Full-face laser resurfacing with the Active FX™ application of the Lumenis UltraPulse® Encore™ was selected. This case was reported to alert physicians to be aware of the potential for such complications and suggest the need for better formulation of these topical anesthetic creams.Ī 64-year-old Caucasian woman presented for treatment of fine lines and wrinkles, seborrheic keratoses, and lower and upper eyelid dermatochalasis with marked hyperpigmentation. The bilateral corneal abrasions occurred after skin resurfacing treatment despite the use of corneal shields throughout the procedure. In the case reported where gritty particulate matter caused corneal abrasions due to problems with the manufacture of a particular compounded topical anesthetic: benzocaine 20%, lidocaine 8%, tetracaine 4% (BLT), the issue could have been avoided had appropriate quality assurance been exercised. Any practice desirous of a sustainable business will naturally wish to mitigate manageable risks while still providing the best possible patient experience. Hence, the precarious balancing act realized between appropriate numbing and appropriate safety recognition. However, there is also a large benefit to ensuring the continued safety of patients when using these products. Naturally, there is a substantial benefit to both practitioners and patients in providing the highest degree of numbing. Improper use of overly highly concentrated topical anesthetics can lead to severe consequences, including death.1,3,4 However, no standard guidelines exist for optimal use, dosage, formulation, and safety of all topical anesthetics. Further, the risks of adverse events increases in the event the overly high concentration is included in a formulation that drives higher concentrations into the circulatory system, such as in the case using the potent driver DMSO. In other words, just because a compounded product lists very high concentrations of the API's, does not at all suggest they will enter into the dermis and thereby create an improvement in efficacy, but, in fact, may only increase the risk of adverse events from particulate matter that remains insoluble. When the API comes out of solution, the remaining product may simply lay on the top surface of the skin and not add to an additional numbing effect, but, conversely, simply increase the risk for adverse events, such as the corneal damage event seen in one patient where the event was reported. The grittiness often associated with some of these compounded products may be due to insolubility from the manufacture of overly concentrated solutions. One of the most commonly used is benzocaine, lidocaine, tetracaine (commonly known as BLT), which can vary in percent as well as rheology, namely yielding a gritty or smooth texture.1 Application of topical anesthetics has proven to decrease pain and discomfort associated with these procedures, including cosmetic procedures, such as filler injectables, laser hair removal, and skin resurfacing with laser and light-based devices.1,2 To date, there are several compounded topical anesthetics available for physicians for in-office use on their patients. Topical anesthetics are now widely used in dermatologic procedures. Reduce your patience pain and increase their confidence with our BLT cream today.Appropriately Concentrated BLT Anesthetics May Reduce Risk of Adverse Events This is what keeps the cream fresh and sanitary. Once utilized, the packets are then discarded and not reused. In this way, the active ingredients maintain their maximum potency. We package our cream in 3 single-use sachets which are mixed together just prior to use. Our BLT cream is safe and effective, and is the best, most convenient, and cost-effective non-prescription option. These topical anesthetics creams are the best to utilize when numbing the skin.īLT topical numbing cream from Centura Pharma consists of benzocaine, lidocaine, and tetracaine, in the highest dosage allowed for over-the-counter creams. Numbing creams that are compounded of BLT (benzocaine, lidocaine, and tetracaine) and used during laser tattoo removal are more effective to comfort patients and numb the pain throughout the entire procedure. The icepack cannot numb the skin during the treatment, only before and after. While this method is easy and cost-efficient, it does not last long. An ice-pack method is a short-term option for clinics that perform low to moderate laser tattoo removal treatments. Offering BLT numbing cream can reduce the pain during the procedure and give the client the confidence to move forward with scheduling. That’s why most tattoo removal clinicians use a topical numbing cream for their patients prior to treatment sessions. They report that the laser pulses feel like a rubber band snapping against your skin. Many people compare the pain of tattoo removal pain to the pain of a bad sunburn.
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