Topical lidocaine products are applied to the surface of the skin. They're commonly used for temporary relief of pain, itching, and burning from certain conditions, such as sunburns, scrapes, and minor cuts or skin irritations. They're also used to ease pain and discomfort in medical or skin procedures. Topical lidocaine come in many different forms, such as topical creams, ointment, gels, and foaming soaps, and most are available over the counter. If used as directed, topical lidocaine shouldn't cause many side effects. But if you apply more than recommended, topical lidocaine can cause dizziness, headache, and confusion.
Topical lidocaine products come in many forms and strengths. Each can be used for different conditions.
In general, they're used for temporary relief of pain, itching, burning, or discomfort from:
Minor burns
Sunburns
Minor cuts
Scrapes
Insect bites
Minor skin irritations
Joint and muscle pain
Hemorrhoids and other irritations in the anal area
Tattoos, piercings, microblading, and other skin procedures
Topical lidocaine products ease pain and skin irritation by numbing the nerves and making them less sensitive to pain or irritation. Lidocaine is a local anesthetic, meaning it only lowers pain in the area of skin closely around or directly in contact with the medication.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Blistering, crusting, irritation, itching, or reddening of the skin
cracked, dry, or scaly skin
fast heartbeat
hives or welts, itching, skin rash
hoarseness
irritation
joint pain, stiffness, or swelling
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
noisy breathing
swelling of the eyelids, face, lips, hands, or feet
tightness in the chest
trouble breathing or swallowing
Incidence not known
Blistering, bruising, burning, discoloration, itching, redness, or swelling at the application site
bluish-colored lips, fingernails, or palms
blurred vision
chest pain or discomfort
cold, clammy, or pale skin
confusion
dark urine
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
drowsiness or dizziness
false or unusual sense of well-being
fear or nervousness
headache
irregular, fast or slow, or shallow breathing
loss of consciousness
no blood pressure or pulse
pale or blue lips, fingernails, or skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid heart rate
seizures
shakiness in the legs, arms, hands, or feet
slow or irregular heartbeat
stopping of the heart
trembling or shaking of the hands or feet
twitching
unusual bleeding or bruising
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Bad, unusual, or unpleasant (after) taste
change in taste
cold or numbness
confusion about identity, place, and time
continuing ringing or buzzing or other unexplained noise in the ears
double vision
hearing loss
heat sensation
lack or loss of strength
metallic taste
sleepiness or unusual drowsiness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Available in many strengths and forms
Most strengths and forms are available over the counter
Most strengths and forms are available as lower-cost generic medications
Can be used as needed
Not recommended for use over large areas of injured or blistered skin because of higher risk of side effects
Not recommended for use in young children
Generally not recommended for use for longer than 1 week, unless directed by your doctor
Always wash your hands after applying topical lidocaine. Otherwise, leftover lidocaine on your hands can cause very bothersome irritation if it accidentally gets on sensitive areas of the skin, such as your eyes.
Avoid applying topical lidocaine to large areas of your skin, especially if you have blisters or open wounds. This can cause your skin to absorb more medication and lead to serious side effects.
If you're using the lidocaine 5% cream for hemorrhoids, only apply the medication to the irritated skin outside the anus. Don't use your finger or applicators to insert the cream inside the anus.
Make sure to shake the container before using the lidocaine spray and the lidocaine foaming soap.
Talk with your healthcare provider if your pain lasts more than 7 days, if your condition doesn't get better, or if your symptoms returns after getting better.
It's not recommended to use more than one medication that contains lidocaine at the same time. Doing so can lead to skin irritations or more serious side effects, such as seizure, heart rhythm problems, and coma. Topical lidocaine can be found in many over-the-counter pain medications that you apply on your skin. These include pain patches, soaps, gels, and creams. Talk with your pharmacist or healthcare provider if you're not sure whether you're using multiple topical lidocaine products.
