Topical application tips

The following steps will help maximize effectiveness when using recommended topical anesthetics.

Clean skin.

It helps the anesthetic penetrate and helps prevent infection during treatment. Some like to apply it right after a shower or after putting a hot washcloth on their face for a few minutes.

Stephen Kingsley of Ferndale Labs writes: "You must not use any organic-based cleaners to clean the skin before applying ELA-Max. Mild soap and water is recommended. Organic cleaners will strip the naturally occurring oils from the skin that are required for ELA-Max to absorb into the skin. You can use anything to clean the skin only AFTER you have removed ELA-Max (just prior to beginning the procedure).

Spread a thick layer on the area you want numbed.

It should be a least 3 mm (about 1/4 ") thick. Some people find it helpful to rub a small amount into the skin before adding the thick layer. It’s best to apply an even thicker layer on more sensitive areas. I find it also helps to apply it past the lip line and onto the lips a bit. Rub the excess from your finger on an area you haven’t treated- even a little might help some. I find that these products burn a little right when I put it on, but that quickly subsides. If it burns a lot, your skin may be having a reaction to the cream. Wipe it off and check with a doctor.

Stephen at Ferndale adds: "In addition, all topical anesthetics must be applied in a thick layer to be effective (think cake frosting). People are tempted to apply it lightly because it is not inexpensive. Unfortunately, a light application will not give you the desired result."

EMLA only: Cover the EMLA with an occlusive dressing.

That’s medspeak for an airtight product like Saran Wrap. Any type of plastic can be used (I’ve even used plastic grocery bags), but it’s better if it’s transparent so you can see the EMLA. A cling wrap like Saran Wrap will adhere to the face pretty well. The plastic keeps the cream from drying out, and enhances skin absorption of the EMLA. The EMLA instructions recommend using a transparent plastic dressing called Tegaderm. However, this is way too expensive. Stick with cling wrap (pun intended).

I find it helpful to put the cling wrap on in pieces. This way my electrologist can leave most of it covered until she’s ready to work on that area. I cut a V-shaped piece which I put on my upper lip. The point partially covers each nostril (I can still breathe), and each leg of the inverted V extends down a little past the corners of the mouth. The inside of the V leaves my mouth free for important things like talking and breathing. A rectangular piece that goes from my lower lip to under my chin and about an inch beyond each corner of my mouth. I use scotch tape to hold the cling wrap in place- a small piece on the outside of each leg. Then I tape down the rectangle on all four sides, even a tiny piece of tape attaching it to my lower lip. This ensures the lip line won’t get uncovered which happens quite easily. This is very important- it keeps the EMLA from getting squeezed out from under the cling wrap during treatment. Without the tape, the cling wrap tends to slide around, wasting the EMLA and possibly leaving the lip line and nostrils uncovered. This is about the last thing you want. I ask my electrologist throughout treatment to check to make sure it’s still covered, and sometimes I check it myself with a hand-held mirror.

Try to avoid wrinkles in the cling wrap– creases tend to make the EMLA thinner and not as effective. If you get a wrinkle after attaching the cling wrap, simply push the EMLA around underneath the dressing to even it back out. (that’s why it’s good to use clear plastic). I usually end up pushing the EMLA back toward my lip line after attaching the dressing.

As a time-saver, some people drive to the electrologist after applying the EMLA and cling wrap at home. That way they don’t have to get there an hour early. I’ve even ridden my bike to treatment with the stuff on, and I’ve gone through fast-food drive-throughs with the junk. But I’m a little less concerned about appearances and stuff like that as some of you might be. If a few people think I look like an idiot, that’s a price I’m willing to pay for nearly painless electrolysis.

Wait.

How long should you wait? It depends. Some people find it is at maximum effectiveness after only 15 minutes. Others need it on for 90 minutes or more. You just have to experiment till you find what works for you. I’d suggest starting with 30-60 minutes, though, and then try a little less waiting time each session.

Start treatment.

Timing is everything. When the topical anesthetic is wiped away, the skin is often either lighter or redder in color and usually feels a little cooler if it’s been properly absorbed.

Additional EMLA-specific observations

Begin treatment immediately after uncovering

The numbness starts to wear off as soon as the dressing is removed and the cream is wiped away. Sometimes this happens quite quickly, other times it may stay numb long after treatment. The EMLA instructions claim it should last at least 20 minutes. It’s important to work on an area as soon as it’s wiped clean if you want the full effect. Let them remove the wrap as he or she gets to the next area. They should peel it back like a sardine can lid, only uncovering the area they are just about to work on. Sometimes, the stuff may just be too messy and getting in the way, in which case it might be easier to remove the whole price of plastic. That’s why it’s good to do the plastic in several smaller pieces.

Freshly-opened tubes seem more potent

Many people have commented on the difference in potency between a freshly-opened tube and one that’s been open awhile. Once the EMLA in the tube has been exposed to the air it seems that it starts to lose effectiveness. Temperature seems to affect it adversely as well, so don’t let it get too hot or cold. If you aren’t on a prescription co-payment plan and are paying full price out of pocket, you might look into the 5-gram tubes, which could be used up before the EMLA starts to lose effectiveness.

Avoid getting it in creases

I find that if the EMLA sits in the creases that run from my nose to the corners of my mouth (nasolabial folds), I get a rash. I can prevent that by covering those creases with scotch tape BEFORE applying EMLA, and then taping the cling wrap over the whole thing.

Trivia answer

EMLA stands for Eutectic Mixture of Local Anesthetics. A eutectic mixture has a melting point below room temperature. Lidocaine and prilocaine crystals turn to oils at room temperature.

Tricky tubes

Careful when you puncture a new tube! When the seal is broken, the pressurized cream sometimes oozes out quickly. A friend observed a phenomenon I’ve had myself: a depressing point when you’re in the middle of a tube where the tube looks to contain more EMLA that it really has in it. You’re flattening it out… still no EMLA. When it finally does start coming out again you have a lot less than you thought you had left, so plan accordingly if you use it generously. Finally, it can be a bit tricky getting the last few grams out. Best bet is to roll up the tube as you empty it, then squeeze out the last part like a syringe: thumb pressing down on the rolled-up part, index and middle fingers on side of the mouth of the tube. It will probably all come out at once, so point it toward your palm so it doesn’t spill on the floor.