title: Comparative Efficacy and Patient Preference of Topical Anaesthetics in Dermatological Laser Treatments and Skin Microneedling.
abstract: BACKGROUND
  Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA(®)), 4% tetracaine gel (Ametop™) and 4% liposomal lidocaine gel (LMX4(®))) in patients undergoing laser procedures and skin microneedling.
  
  
  METHODS
  This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre.
  
  
  METHODS
  All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure.
  
  
  METHODS
  Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice) were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant.
  
  
  CONCLUSIONS
  Patients reported a mean (±SD; 95% confidence interval) pain score of 5 (±2.58; 3.66-6.46) with Ametop™, 4.38 (±2.53; 2.64-4.89) with EMLA(®) and 3.91 (±1.95; 2.65-4.76) with LMX4(®). There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4(®) as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures.
authors.affiliation: Laser Division, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
authors.forename: Yi Zhen
authors.initials: YZ
authors.lastname: Chiang
authors.affiliation: Laser Division, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
authors.forename: Firas
authors.initials: F
authors.lastname: Al-Niaimi
authors.affiliation: Laser Division, Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
authors.forename: Vishal
authors.initials: V
authors.lastname: Madan
keywords: 2.5% lidocaine/2.5% prilocaine cream; Laser; Topical anaesthetics; liposomal lidocaine gel; skin microneedling; tetracaine gel