Emla cream is a topical anesthetic, or numbing agent, applied to the skin. It contains a mixture of two active ingredients: lidocaine and prilocaine. This combination allows the medication to numb the skin’s surface before certain procedures. The formulation of two anesthetics in a single cream facilitates deeper penetration into the skin layers compared to products containing only one. This blocks nerve signals in the targeted area, temporarily preventing the sensation of pain.
Common Uses for Emla Cream
In clinical settings, it is used to prepare the skin for needle insertions, such as for vaccinations, blood draws, or the placement of intravenous lines. It is also used ahead of minor skin surgeries like biopsies or the removal of small lesions.
Cosmetic practitioners may apply the cream before procedures like laser hair removal, microblading, microneedling, and the injection of dermal fillers or neurotoxins. Individuals use the cream for personal applications like tattoos and body piercings, which involve repeated needle punctures of the skin. Another application is its off-label use for premature ejaculation, where it reduces sensitivity.
Application and Effect Timeline
The process begins with cleaning and thoroughly drying the intended patch of skin. A thick layer of the cream should then be applied to the area, ensuring it remains visible on the surface and is not rubbed in completely.
After applying the cream, the area must be covered with an occlusive dressing. This is an airtight and watertight seal, such as transparent plastic wrap or a specialized medical dressing like Tegaderm. This covering prevents the cream from drying out and enhances its absorption by trapping the medication against the skin.
For most procedures, the cream should be left on the skin under the dressing for at least 60 minutes. On the face, the numbing effect can occur more quickly, sometimes within 30 to 60 minutes. Once the waiting period is over, the dressing and all of the cream are wiped away immediately before the procedure begins. The numbing effect is temporary, lasting for one to two hours after the cream has been removed.
Potential Side Effects and Safety Considerations
Using this cream can lead to temporary, mild reactions at the application site. These common effects include skin paleness, redness, slight puffiness, or an initial sensation of burning or itching. These reactions are normal responses to the anesthetics and resolve on their own shortly after the cream is removed. Taking care not to injure the numbed area is important, as sensations of pain, heat, or cold will be diminished.
Although rare, more significant side effects can occur. A serious allergic reaction may present as a rash, hives, itching, or swelling and can, in very uncommon cases, progress to anaphylactic shock, which involves difficulty breathing. Another serious but rare side effect is methemoglobinemia, a blood disorder where the blood’s ability to carry oxygen is reduced. Symptoms of this condition include blue-tinged skin, particularly around the lips and nails, and shortness of breath, requiring immediate medical attention.
The cream should not be used on broken skin, cuts, or open wounds, with the exception of a leg ulcer under medical supervision. It is also contraindicated for individuals with a known allergy to lidocaine, prilocaine, or other amide-type local anesthetics. People with certain conditions, such as a genetic enzyme deficiency or a history of methemoglobinemia, should inform their doctor before use. If any severe or unusual effects are experienced, use should be stopped and medical advice sought promptly.
Acquiring Emla Cream
The availability of Emla cream varies depending on national and local regulations. In many countries, including the United Kingdom and Canada, it can be purchased over-the-counter from a pharmacy without a prescription.
In other regions, such as the United States, Emla cream is classified as a prescription-only medication. This means a healthcare provider must first assess the patient’s medical history and the intended use before authorizing a prescription. The status of the cream can differ, so it is always best to check with a local pharmacist or a healthcare provider.