Thank you for your question in regards to tattoo removal. Its not recommended to place ice over an area that is already numb. Icing alone should help with the discomfort of the procedure. Icing after treatments are recommended to reduce the risks of blistering and helps with patient comfort. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.
Ice pack plus lidocaine cream for tattoo removal?
I don't think this is a good idea. It is possible to burn the skin with the ice and you not knowing it because it is numb. If the area being treated is small, it can be injected with lidocaine and be completely numb. If it is large, there is a limit as to how much lidocaine can be applied topically without getting toxic (overdosing) from it. Discuss with your doc and there are other options such as cold air - Zimmer, or icing just before the area is treated.