What Is Used as a Topical Anesthetic?

Topical anesthesia comes as a cream or spray to numb parts of the skin or mucous membranes for minor skin and dental procedures.

Topical anesthesia is used to numb surface body parts such as skin, eyes, mouth, nose, ears, throat, genitals, and anus.

Topical anesthetics are available in several forms:

Topical anesthetics are used:

To apply or remove stitches
To insert an intravenous (IV) line
To insert a catheter
Prior to laser skin treatments
For anything involving a needle poke
To relieve pain caused by skin conditions such as sunburn, minor skin burns, and other minor scratches and cuts
For pain relief in ear infections
To relieve itching caused by insect bites and stings, or contact with poison ivy/oak/sumac
To numb the surface of the eye for ophthalmologic procedures
To numb oral tissue before dental procedures local anesthetics are administered via needle
To numb a sore throat or mouth sores
To relieve hemorrhoids
For temporary relief of premature ejaculation when applied to the head of the penis

Some common topical anesthetics include:

Amides
- Dibucaine (Nupercainal)
- Lidocaine (Xylocaine, ELA-Max, Lidoderm)
Esters
- Benzocaine (Americaine, Cetacaine, Dermoplast, Solarcaine)
- Cocaine
Miscellaneous
- Dyclonine (Cepacol, Sucrets)
- Pramoxine (ProctoFoam, Caladryl Cream for Kids)
- Lidocaine/prilocaine (EMLA)
- Lidocaine 70 mg and tetracaine 70 mg (Synera Patch)

Side effects of topical anesthetics include:

While uncommon, when there are high concentrations of anesthetics absorbed systemically, more serious side effects may occur such as:

Systemic toxicity, particularly with repeated use in infants or children, from oral viscous lidocaine
Central nervous system (CNS) stimulation (including seizures), followed by CNS depression (including respiratory arrest)
Slow heart rate
Irregular heartbeats (arrhythmias)
Low blood pressure (hypotension)
Cardiovascular collapse
Cardiac arrest
High blood pressure, fast heart rate, and chest pain (angina) in local anesthetics that contain epinephrine
Gag-reflex suppression with oral administration.
Methemoglobinemia (very rare)