Review of Lidocaine/Tetracaine Cream as a Topical Anesthetic for Dermatologic Laser Procedures

Abstract

There are multiple different topical anesthetic options available to minimize the pain associated with cosmetic dermatologic procedures. These options, either alone or in combination, have diverse profiles for effectiveness, ease of use, application time, need for occlusion, and side effects. The lidocaine/tetracaine cream (Pliaglis®, Galderma Laboratories, Texas, USA), one of the newer combination options, offers effective pain alleviation that has been evaluated in numerous clinical trials. This combination anesthetic is associated with a very favorable profile because of its ease of use and mild side effects compared to other topical local anesthetics. An overview of available topical local anesthetics will be provided with an outline of clinical study characteristics and results regarding the use of lidocaine/tetracaine cream.

Comparison of Topical Anesthetics for Radiofrequency Ablation of Achrocordons: Eutectic Mixture of Lignocaine/Prilocaine versus Lidocaine/Tetracaine

“…Topical anesthetics must be able to penetrate the relatively impermeable barrier of the stratum corneum and have minimal systemic absorption [10, 14]. Eutectic mixtures allow individual anesthetic compounds, which are normally in the solid state at room temperature, to be combined as liquids.…”

“…EMLA cream requires 40–60 min of application under occlusion for adequate analgesic effect [3, 14]. EMLA does not provide adequate anesthesia at peripheral skin margins [14].…”

Developing transcutaneous nanoenabled anaesthetics for eyelid surgery

“…Local anaesthetics (LAs) work through the reversible inhibition of action potential generation and propagation with the pharmacological properties determined by their molecular structure (consisting of an aromatic ring (conferring lipophilicity and potency), an intermediate chain (determining stability) and an amine group 2 3. Due to these properties, most LAs require a needle to bypass the skin barrier and provide effective dermal anaesthesia.…”

“…Of the most commonly used topical products for dermal anaesthesia, EMLA cream (an 1:1 oil/water emulsion with the oily phase being an eutectic mixture of lidocaine 2.5% w/w and prilocaine 2.5% w/w cream) and Pliaglis (lidocaine (7% w/w) and tetracaine (7%) in a creamy vehicle that upon drying on exposure to air turns into a pliable, occlusive membrane) rely on eutectic mixtures of the anaesthetics to lower their melting point, hence solubilising the originally crystalline anaesthetic drugs to allow for their incorporation within the formulation in high concentration and thus, enhancing their permeation across the skin 2 3. Ametop gel, another popular topical product, uses xanthan gum gel to suspend its anaesthetic component, tetracaine 2 3. The limitation of these products is, that lengthy application and dermal occlusion are needed to achieve maximal effect 2 3…”

“…Ametop gel, another popular topical product, uses xanthan gum gel to suspend its anaesthetic component, tetracaine 2 3. The limitation of these products is, that lengthy application and dermal occlusion are needed to achieve maximal effect 2 3…”