What is EMLA (Numbing Cream)?

EMLA is a topical anaesthetic cream which numbs the skin. The medical procedure then becomes more painless. Lidocaine and prilocaine are the two local anaesthetics in EMLA. They act by blocking the signals of nerves. This way, the feeling of pain in that area decreases where the cream has been applied. The effect starts to work in 30-60 minutes, depending on the procedure. It is ideal for adults as well as children, thus accommodating diverse medical conditions.

EMLA is highly used in hospitals, clinics, and even in-home care under a clinicians supervision. With the fact that it numbs the skin and makes it a favourite for anything from vaccinations to blood draws, laser treatments, and minor skin surgeries, It is also easy to apply and comes with straightforward instructions for safe application.

What is Emla (Numbing Cream) Used For?

Emla (numbing cream) is a versatile topical anaesthetic used in various medical and cosmetic settings to ease discomfort and reduce pain. Its numbing effect makes procedures less stressful, especially for individuals sensitive to pain. Here’s a detailed look at its common uses:

Medical Procedures: Emla is commonly applied before injections, vaccinations, or blood draws. It numbs the skin’s surface, minimising the sting and discomfort of needles. This is particularly helpful for children, people with needle phobia, or those undergoing frequent blood tests.
Minor Skin Surgeries: For procedures like mole removal, skin biopsies, or wart treatments, Emla reduces the pain associated with minor surgical incisions. It allows healthcare providers to perform delicate work without causing significant discomfort to the patient.
Cosmetic Treatments: Many cosmetic procedures, such as laser hair removal, micro-needling, dermal filler injections, and tattoo removals, can be painful. Emla helps numb the skin, making these aesthetic treatments more comfortable and reducing post-procedure irritation.
Catheter Insertions: In hospitals and clinics, Emla is used to ease the insertion of catheters or other medical devices. It helps reduce the discomfort caused by inserting tubes into veins or other body parts, improving patient comfort during such procedures.

How Does Emla (Numbing Cream) Work?

Emla works by numbing the skin’s surface, making it less sensitive to pain. It contains two active ingredients—lidocaine and prilocaine—which are local anaesthetics. These ingredients temporarily block the transmission of nerve signals in the skin, preventing pain signals from reaching the brain.

Mechanism of Action:

Nerve Signal Blocker: Emla’s active ingredients interfere with sodium channels in nerve cells, blocking the nerves' ability to send pain signals. This results in a temporary loss of sensation in the treated area.
Surface Penetration: Once applied, the cream penetrates the outer layer of the skin, reaching the nerve endings beneath. This process takes about 30-60 minutes, depending on the skin’s thickness and the area treated.
Temporary Effect: The numbing effect of Emla typically lasts for 1 to 2 hours after the cream is removed. This temporary effect is ideal for short procedures, as normal sensation gradually returns without long-term impact.

When to Consider Emla (Numbing Cream) for Pain Relief

Emla is an effective option for managing pain related to minor medical and cosmetic procedures. It’s particularly useful in situations where discomfort may cause anxiety or distress. Here’s when to consider using Emla:

Before Injections: If you’re anxious about needles or sensitive to pain, Emla can be applied before vaccinations, IV insertions, or blood tests. It reduces the sharp sting of the needle, making the process more tolerable.
During Skin Treatments: Emla is commonly used before cosmetic procedures like laser hair removal, tattoo applications or removals, micro-needling, and minor dermatological surgeries. It helps minimise discomfort during these often painful treatments.
For Sensitive Individuals: People with a low pain threshold as  It helps reduce anxiety and discomfort, improving the overall experience.

Who Should Use It:

• Adults undergoing minor procedures
• Individuals with needle phobia or anxiety about medical procedures
• Patients requiring frequent injections or blood tests
• People undergoing cosmetic treatments like laser therapy
  
  

Who Should Avoid It:

• People allergic to lidocaine, prilocaine, or other ingredients in Emla
• Individuals with certain heart conditions, like severe arrhythmias
• People with a history of methemoglobinemia, a rare blood disorder
• Infants under 12 months without strict medical supervision
• Those with open wounds, infected skin, or severe skin conditions at the application site
  
  

Can You Buy Emla (Numbing Cream) Over the Counter?

Yes, Emla is available over the counter in the UK and it can be purchased from most pharmacies without a prescription. It comes in various forms, including creams and patches, for different needs. However, while it’s easily accessible, it’s essential to follow the instructions provided on the packaging or by your pharmacist to ensure safe use.

Although Emla doesn’t require a prescription, consulting with a pharmacist or healthcare provider is highly recommended, especially if you have underlying medical conditions or are using other medications. For large areas of application, professional advice is important to avoid potential side effects.

