answer

Topical pain relievers such as LMX can be used before having a laser hair removal treatment. It is usually placed over the area that is going to be treated and covered with plastic wrap or tegaderm for approximately one hour before treatment (twenty minutes is too short). Using these creams that numb the area can make the session more comfortable for the patient. For larger areas such as the back, legs, or bikini area it is not recommended because the use of a large amount of lidocaine cream can cause significant side effects. The good news is that laser hair removal is a tolerable procedure, and most people do not need the numbing creams compared to other procedures that require the use of these creams.

Madeline Krauss, MD · Answer

We recommend Topicaine brand 4% lidocaine gel for 30 minutes prior to the procedure. Patients are instructed to use no more than a 30 gram tube to avoid significant absorption into the blood stream. We find our patients are much more comfortable if the have numbed the area. If a large area needs to be performed, we sometimes break it into 2 procedures over 2 different days to avoid the need for too much numbing cream.

Emily Altman, MD · Answer

If large areas are treated and/or if the numbing cream is used under occlusion, like plastic wrap, enough of the lidocaine can be absorbed to cause very serious side effects.  Deaths have been reported after such use of numbing creams.

	That is not to say we don't use numbing creams prior to laser hair removal or laser procedures in general.  But numbing creams should not be used on large areas at one time and only small areas should be under occlusion.

Daniel Berg, MD · Answer

Topical anesthetics can be very helpful for lasers in general and certainly for hair removal.  Several are widely available commercially (e.g. EMLA cream or LMX cream) and some practices like to compound their own.  Typically these are applied roughly an hour before treatment and wiped off just for the treatment.

	There is a possibility of toxicity if too large an area is treated so check with your physician/ read the package insert to find out how much you can use at one time.

Jason Pozner, MD · Answer

Its pretty much standard practice to use a topical anesthetic for laser hair removal. Most of us use some lidocaine or lidocaine derivative applied to the skin for a time depending upon anesthetic used. Need to be careful for large areas to avoid toxicity.

Mitchell Schwartz, MD - Account Suspended · Answer

With laser hair removal the degree of discomfort varies with each person, depending on their pain threshold. In our office, a topical anesthetic may be requested based on individual preferences or tolerances as well as particular anatomic sites. This should be applied 30 minutes to 1 hour prior to treatment. We use a prescription-strength three part anesthetic mixture that is specially compounded for us by the pharmacist. It is much safer when applied in our office and not available for patients to purchase on their own. In our office, discomfort is also minimized by Dynamic Cooling Device (DCD) technology where cryogen is sprayed onto the skin a fraction of a second before each laser pulse.

Can a Topical Pain Reliever Be Used for Hair Removal?

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