Pain reduction medical data

The 1990’s saw the introduction of an important breakthrough in pain reduction for hair removal: the EMLA brand topical cream (which stands for Eutectic Mixture of Local Anesthetics). This prescription medication has shown to be very useful in dermatological procedures, especially in children. Drawbacks include inconvenience of having to cover it with an airtight dressing for 30-90 minutes after application, as well as concerns of getting it in the eyes. Although there is no data, EMLA use may also affect laser treatment by forcing blood out of the epidermis.

Recently, topical anesthetics made with tetracaine have become available, as well as over-the-counter lidocaine preparations in prescription strength and custom-made compounded products.While pain-reducing results are mixed, many find the gels the Ametop and ELA-Max preferable both in speed of absorption and ease of use. See also:

Pain reduction tips
Factors that affect pain
Products with significant medical risks
Topical anesthetics

.

= recommended only for in-depth researchers
= may be worth ordering
= strongly recommended

Published medical data

Hjorth (1991): 18 of 21 women preferred EMLA to a placebo during upper lip electrolysis.

Lycka (1992): An early positive review of EMLA and its uses.

Wagner (1994): 30 women had significantly less pain using EMLA over a placebo during upper lip electrolysis.

Hung (1997): In 40 subjects, a gel with 5% tetracaine was preferred over EMLA for pain reduction.

Whealton (1998): A good review of medical literature on anesthesia, especially EMLA and iontophoresis.

Choy (1999): 34 children treated with EMLA and tetracaine gel (Ametop) before a procedure had similar pain relief, though Ametop may be easier to use.

van Kan (1999): Of 32 children treated with EMLA and 34 treated with 4% tetracaine gel. 97% of EMLA patients had adequate pain relief, compared to 76% with tetracaine. However, they found tetracaine much easier to use.

Romsing (1999): 60 children treated with EMLA and tetracaine prior to IV injection. The tetracaine treatment reduced pain in 45%, but the EMLA in only 10%. Tetracaine was also faster-working and easier to use.

Browne (1999): In 32 patients treated with both EMLA and tetracaine gel overall pain reduction and ease of I.V. insertion was better with tetracaine.

Friedman (1999): 12 patients had EMLA, ELA-Max, Betacaine, and Ametop applied prior to laser. EMLA and ELA-Max were found to be most effective.

Altman (1999): 10 patients found ELA-Max uncovered for 20 minutes to work as well during flashlamp treatment as EMLA covered for 1.5 hours.

Eremia (2000): 12 patients had reduced pain from Alexandrite and diode laser treatment to armpits after application of ELA-Max.

Side effects

Eaglstein (1999): Describes two patients with corneal abrasions after getting EMLA in eye.

McKinlay (1999): A brief letter warning about getting EMLA in the eye.