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Dr. Alpana Mohta Ranka, MD, DNB, IFAAD, is a dual-board-certified dermatologist with over 90 research publications in peer-reviewed scientific journals.

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Numbing Creams for Tattoos: Dermatologist's Recommendations

In this article, we'll explore what numbing creams are, their benefits, and potential side effects, and offer some recommendations to make your tattooing experience as comfortable as possible.


Now, as a dermatologist, I don't really recommend people getting a tattoo due to the numerous risks and side effects. However, if you have already made the decision, I am not the one to judge.

Now that we have got that out of the way, let me help you explore the world of painless (less painful) tattooing. If you want to jump straight to the recommendations, be my guest, but I think you'd really benefit from reading the entire article, especially from this section.

What is Tattoo Numbing Cream?

Numbing creams are topical (the word topical means that it needs to be applied on the surface of your skin) anesthetics that temporarily desensitize the skin's surface.

Numbing cream applied on hand

They contain active ingredients like lidocaine, prilocaine, tetracaine, or benzocaine, which block the nerve signals in the skin, reducing the sensation of pain.


Getting your hands on a cream that contains both lidocaine and prilocaine would be your best bet (known as EMLA), but you'll need a prescription from a dermatologist for that since it's not available over the counter (OTC). Having said that, creams with just lidocaine are available OTC and can be helpful in reducing the pain associated with getting a tattoo.


Benefits of Using Numbing Cream for Tattoos

All the benefits of using numbing creams are associated with their ability to reduce pain.

  1. Pain Relief: The most evident benefit is pain reduction. Especially for tattoos in sensitive areas, these creams can make the process more bearable.

  2. Reduces Anxiety: Knowing you have a way to manage the pain can reduce anxiety and apprehension before the tattoo session.

  3. Better End Result: When you're relaxed and not flinching from pain, the tattoo artist can work more efficiently, leading to a better-quality tattoo.

Potential Side Effects

While numbing creams are generally safe, some potential side effects include:

  • Redness or irritation

  • Swelling

  • Burning sensation

  • In rare cases, allergic reactions

  • If you're pregnant, it's generally considered safe (pregnancy category B), but if you're nursing, be careful because lidocaine can pass into breast milk.

Always conduct a patch test before using any product.


Additionally, you may want to see a dermatologist before your tattoo session just in case you have had any skin allergies, keloidal tendencies, or other issues in the past.

How to Apply Numbing Cream Properly

  1. Clean the Area: Start with clean, dry skin.

  2. Apply Generously: Put a thick layer of the cream on the area to be tattooed.

  3. Cover with Plastic Wrap: This helps activate the cream and keeps it from rubbing off.

  4. Wait: Different numbing products have different timings. For instance, lidocaine sprays start working in about two minutes, while creams can take anywhere from 30 to 60 minutes. Leave the cream on for the recommended time (usually 30 minutes to an hour) before your appointment. Leaving it on longer might harm your skin, but removing it too soon can make the lidocaine not work as well.

  5. Wipe Off: Your tattoo artist will remove the cream before starting. It's best to wipe off the cream using a sterile alcohol swab in order to avoid contamination and inadvertent insertion of any lidocaine cream particles into the skin during tattooing.

How Long Does the Effect of Tattoo Numbing Creams Last?

The duration of effectiveness for tattoo numbing creams can vary based on their formulation and concentration of active ingredients, primarily lidocaine, prilocaine, or a combination of both (known as EMLA). On average, the numbing effect lasts between 1 to 4 hours.


Factors Influencing Duration:

  • Concentration of Active Ingredients: Creams with higher concentrations of lidocaine or prilocaine generally last longer. The best numbing creams have 5% lidocaine, which is the strongest allowed for over-the-counter use by the FDA.

  • Skin Type and Thickness: Areas with thicker skin may retain the numbing effect longer than thin-skinned areas.

  • Application Method: The way the cream is applied can influence its duration. Some creams recommend occlusion (covering the cream with plastic wrap) to enhance its effects.

  • Duration of Application: The depth and duration of anaesthesia will depend on the duration of application of your tattoo numbing cream.

