1. About lidocaine skin cream
Lidocaine is a local anaesthetic. Using the skin cream makes your skin numb.
You can use it before having blood taken or having a drip put in. Your doctor or nurse may also tell you to use it before having a small surgical procedure.
Lidocaine skin cream is available on prescription.
It can also be bought from a pharmacy (to use before any cosmetic procedure involving a needle).
Some of the skin creams contain lidocaine mixed with other local anaesthetics.
Other types of lidocaine
There are different types of lidocaine, including mouth gels, throat sprays and suppositories.
2. Key facts
- Lidocaine skin cream works quite quickly – it takes 30 to 60 minutes to take effect.
- Only use the cream on undamaged skin. Do not put it on cuts or grazes.
- The most common side effects are itching and tingling.
- Avoid scratching or rubbing the treated area of skin, or exposing it to extreme heat or cold, until the numbing effect has worn off.
- Brand names include EMLA, LMX4 and Nulbia.
3. Who can and can't use lidocaine skin cream
Most adults and children can use lidocaine skin creams.
Lidocaine skin cream is not suitable for some people. Tell your pharmacist or doctor before using this medicine if:
- you have had an allergic reaction to lidocaine or any of the other ingredients
- the skin where you need to use the cream has cuts, rashes, eczema, bleeding and scabs, and if the skin feels sore
- you or your child have the rare inherited conditions porphyria, methaemoglobinaemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency
Lidocaine skin creams such as EMLA and Nulbia may not be suitable for people with porphyria, methaemoglobinaemia or G6PD deficiency because they contain a combination of local anaesthetics.
4. How and when to use it
A doctor or nurse will usually give you a prescription for the lidocaine cream or the cream itself ahead of your appointment. Always follow the instructions that come with your cream.
If you're having a drip fitted or having blood taken, put the lidocaine cream on 1 hour beforehand.
For minor surgery, your doctor may tell you to use the cream more than 1 hour before the procedure.
If the procedure is delayed and the numbing effects of the cream have worn off, ask your doctor or nurse for advice before using any more cream.
If you're having a cosmetic procedure and have bought lidocaine from a pharmacy to numb the area, tell the person doing the procedure before it starts. It will help them to know that the area has been numbed and you will not feel as much pain.
How much to use
The amount you use depends on the procedure you're having and the type of lidocaine cream you're using.
Read the instructions that come with the cream or follow the advice of your doctor or nurse.
They may tell you to use a whole tube of cream on each area of your skin, more than 1 tube, or only part of a tube.
How to put it on
- Gently squeeze the tube so the cream goes straight onto the area of skin to be treated.
- Do not rub it in.
- Place a waterproof dressing over the cream to keep it in place. (The dressings come with the cream.)
- Make a note of the time that you put the cream on.
- As soon as you've finished putting the cream on, wash your hands carefully with soap and water.
- When you're about to have your procedure, take off the dressing and wipe off any excess cream with a tissue. You may not need to do this if the cream has soaked into your skin.
Do not use the cream on your eyes, ears, nose or the inside of your mouth, or on your genitals or bottom (anus) – unless your doctor tells you to.
What if I forget to put it on?
If you forget to use the cream, or you put it on less than 1 hour beforehand, tell the person who is going to do the procedure. They may want to delay it.
Do not apply extra cream, as this will not make the lidocaine work any faster.
What if I apply too much?
Using more than the recommended amount can cause side effects. This can also happen if you put the cream on a large area of skin, or use it for longer than recommended.
If you've been prescribed lidocaine, you're unlikely to use too much cream, as a doctor or nurse will usually give you the amount you need for a one-off procedure.
Non-urgent advice: Ask a doctor or nurse for advice if:
- you're worried that you may have used too much lidocaine cream
5. Side effects
Lidocaine skin cream is generally very safe. Many people do not have any side effects at all, or only mild ones, when using the cream.
Common side effects
These common side effects may happen in up to 1 in 10 people.
Tell your doctor or nurse if these side effects bother you or do not go away:
- itching or tingling where the cream was applied
- pale skin with red spots or mild swelling where the cream was applied
Serious allergic reaction
It's extremely rare to have an allergic reaction (anaphylaxis) to a lidocaine.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of lidocaine. For a full list see the leaflet inside your medicine packet.
You can report any suspected side effect to the UK safety scheme.
6. How to cope with side effects
What to do about:
- itching or tingling – if this becomes too uncomfortable, take the cream off. Tell the doctor or nurse that you took the cream off early, as your skin may not be numb enough to have the procedure. If possible, contact them as soon as possible for advice
- pale skin with red spots or mild swelling – this should go away once you take the cream off. If this is still bothering you 24 hours later, contact your doctor
7. Pregnancy and breastfeeding
Lidocaine is generally considered safe to use during pregnancy and breastfeeding. However, check with your doctor, a pharmacist or your midwife first.
Tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.
8. Cautions with other medicines
Lidocaine can potentially affect the way other medicines work. However, this more likely when you're using lidocaine at higher doses or if you're having lidocaine injections.
If you're using your lidocaine skin cream as directed, it usually will not affect any other medicines.
Speak to your pharmacist if you have any questions.
Mixing lidocaine with herbal remedies and supplements
There's very little information about taking herbal medicines and supplements with lidocaine.
For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.
9. Common questions
How does lidocaine work?
Lidocaine is a local anaesthetic, which numbs the area where you've used it.
It works by stopping nerves from sending pain signals to your brain.
Using lidocaine skin cream beforehand will ease any pain at the site of the procedure (such as a needle being used to take blood).
How long does it take to work?
Lidocaine cream works relatively quickly.
Most people will start to feel a numbing effect within 30 to 60 minutes.
How long will I use it for?
You will use lidocaine skin cream as a one-off, before a minor procedure like taking a blood sample.
Can I drink alcohol with it?
Alcohol is generally not recommended before any medical procedure.
However, drinking alcohol is unlikely to have any effect on how the cream works.
Are there other anaesthetic creams to buy at pharmacies?
There are a number of creams made for numbing the skin before procedures. They work in the same way and are likely to have a similar effect.
Ask a pharmacist for advice if you're not sure which cream to use.
Is there any food or drink I need to avoid?
No, using lidocaine cream does not affect what you can eat or drink.
However, if you're having a minor procedure, follow any instructions from your doctor or nurse about eating and drinking beforehand.
Will it affect my fertility?
There is no firm evidence that lidocaine treatments affect male or female fertility.
Can I drive or ride a bike?
Yes. Lidocaine treatments will not affect your ability to drive or ride a bike.