Precautions While Using Emla (Numbing Cream)

While Emla is generally safe, taking certain precautions can prevent complications:

Avoid Broken Skin: Do not apply Emla to open wounds, irritated skin, or areas with rashes or infections. This can increase the risk of absorption into the bloodstream, leading to potential side effects.
Dosage Limits: Stick to the recommended dose and application area. Using too much can cause adverse reactions, including skin irritation or, in rare cases, systemic effects like methemoglobinemia.
Medical Conditions: Inform your 123Meds prescriber if you have heart conditions, liver problems, blood disorders, or a history of allergic reactions to local anaesthetics.

Avoid Contact with Eyes and Mouth: Emla should not be used inside the eyes, nose, mouth, or ears as it can cause irritation and unintended numbing of delicate tissues.

Alternative Medications for Pain Relief

If Emla isn’t suitable, several alternative medications are approved in the UK for localised pain relief. These alternatives are effective for different types of pain and are licensed for use:

Ibuprofen Gel: A non-steroidal anti-inflammatory drug (NSAID) used to reduce inflammation and pain in joints, muscles, and soft tissues. It’s commonly used for conditions like sprains, strains, and arthritis.
Naproxen Cream: Another NSAID, naproxen cream helps relieve localised pain associated with arthritis, tendonitis, and other musculoskeletal conditions. It reduces inflammation and soothes sore areas.
Diclofenac Gel: Widely used for joint and muscle pain, diclofenac gel targets inflammation directly at the site of pain. It’s effective for conditions like osteoarthritis, sports injuries, and back pain.
Capsaicin Cream: Derived from chilli peppers, capsaicin cream, is used to relieve nerve-related pain, especially in conditions like diabetic neuropathy and arthritis. It works by reducing the intensity of pain signals in the affected area.

At 123Meds, we offer a range of medicines for pain relief - if you are unsure about what is best for your needs, one of our prescribers will be happy to discuss this with you.

How to Use Emla (Numbing Cream)

1. Clean the Area: Start by gently washing the skin with mild soap and water. Pat the area dry with a clean towel to ensure no moisture interferes with the cream's absorption. This step helps remove any dirt, oils, or bacteria that could affect the skin or the cream's effectiveness.

2. Apply a Thick Layer: Squeeze out the recommended amount of Emla cream, typically as advised by your healthcare provider or as indicated on the package. Apply it generously to cover the entire treatment area without rubbing it in, as rubbing can reduce its numbing effect.

3. Cover with Dressing: Place an airtight, occlusive dressing (such as a plastic film) over the cream. This helps the active ingredients absorb into the skin more effectively and prevents the cream from smearing or drying out prematurely.

4. Wait for the Numbing Effect: Leave the cream on the skin for 30 to 60 minutes to allow the numbing effect to develop fully. For certain procedures, your doctor may recommend a longer application time. Do not exceed the recommended duration.

5. Remove and Clean: Carefully remove the dressing and gently wipe off any excess cream with a clean tissue or cloth. Clean the area with mild soap and water if needed. The skin should feel numb, indicating it’s ready for the procedure.

Active Ingredients:

Lidocaine (2.5%) and Prilocaine (2.5%): These are the key components responsible for the numbing effect. They work by blocking nerve signals in the skin, reducing the sensation of pain.

Inactive Ingredients:

Polyethylene Glycol: Acts as a base to help distribute the active ingredients evenly.
Carbomer: A thickening agent that gives the cream its smooth texture.
Sodium Hydroxide: Used to adjust the cream's pH balance for safe skin application.
Purified Water: Helps to dissolve the ingredients and maintain the cream’s consistency.

Always check the patient information leaflet (PIL) in your pack for the full ingredient list — especially if you have skin allergies or sensitivities.

While Emla is generally safe when used as directed, some individuals may experience side effects:

Mild Side Effects:

Redness: Temporary redness at the application site.
Swelling: Mild puffiness or skin irritation.
Itching: A common reaction as the skin adjusts to the cream.
Mild Burning Sensation: A slight warming or tingling feeling shortly after application.
Skin Discoloration: Temporary lightening or darkening of the skin.
Temporary Numbness: Extended numbness, even after removal, usually resolves on its own.
Rash: Mild, localised skin rash.
Warm Sensation: A feeling of warmth where the cream was applied.

Severe Reactions (Seek Medical Help Immediately):

Allergic Reaction: Symptoms like hives, rash, swelling of the face, lips, tongue, or throat, and difficulty breathing.
Severe Skin Irritation: Blistering, intense burning, or prolonged pain that doesn’t subside.
Methemoglobinemia Risk: A rare but serious condition where the blood can’t carry enough oxygen, leading to symptoms like fatigue, dizziness, shortness of breath, or bluish skin.
Most mild side effects are temporary and resolve without medical intervention.

If you do experience any severe or persistent side effects, please seek urgent medical evaluation by contacting your GP, NHS111 or A&E as appropriate.