  • Brand and Formulation: Some brands or specific formulations might have ingredients that extend or reduce the duration of the numbing effect. Currently, there are some liposomal lidocaine numbing creams in the market that are superior to standard lidocaine. They use tiny lipid (fat) particles called liposomes to deliver the lidocaine deeper into the skin. This allows for more effective and longer-lasting numbing, reducing pain and discomfort during the tattooing process.

I haven't seen any OTC creams lasting more than 2 hours. So, ideally, while booking the appointment, you should talk to your tattoo artist to see if they'd be okay with doing the tattoo in multiple sessions. You would need to reapply the cream after you think its effect is wearing off. The complete effectiveness of the cream only begins around 30-60 minutes of application.


Numbing Creams for Tattoos: Recommendations

Zensa Lidocaine Cream


Mad Rabbit Numbing Cream for Tattoos

Treatonic Lidocaine Numbing Cream for Tattoos

Lidocaine Patch

Lidocaine patches offer several advantages, especially when getting a tattoo on a large surface area like your entire arm or forearm. They provide uniform anesthesia across the area, ensuring consistent numbness. The patches also offer better occlusion, which means they stay securely in place. Plus, they provide controlled and predictable efficacy, making them a reliable choice for minimizing pain during extensive tattoo sessions.


Lidocaine Patch

Lidocaine Spray

Lidocaine spray provides fast-acting pain relief, making it a convenient choice for small amateur tattoos. Its precise application allows for targeted numbness, reducing discomfort while minimizing unnecessary numbing of surrounding areas for small and superficial tattoos.


Additionally, it's suitable for individuals with skin sensitivities, as it often has a lower risk of skin irritation compared to some other lidocaine forms.

What is EMLA Cream?

EMLA stands for Eutectic Mixture of Local Anesthetics. It's a special cream used to numb the skin before various procedures, including tattoos. Unlike lidocaine, this combination cream is only available as a prescription medication.

EMLA is unique because it contains two local anesthetic agents: lignocaine and prilocaine. It comes in a 5% oil-in-water emulsion form, with a melting point of 18°C.


Is EMLA better than Lidocaine?

EMLA is superior to using lidocaine alone because it's a eutectic mixture, which means it has a lower melting point and can deliver a higher concentration of anesthetics. This allows for more effective numbing. Both the duration as well as the depth of anesthesia provided by EMLA is superior to lidocaine alone.

Plus, it contains both lignocaine and prilocaine, making it more potent in numbing the skin.


How Does EMLA Work?

EMLA works by numbing the skin's surface. When applied in a thick layer to intact skin, it penetrates through the outer layer and numbs the nerves beneath the skin. The numbing effect depends on how long EMLA is in contact with the skin. It can reach a depth of 3 mm after 60 minutes of application and 5 mm after 120 minutes. The numbing can last for up to 3 hours under a covering and an additional 1-2 hours after removal of the cream.


How Deep is the Anesthesia with EMLA (Compared to Tattoo Depth)?

EMLA cream can provide adequate anesthesia for tattoo procedures. For a professional tattoo, the application of EMLA for 60 minutes under occlusion is sufficient. It reaches a depth of up to 3 mm after 60 minutes of application, which is usually sufficient since tattoo needles typically don't penetrate deeper than a 1.5-2 mm into the skin. This depth of anesthesia can accommodate both amateur and professional tattoos.


Precautions While Using EMLA

  • EMLA is only available as a prescription-strength formulation, and you must always consult your physician before starting its usage.

  • If you're pregnant, it's considered safe (pregnancy category B), but if you're nursing, be careful because some of the anesthetic can pass into breast milk.

  • Be cautious about allergic reactions or side effects; consult a healthcare professional if any concerns arise.

  • Always follow the recommended dosage and application instructions.

  • Ensure proper covering (e.g., tegaderm or clear plastic wrap) to enhance penetration.

Conclusion

After you get your tattoo done, remember to follow adequate measures to take care of your tattooed skin. Sun protection is necessary even on the tattooed area of the skin, so do use sunscreen to protect the skin from UV rays.

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