Topical anesthetic in HOF: what it is and usage precautions

A topical anesthetic is the cream, gel or ointment applied to the skin or mucosa to reduce superficial pain before a procedure. It acts only on the outermost layers, which helps at the moment of the needle puncture, but it does not numb deep planes.

In orofacial harmonization, it is commonly used before fillers, mainly in the lips, and before procedures with many punctures. Formulations usually contain lidocaine, alone or combined with other local anesthetics.

What are the limits of topical anesthetic?

• The effect depends on contact time, the area and the thickness of the skin. Mucosa absorbs faster than skin.
• It reduces the pain of the puncture, but does not remove the discomfort of the tissue being stretched by the product.
• It can cause transient local pallor or redness, which interferes with reading the skin color during injection.

What safety precautions does it call for?

Topical anesthetic is not harmless. Applied over a large area, on mucosa or for a long time, absorption increases and adds to that from other anesthetic sources used in the same visit. The medical history should include allergies, medications in use and pregnancy. The formulation, area and application time follow the package insert and the decision of the qualified professional.

Before antisepsis, the cream must be completely removed, so as not to carry residue into the puncture site. Warning the patient about the temporary numbness also avoids surprises, such as biting the lip after the visit. Pallor and color change during injection should be read carefully, as explained in safety and complications.

Also known as: surface anesthetic, numbing ointment, numbing cream.