EMLA

ELA-MaxÈ Cream (lidocaine 2.5% plus prilocaine 2.5%) is a topical anesthetic cream. This may be the solution to hair removal pain for you, or it may not. Some people swear by it; others say it does nothing for them. I am firmly in the camp of EMLA fans, but I do think it is sometimes overhyped. I have very rarely experienced 100% anesthesia from topical anesthetics like EMLA. However, it does an excellent job of taking the edge off the pain for me, and that's all I really want.

Disclaimer:

A pain medication which works perfectly for one consumer may not work at all for another.

I make absolutely no guarantee that any product mentioned in this section will work for you or will work better or worse for you than another product.

For details, see my  Pain management intro page.

EMLA is a thick white cream with very little smell and a rather bitter taste. It contains two common local anesthetics: 2.5% lidocaine and 2.5% prilocaine. It's not a good idea to get the junk in your mouth (or worse, your eye), so be careful. I usually keep a tissue in my hand in case some accidentally gets smeared in my mouth or eye.

EMLA was developed by Swedish pharmaceutical Astra (now part of Merck) and is only available in the U.S. by prescription. There are some medical advisories, so read all instructions before using it. EMLA comes in 5 and 30 gram ointment tubes, with the 30-gram tube usually around $40. I buy the 30 gram ones since my insurance co-payment is $10 per prescription, no matter what the size. I just went to my regular doctor and told him I wanted some. Some hair removal clinics refer clients to a doctor who will get them an EMLA prescription.

How long does a tube last? It depends. Some people make a 30 gram tube last for months; others use a whole tube in a couple of sessions. I personally feel that the price is far outweighed by how much more tolerable it can make treatment, but not everyone does.

EMLA application tips

Additional EMLA observations

Begin treatment immediately after uncovering

The numbness starts to wear off as soon as the dressing is removed and the cream is wiped away. Sometimes this happens quite quickly, other times it may stay numb long after treatment. The EMLA instructions claim it should last at least 20 minutes. It's important to work on an area as soon as it's wiped clean if you want the full effect. Let them remove the wrap as he or she gets to the next area. They should peel it back like a sardine can lid, only uncovering the area they are just about to work on. Sometimes, the stuff may just be too messy and getting in the way, in which case it might be easier to remove the whole price of plastic. That's why it's good to do the plastic in several smaller pieces.

Freshly-opened tubes seem more potent

Many people have commented on the difference in potency between a freshly-opened tube and one that's been open awhile. Once the EMLA in the tube has been exposed to the air it seems that it starts to lose effectiveness. Temperature seems to affect it adversely as well, so don't let it get too hot or cold. If you aren't on a prescription co-payment plan and are paying full price out of pocket, you might look into the 5-gram tubes, which could be used up before the EMLA starts to lose effectiveness.

Avoid getting it in creases

I find that if the EMLA sits in the creases that run from my nose to the corners of my mouth (nasolabial folds), I get a rash. I can prevent that by covering those creases with scotch tape BEFORE applying EMLA, and then taping the cling wrap over the whole thing.

Trivia answer

EMLA stands for Eutectic Mixture of Local Anesthetics. A eutectic mixture has a melting point below room temperature. Lidocaine and prilocaine crystals turn to oils at room temperature.

Tricky tubes

Careful when you puncture a new tube! When the seal is broken, the pressurized cream sometimes oozes out quickly. A friend observed a phenomenon I've had myself: a depressing point when you're in the middle of a tube where the tube looks to contain more EMLA that it really has in it. You're flattening it out... still no EMLA. When it finally does start coming out again you have a lot less than you thought you had left, so plan accordingly if you use it generously. Finally, it can be a bit tricky getting the last few grams out. Best bet is to roll up the tube as you empty it, then squeeze out the last part like a syringe: thumb pressing down on the rolled-up part, index and middle fingers on side of the mouth of the tube. It will probably all come out at once, so point it toward your palm so it doesn't spill on the floor.

Pages in this section:

What's it feel like?

Factors that affect pain

Over 30 pain reduction tips

EMLA application tips

Other topical anesthetics

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