Lidocaine is a local anaesthetic. Using the skin cream makes your skin numb.

You can use it before having blood taken or having a drip put in. Your doctor or nurse may also tell you to use it before having a small surgical procedure.

Lidocaine skin cream is available on prescription.

It can also be bought from a pharmacy (to use before any cosmetic procedure involving a needle).

Some of the skin creams contain lidocaine mixed with other local anaesthetics.

Other types of lidocaine

There are different types of lidocaine, including mouth gels, throat sprays and suppositories.

Find out more about using lidocaine for a sore mouth or throat and lidocaine for piles.

• Lidocaine skin cream works quite quickly – it takes 30 to 60 minutes to take effect.
• Only use the cream on undamaged skin. Do not put it on cuts or grazes.
• The most common side effects are itching and tingling.
• Avoid scratching or rubbing the treated area of skin, or exposing it to extreme heat or cold, until the numbing effect has worn off.
• Brand names include EMLA, LMX4 and Nulbia.

Most adults and children can use lidocaine skin creams.

Lidocaine skin cream is not suitable for some people. Tell your pharmacist or doctor before using this medicine if:

• you have had an allergic reaction to lidocaine or any of the other ingredients
• the skin where you need to use the cream has cuts, rashes, eczema, bleeding and scabs, and if the skin feels sore
• you or your child have the rare inherited conditions porphyria, methaemoglobinaemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency

Lidocaine skin creams such as EMLA and Nulbia may not be suitable for people with porphyria, methaemoglobinaemia or G6PD deficiency because they contain a combination of local anaesthetics.

A doctor or nurse will usually give you a prescription for the lidocaine cream or the cream itself ahead of your appointment. Always follow the instructions that come with your cream.

If you're having a drip fitted or having blood taken, put the lidocaine cream on 1 hour beforehand.

For minor surgery, your doctor may tell you to use the cream more than 1 hour before the procedure.

If the procedure is delayed and the numbing effects of the cream have worn off, ask your doctor or nurse for advice before using any more cream.

If you're having a cosmetic procedure and have bought lidocaine from a pharmacy to numb the area, tell the person doing the procedure before it starts. It will help them to know that the area has been numbed and you will not feel as much pain.

How much to use

The amount you use depends on the procedure you're having and the type of lidocaine cream you're using.

Read the instructions that come with the cream or follow the advice of your doctor or nurse.

They may tell you to use a whole tube of cream on each area of your skin, more than 1 tube, or only part of a tube.

How to put it on

1. Gently squeeze the tube so the cream goes straight onto the area of skin to be treated.
2. Do not rub it in.
3. Place a waterproof dressing over the cream to keep it in place. (The dressings come with the cream.)
4. Make a note of the time that you put the cream on.
5. As soon as you've finished putting the cream on, wash your hands carefully with soap and water.
6. When you're about to have your procedure, take off the dressing and wipe off any excess cream with a tissue. You may not need to do this if the cream has soaked into your skin.

What if I forget to put it on?

If you forget to use the cream, or you put it on less than 1 hour beforehand, tell the person who is going to do the procedure. They may want to delay it.

Do not apply extra cream, as this will not make the lidocaine work any faster.

What if I apply too much?

Using more than the recommended amount can cause side effects. This can also happen if you put the cream on a large area of skin, or use it for longer than recommended.

If you've been prescribed lidocaine, you're unlikely to use too much cream, as a doctor or nurse will usually give you the amount you need for a one-off procedure.

Lidocaine skin cream is generally very safe. Many people do not have any side effects at all, or only mild ones, when using the cream.

Common side effects

These common side effects may happen in up to 1 in 10 people.

Tell your doctor or nurse if these side effects bother you or do not go away:

• itching or tingling where the cream was applied
• pale skin with red spots or mild swelling where the cream was applied

Serious allergic reaction

It's extremely rare to have an allergic reaction (anaphylaxis) to a lidocaine.

These are not all the side effects of lidocaine. For a full list see the leaflet inside your medicine packet.

What to do about:

• itching or tingling – if this becomes too uncomfortable, take the cream off. Tell the doctor or nurse that you took the cream off early, as your skin may not be numb enough to have the procedure. If possible, contact them as soon as possible for advice
• pale skin with red spots or mild swelling – this should go away once you take the cream off. If this is still bothering you 24 hours later, contact your doctor

Lidocaine is generally considered safe to use during pregnancy and breastfeeding. However, check with your doctor, a pharmacist or your midwife first.

Lidocaine can potentially affect the way other medicines work. However, this more likely when you're using lidocaine at higher doses or if you're having lidocaine injections.

If you're using your lidocaine skin cream as directed, it usually will not affect any other medicines.

Speak to your pharmacist if you have any questions.

Mixing lidocaine with herbal remedies and supplements

There's very little information about taking herbal medicines and supplements with lidocaine.