EMLA Cream (lidocaine and prilocaine) is a local topical anesthetic used to numb the skin during relatively minor cosmetic or health care procedures. It is frequently used both in medical settings and in the home. The cream is applied as-needed 1 to 3 hours prior to a painful procedure. Effects last around 1 hour.

An alternative to EMLA Cream is EMLA Patches, which can be used interchangeably if desired. Patches are sometimes more convenient for holding the medication in place, depending on the application site; cream can be held in place with a dressing if needed, but this is not as easy or convenient as a patch. However, patches can be quite difficult to apply to some areas of the body.

Both creams and patches are often used to numb the skin prior to:

• Administering injections
• Changing catheters
• Cleaning or debriding ulcers
• Minor cosmetic surgery
• Getting body piercings or tattoos
• Other minor topical procedures

EMLA Cream should not be used on patients under 12 years of age without doctor instruction.

EMLA Cream in the Home

EMLA Cream can be used in a variety of routine cosmetic or home health care procedures. It is important to note, however, that the medication can cause serious side effects if used improperly. The greatest risk is too much of the medication being absorbed into the bloodstream, which can happen if the medication is used:

• Over large areas of the body
• On the eyes, nose, lips or mouth
• On mucous membranes of the vagina, penis, or rectum
• In the ears
• On open wounds or broken skin
• On infected skin

In home health care situations EMLA Cream is often used on mucous membranes or broken skin. This should only be done with doctor instruction, however, to prevent potentially serious side effects. On intact skin there is little concern about side effects from EMLA Cream, as long as it is not used on very large areas of the body.

Numbing effects are dependent on the length of time the cream is left on the skin, usually ranging from one to three hours:

• For minor procedures, such as administering an injection, leave cream in place for at least one hour.
• For painful procedures, such as cleaning ulcers, leave cream on skin for at least two hours.
• If needed, cream may be left on skin for up to three hours; little benefit is likely to be had by leaving cream on for longer than three hours.
• On male genitals, cream is typically left in place for 15 minutes.
• On female genitals, cream is left in place for 10 minutes.

Administering EMLA Cream is fairly straightforward:

• Apply a thick layer of cream over the area to be numbed.
• Cover the cream with an occlusive dressing (a dressing which is air- and water-tight) if possible.
• Cream should be removed and the area sterilized prior to the procedure.
• Numbing effects last around one hour after the cream is removed.

Care should be taken to avoid accidental injury to treated areas; injuries may not be noticed while the skin remains anesthetized.

Warnings & Side Effects

Patients with blood disorders or heart, kidney or liver disease should speak with a doctor about potentials risks before using EMLA Cream. Elderly patients should use with caution until effects are known, as side effects may be enhanced.

Side effects are rare if the medication is used properly, but some individuals do react adversely to treatment. If any negative effects do develop, remove the cream and seek medical attention if needed:

• Blistering of skin at application site
• Severe dizziness
• Fainting
• Rapid, slow or irregular heartbeat
• Blue tinge to skin around lips
• Difficulty breathing
• Seizure
• Severe confusion or anxiety

If the product is ingested by adults, children or pets, seek emergency medical attention.