Author: Bob Brensel | President, Pharmacist | ScriptWorks
Bob Brensel, RPh, earned his Pharmacy Degree at University of the Pacific in Stockton, California in 1980. Former California Pharmacists Association’s Award Winner for Recognition of Outstanding Achievement in Compounding Pharmacy. Read More →
Topical Anesthetics in Cosmetic Numbing Procedures: Compounded Benzocaine, Lidocaine, & Tetracaine Rx Combinations
Topical anesthetics are medications applied directly to the skin to numb the surface area. These medications temporarily block nerve signals in the skin, reducing sensations and making procedures and therapies more tolerable for patients. They are commonly used to reduce discomfort during cosmetic procedures such as laser treatments, micro-needling, and dermal filler injections. Other medical practitioners may also use them for various clinical applications.
ScriptWorks Pharmacy specializes in providing California practitioners with compounded topical anesthetics that combine benzocaine, lidocaine, and tetracaine (commonly referred to as topical BLT) for enhanced numbing effects in professional settings. We designed these compounded formulations to improve patient comfort while giving healthcare providers more control over medication strengths and applications.
Understanding Compounded Topical BLT
Topical BLT combines three key anesthetic agents:
Benzocaine: A fast-acting topical anesthetic that provides quick relief.
Lidocaine: Known for its versatility, lidocaine is widely used in medical and cosmetic settings for numbing the skin and mucous membranes.
Tetracaine: A potent anesthetic that offers prolonged numbing effects.
By combining these ingredients in customized strengths, our topical anesthetics provide targeted numbing based on the patient’s needs and the type of procedure being performed.
“Practitioners are increasingly using topical anesthetics to decrease the pain associated with superficial dermatologic, aesthetic, and laser procedures.”
Source: Dermatologic Surgery
Potential Benefits of Compounded Topical Anesthetics for Cosmetic Procedures
Compounded topical anesthetics like topical BLT offer several potential benefits including:
Customized Strengths: Providers can adjust the concentration of benzocaine, lidocaine, and tetracaine to achieve optimal numbing for various procedures.
Enhanced Patient Comfort: Custom formulations may improve numbing efficiency, reducing discomfort during more extensive procedures.
Reduced Risk of Systemic Absorption: By adjusting ingredient ratios, prescribers can minimize the risk of excessive absorption, potentially improving patient safety.
Flexible Application Options: Compounded topical anesthetics like topical BLT can be designed in gels, creams, or ointments, allowing healthcare providers to choose the most appropriate formulation for different skin types and affected areas.
How Providers Can Incorporate Compounded Topical BLT into Practice
Who Prescribes Topical Anesthetics in California?
Compounded topical Benzocaine, Lidocaine, and Tetracaine (BLT) are potent anesthetics widely used across various medical procedures in addition to cosmetic reasons. Below is an overview of professionals who commonly prescribe these patient-specific compounded medications.
Cosmetic Practitioners, Med Spas, & Dermatology
In California, licensed practitioners and estheticians (working under the direct supervision of a licensed medical practitioner) may use compounded BLT for cosmetic procedures, such as:
- Laser Hair Removal: Numbing creams may help reduce discomfort during hair removal sessions, especially in sensitive areas.
- Micro-Needling: Patients undergoing skin rejuvenation therapies may experience improved comfort with compounded BLT.
- Tattoo Removal: The numbing effect of topical anesthetics may help minimize discomfort during laser tattoo removal procedures.
- Dermal Fillers and Botox: Topical anesthetics may help reduce injection site discomfort for smoother, more tolerable procedures.
- Chemical Peels and Skin Resurfacing: By reducing skin sensitivity, topical anesthetics may help improve the overall patient experience during these procedures.
- Morpheus8®: Numbing creams may be applied before this micro-needling with radiofrequency procedure to help enhance patient comfort.
- MonaLisa Touch®: Topical anesthetics may be used before this laser therapy to help minimize sensitivity during the procedure.
Top BLT Compounds:
Benzocaine 20% – Lidocaine 10% – Tetracaine 10% Ointment (Commonly requested for laser procedures)
Benzocaine 20% – Lidocaine 6% – Tetracaine 4% Cream (Commonly requested for needle stick procedures)
Lidocaine 23% – Tetracaine 7% Ointment (Commonly requested for Morpheus8®)
Lidocaine 23% – Tetracaine 7% Vaginal Gel (Commonly requested for MonaLisa Touch®)
Topical Anesthetics Rx Order Form
We make it easy for CA prescribers to get Topical Anesthetics (Topical BLT) for their patients.
Easily select from our recommended options to customize for each patient.
Licensed Medical Practitioners
In California, any licensed medical practitioner such as physicians, physician assistants, and nurse practitioners are authorized to prescribe topical BLT. These professionals utilize it to enhance patient comfort during procedures like:
- Dermatological therapies: Including laser therapies, skin biopsies, and mole removals.
- Minor surgical procedures: Such as suturing minor lacerations or performing superficial surgeries.
- Cosmetic applications: Like administering dermal fillers or Botox injections.
Their medical training and licensure ensure that topical BLT is used appropriately, considering patient-specific factors and potential contraindications.
Dentists and Oral Surgeons
Dentists and oral surgeons in California may prescribe compounded topical or oromucosal anesthetics for:
- Pre-injection numbing: To reduce discomfort before administering local anesthetics.
- Soft tissue procedures: Such as gingival surgeries or lesion removals.
- Management of oral lesions: To alleviate pain from conditions like aphthous ulcers.
Their expertise in oral anatomy and pain management allows for the safe application of these anesthetics.
Podiatrists
Podiatrists often perform procedures that may benefit from the application of topical BLT, including:
- Ingrown toenail: Providing local anesthesia during nail avulsion.
- Callus or wart removal: Minimizing discomfort during debridement.
- Minor foot surgeries: Offering pain relief for superficial surgical interventions.
Applying BLT (Benzocaine/Lidocaine/Tetracaine)
Topical BLT (benzocaine/lidocaine/tetracaine) may be applied to the designated area and left on for approximately 15–20 minutes, sometimes longer if needed. Before beginning any procedure, the medication is fully removed. A trained practitioner applies it using either an applicator with a gloved hand or just a gloved hand. This helps prevent accidental transfer of the anesthetic, which could cause numbness if it comes into contact with the practitioner’s skin.
Choosing a Trusted Compounding Pharmacy in California for Topical Anesthetics
Selecting a reliable compounding pharmacy is crucial when sourcing customized topical anesthetics. ScriptWorks Pharmacy is dedicated to producing high-quality compounded medications following strict safety and quality standards. Our experienced pharmacists collaborate with healthcare providers to create customized numbing solutions that support patient comfort during cosmetic procedures.
Why ScriptWorks?
Since 2003, the pharmacists and technicians at ScriptWorks have been formulating and preparing customized medicines for people and pets. We work closely with healthcare providers, veterinarians, and other medical professionals to develop customized medicine solutions.
We are a PCAB-accredited pharmacy, which means an independent board of auditors and inspectors has certified our procedures and policies in every aspect of compounding. Learn more about PCAB accreditation here.
Contact ScriptWorks Pharmacy for Expert Guidance
For healthcare professionals looking to improve patient comfort with customized topical anesthetics, ScriptWorks Pharmacy offers expert guidance and tailored solutions. Contact our team today to learn more about how compounded BLT may enhance your practice and improve patient outcomes. Your patients deserve the best.
References:
Alster, T. (2013). Review of Lidocaine/Tetracaine cream as a topical anesthetic for Dermatologic laser procedures. Pain and Therapy, 2(1), 11–19. Link
Georgette Oni, Yvonne Rasko, Jeffrey Kenkel, Topical Lidocaine Enhanced by Laser Pretreatment: A Safe and Effective Method of Analgesia for Facial Rejuvenation, Aesthetic Surgery Journal, Volume 33, Issue 6, August 2013, Pages 854–861. Link
Hendricks, A. J., & Farhang, S. Z. (2022). Dermatologic facial applications of Morpheus8 fractional radiofrequency microneedling. Journal of cosmetic dermatology, 21, S11-S19. Link
Huang, W., & Vidimos, A. (2000). Topical anesthetics in dermatology. Journal of the American Academy of Dermatology, 43(2), 286-298. Link
Oni G, Rasko Y, Kenkel J. Topical lidocaine enhanced by laser pretreatment: a safe and effective method of analgesia for facial rejuvenation. Aesthet Surg J. 2013 Aug 1;33(6):854-61. doi: 10.1177/1090820X13496248. PMID: 23908302. Link
Rosa, A. L., Sverzut, C. E., Xavier, S. P., & Lavrador, M. A. (1999). Clinical effectiveness of lidocaine and benzocaine for topical anesthesia. Link
Sobanko JF, Miller CJ, Alster TS. Topical anesthetics for dermatologic procedures: a review. Dermatol Surg. 2012 May;38(5):709-21. doi: 10.1111/j.1524-4725.2011.02271.x. Epub 2012 Jan 13. PMID: 22243434. Link