Cosmetic Surgery :: Hazards of using skin numbing products for cosmetic procedures

FDA is issuing this advisory to alert you to the potential hazards of using skin numbing products, also known as topical anesthetics, for cosmetic procedures.

These topical anesthetics contain anesthetic drugs such as lidocaine, tetracaine, benzocaine, and prilocaine in a cream, ointment, or gel. Topical anesthetics are widely used to numb the skin for medical and cosmetic procedures, and to relieve pain and burning and itching due to a variety of medical conditions. FDA has approved many products for these uses. Some must be prescribed by a doctor; others may be purchased without a prescription.

Applying topical anesthetics for a medical procedure is usually done in a doctor?s office by a trained medical professional. However, FDA is aware that use of these products before a cosmetic procedure may not be supervised by trained health professionals. Without this supervision, a patient may apply large amounts of topical anesthetics to their skin. This application can result in high levels of these products in the blood causing life-threatening side effects, such as an irregular heartbeat, seizures, and death.

Topical anesthetics are sometimes used in ways not approved by FDA and at doses that may pose a risk for serious harm to consumers. FDA is aware of two instances where women, aged 22 and 25 years old, applied topical anesthetics to their legs to lessen the pain of laser hair removal. These women then wrapped their legs in plastic wrap, as they were instructed, to increase the creams? numbing effect. Both women had seizures, fell into comas, and subsequently died from the toxic effects of the anesthetic drugs. The skin numbing creams used in these two cases were made in pharmacies and contained high amounts of the anesthetic drugs lidocaine and tetracaine. FDA also has received reports of serious and life-threatening side effects such as irregular heart beat, seizures and coma, and slowed or stopped breathing following the use of these numbing products. These effects happened in both children and adults and when the anesthetic drug was used both for approved and unapproved conditions.

If you are thinking about having a cosmetic or medical procedure on your skin, you should discuss with your doctor if you need a numbing product to ease the pain and, if so, if you can use a topical anesthetic approved for that use by the FDA. You should also discuss with your doctor whether there are other ways to reduce the pain you may feel during the procedure. Some patients report that they do not need to use topical anesthetics. Some procedures may require a degree of numbness that cannot be safely achieved with these products. There are other techniques that doctors can use if a high amount of numbness is needed.

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