Topical lidocaine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Using topical lidocaine more often or at a higher dose than recommended
Use topical lidocaine only as directed by your healthcare provider. Using it more often or at a higher dose than recommended can cause this medication to build up in your body. Contact your doctor before you apply topical lidocaine on infected wounds or severely damaged skin. These conditions can cause your body to absorb high amounts of lidocaine. Too much lidocaine can lead to serious side effects, such as seizures, trouble breathing, low blood pressure, slow heart rate, and your heart suddenly stopping. Get medical help right away if you experience these symptoms while using topical lidocaine.
Risk factors: History of methemoglobinemia | History of low glucose-6-phosphate dehydrogenase (G6PD) | Heart or lung problems | Age 6 months or younger | Exposure to other oxidizing agents, such as chlorine and hydrogen peroxide
Lidocaine 5% ointment and LiDORx (lidocaine) 3% gel can cause methemoglobinemia, a serious blood problem where your red blood cells cannot bring enough oxygen to your body. Your risk is higher if you have low G6PD, a condition passed down from parent to child, where your red blood cells tend to burst or break apart. Be careful using topical lidocaine if you're around oxidizing chemicals, such as chlorine and hydrogen peroxide. These chemicals might be present in common household products like cleaning supplies and hair dye. Methemoglobinemia can occur immediately or within hours of using topical lidocaine. Earliest signs include headache, tiredness, and your skin turning blue. Get medical help right away to avoid more serious and life-threatening side effects like seizures, loss of consciousness, and heart rhythm problems (fast heart beat, dizziness, shortness of breath).
Each product has specific instructions for use. To make sure you’re using topical lidocaine products correctly, refer to the product’s administration directions and talk to your provider or pharmacist.
Pain, itching, and burning from hemorrhoids and other irritations in the anal area:
The typical dose is to apply lidocaine cream to the affected area(s) up to 6 times a day.
If using prescription-strength gel (LiDORx), the typical dose is to apply one to four pumps of gel to the affected area(s) 3 to 4 times a day. Don't use more than 16 pumps in 24 hours.
Relief of joint and muscle pain:
The typical dose is to apply a thin layer of lidocaine ointment to the affected area(s) every 6 to 8 hours. Don't use more than 3 to 4 doses in 24 hours.
If using prescription-strength gel (LiDORx), the typical dose is to apply one to four pumps of gel to the affected area(s) 3 to 4 times a day. Don't use more than 16 pumps in 24 hours.
Sunburns, scrapes, insect bites, and minor cuts or skin irritations:
The typical dose is to apply lidocaine gel, lotion, cream, or spray to the affected area(s) 3 to 4 times a day
If using lidocaine foaming soap, the typical dose is to apply 2 to 3 pumps and rub into the skin. Leave it on for 5 to 10 minutes. Rinse and air dry. Don't use this medication more than 3 times a day.
Tattoos, piercings, microblading, and other skin procedures
The typical dose is to apply 2 to 3 pumps of lidocaine foaming soap and rub into the skin. Leave it on for 5 to 10 minutes before rinsing or wiping off. Use before, during, and after the procedure.
Medical procedures, vaccines and injections, nerve pain, pruritis, and pruritic eczema
The typical dose is to apply 1 to 4 pumps of prescription-strength gel (LiDORx) to the affected area(s) 3 to 4 times a day. Don't use more than 16 pumps in 24 hours.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Topical lidocaine products come in many forms and strengths. Each can be used for different conditions.
In general, they're used for temporary relief of pain, itching, burning, or discomfort from:
Minor burns
Sunburns
Minor cuts
Scrapes
Insect bites
Minor skin irritations
Joint and muscle pain
Hemorrhoids and other irritations in the anal area
Tattoos, piercings, microblading, and other skin procedures
Pain, itching, and burning caused by hemorrhoids or other problems near the anus or rectum
Pain and itching caused by sunburns, insect bites, and minor cuts, burns, and skin irritation
Nerve pain caused by shingles - 5% and 1.8% patches (by prescription only)
Temporary relief of minor pain - 4% patches (OTC)
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SOLA Pharmaceuticals. (2023). LIDOCAINE 5%- lidocaine 5% cream ointment [package insert]. DailyMed.
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