Safety of lidocaine 15% and prilocaine 5% topical ointment used as local anesthesia for intense pulsed light treatment.
BACKGROUND
Literature cautions against applying lidocaine 15%/prilocaine 5% over an area larger than 300 cm(2). The area of the face, neck, and chest is 400 cm(2) or greater.


OBJECTIVE
To investigate the safety of lidocaine 15%/prilocaine 5% topical anesthetic ointment used as anesthesia for intense pulsed light (IPL) treatment.


METHODS
Lidocaine 15%/prilocaine 5% ointment was applied to the face only (n=10) for 30 +/- 15 minutes or to the face, neck, and chest (n=10) for a total of 60 +/- 15 minutes before IPL. Blood lidocaine and prilocaine levels were measured. Adverse events were recorded.


RESULTS
For the entire cohort, blood was drawn 25.6 +/- 6.6 minutes after IPL was completed. In the face only group, the mean lidocaine level was 0.122 +/- 0.125 microg/mL, and the mean prilocaine level was 0.048 +/- 0.029 microg/mL. In the face, neck, and chest group, the mean lidocaine level was 0.272 +/- 0.208 microg/mL, and the mean prilocaine level was 0.087 +/- 0.060 microg/mL. No adverse events related to systemic toxicity were observed or reported to the nurse. At the 24-hour follow-up, no subject reported symptoms of systemic toxicity after leaving the clinic.


CONCLUSIONS
Under the conditions of this study, topical lidocaine 15%/prilocaine 5% produces low levels of systemic absorption.
Carruthers
J Alastair
JA
Carruthers Dermatology Centre, Inc., Vancouver, BC, Canada. alastair@carruthers.net
Carruthers
Jean D A
JD
Poirier
Judith
J
Oliff
Heather S
HS
Mordaunt
Julie
J
Schreiber
William E
WE
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D003357:Cosmetic Techniques; D005145:Face; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009333:Neck; D009824:Ointments; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D010789:Phototherapy / Q000009:adverse effects*; D010865:Pilot Projects; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects*; D015595:Skin Aging; D013909:Thorax; D055815:Young Adult
D000779:Anesthetics, Local; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine