The 1990's saw the introduction of an important breakthrough
in pain reduction for hair removal: the EMLA brand topical cream
(which stands for Eutectic Mixture of Local Anesthetics). This
prescription medication has shown to be very useful in dermatological
procedures, especially in children. Drawbacks include inconvenience
of having to cover it with an airtight dressing for 30-90 minutes
after application, as well as concerns of getting it in the eyes.
Although there is no data, EMLA use may also affect laser treatment
by forcing blood out of the epidermis.
Recently, topical anesthetics made with tetracaine have become
available, as well as over-the-counter lidocaine preparations
in prescription strength and custom-made compounded products.While
pain-reducing results are mixed, many find the gels the Ametop
and ELA-Max preferable both in speed of absorption and ease of
use. See also:
Hjorth (1991): 
18 of 21 women preferred EMLA to a placebo during
upper lip electrolysis.
Lycka (1992): An early positive review of EMLA and its uses.
Wagner (1994): 30 women had significantly less pain using EMLA
over a placebo during upper lip electrolysis.
Hung (1997): In 40 subjects, a gel with 5% tetracaine was preferred
over EMLA for pain reduction.
Whealton (1998): A good review of medical literature
on anesthesia, especially EMLA and iontophoresis.
Choy (1999): 34 children treated with EMLA and tetracaine gel
(Ametop) before a procedure had similar pain relief, though
Ametop may be easier to use.
van Kan (1999): Of 32 children treated with EMLA and
34 treated with 4% tetracaine gel. 97% of EMLA patients had
adequate pain relief, compared to 76% with tetracaine. However,
they found tetracaine much easier to use.
Romsing (1999): 60 children treated with EMLA and tetracaine
prior to IV injection. The tetracaine treatment reduced pain
in 45%, but the EMLA in only 10%. Tetracaine was also faster-working
and easier to use.
Browne (1999): In 32 patients treated with both EMLA
and tetracaine gel overall pain reduction and ease of I.V. insertion
was better with tetracaine.
Friedman (1999): 12 patients had EMLA, ELA-Max, Betacaine, and
Ametop applied prior to laser. EMLA and ELA-Max were found to
be most effective.
Altman (1999): 10 patients found ELA-Max uncovered for 20 minutes
to work as well during flashlamp treatment as EMLA covered for
1.5 hours.
Eremia (2000): 12 patients had reduced pain from Alexandrite
and diode laser treatment to armpits after application of ELA-Max.
