The U.S. Food and Drug Administration recently alerted healthcare providers and the public to potentially serious and life-threatening adverse events from the improper use of skin numbing products. There are hundreds of such products, also known as topical anesthetics, available as creams, ointments, or gels in over-the-counter and prescription forms.
Skin numbing products are used to alleviate pain associated with numerous disorders, including post-herpetic neuralgia, arthritis, scrapes, burns, and insect bites. They are also increasingly being used as prophylaxis before painful transcutaneous medical procedures, tattooing, and laser hair removal. They are even being used to reduce discomfort associated with mammography.
To desensitize nerve endings that lie near the surface of the skin and cause numbness, topical anesthetics may contain lidocaine, tetracaine, benzocaine, prilocaine, or a combination of these drugs. Even though the intended effect is to numb the skin, they can also be absorbed into the bloodstream in large amounts when used improperly. To date, the FDA has reported the deaths of two women who used topical anesthetics before laser hair removal.
Adverse events: Patients may experience life-threatening adverse events, including irregular heartbeat, seizures, breathing difficulties, coma, or even death.
Patient teaching: Patients may believe that using a surplus of topical anesthetic will enhance effectiveness. Stress that more is not better. Remind patients that they should use a topical anesthetic that contains the lowest strength and amount of medication that will relieve their pain and that it should be applied sparingly. It should only be applied to the area where pain exists or is expected to occur and it should never be applied to broken or irritated skin or mucous membranes.
Also caution them that wrapping or covering skin treated with topical anesthetics with any type of material or dressing can increase the chance of serious adverse events. Warn them never to apply heat to the treated area because this causes an unpredictable amount of anesthetic to reach the bloodstream.
Caution: Review current drug information before administering and monitoring medications.
Drug News is compiled by Susanne J. Pavlovich-Danis, RN, MSN, ARNP-C, CDE, CRRN, who maintains a private practice in Plantation, Fla., and is professor and area chair for nursing at the University of Phoenix, Fort Lauderdale.
Skin numbing products are used to alleviate pain associated with numerous disorders, including post-herpetic neuralgia, arthritis, scrapes, burns, and insect bites. They are also increasingly being used as prophylaxis before painful transcutaneous medical procedures, tattooing, and laser hair removal. They are even being used to reduce discomfort associated with mammography.
To desensitize nerve endings that lie near the surface of the skin and cause numbness, topical anesthetics may contain lidocaine, tetracaine, benzocaine, prilocaine, or a combination of these drugs. Even though the intended effect is to numb the skin, they can also be absorbed into the bloodstream in large amounts when used improperly. To date, the FDA has reported the deaths of two women who used topical anesthetics before laser hair removal.
Adverse events: Patients may experience life-threatening adverse events, including irregular heartbeat, seizures, breathing difficulties, coma, or even death.
Patient teaching: Patients may believe that using a surplus of topical anesthetic will enhance effectiveness. Stress that more is not better. Remind patients that they should use a topical anesthetic that contains the lowest strength and amount of medication that will relieve their pain and that it should be applied sparingly. It should only be applied to the area where pain exists or is expected to occur and it should never be applied to broken or irritated skin or mucous membranes.
Also caution them that wrapping or covering skin treated with topical anesthetics with any type of material or dressing can increase the chance of serious adverse events. Warn them never to apply heat to the treated area because this causes an unpredictable amount of anesthetic to reach the bloodstream.
Caution: Review current drug information before administering and monitoring medications.
Drug News is compiled by Susanne J. Pavlovich-Danis, RN, MSN, ARNP-C, CDE, CRRN, who maintains a private practice in Plantation, Fla., and is professor and area chair for nursing at the University of Phoenix, Fort Lauderdale.
