Orthopedics Medication & Injections An Overview of Lidocaine Cream What to Know About Over-the-Counter Lidocaine By Mali Schantz-Feld Mali Schantz-Feld Mali Schantz-Feld is a medical journalist with over 25 years of experience covering a wide range of health, medicine, and dental topics. Learn about our editorial process Updated on December 01, 2022 Medically reviewed by Grant Hughes, MD Medically reviewed by Grant Hughes, MD LinkedIn Grant Hughes, MD, is a board-certified rheumatologist. He is an associate professor at the University of Washington School of Medicine and the head of rheumatology at Seattle’s Harborview Medical Center. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents How to Use Lidocaine Cream Precautions Side Effects Combination Products Frequently Asked Questions Lidocaine cream is an anesthetic used to temporarily numb the skin and surrounding tissues. Creams containing lidocaine are used to prevent and treat pain and discomfort during some medical procedures. Lidocaine cream also is available as an over-the-counter (OTC) medication that can be used to help with itchiness and pain from minor burns, scrapes, and insect bites. Creams and ointments that contain only lidocaine include: Aspercreme with Lidocaine BenGay Lidosense 4 LMX 4 RectaSmoothe Solarcaine Xylocaine This article explains how to use lidocaine cream, including specific situation for pregnant people, children, older people, and those with certain health issues. It details the side effects of using lidocaine cream. Marina Vol / Getty Images How to Use Lidocaine Cream Before using lidocaine cream or ointment, wash your hands with soap and water. For medical use, apply topically by squeezing the amount needed onto a sterile gauze pad and applying it to the affected area. Wash your hands again very well after applying. Precautions to follow when using lidocaine cream include keeping lidocaine cream away from your mouth, nose, or eyes. Also be aware that side effects may occur, especially when using large amounts. Adverse side effects are directly related to the total dose of lidocaine that you apply. If You Get Lidocaine Cream in Your Eyes Lidocaine cream can cause blurry vision and temporary vision loss if it gets in your eyes. Wash them with water for at least 15 minutes if this occurs. Do not touch or rub your eyes. Call your healthcare provider right away, and don't cover them with a bandage or plastic wrap without medical advice because wrapping the treated area increases absorption into your system. Precautions Lidocaine cream is generally safe to use but precautions are necessary in some people. Children Avoid using a dose larger than what your healthcare provider or the manufacturer recommends when applying lidocaine cream to large areas of injured skin. Do not let your child scratch or rub the skin while it is numb, and do not let the skin get very hot or very cold. When using lidocaine cream, avoid heat sources such as electric blankets or heating pads. Also, don't let your child take long, hot baths or sunbathe, because their temperature may rise and cause too much drug to be absorbed into their body. Lidocaine Cream and Young Children For children younger than 3 years old, lidocaine cream should be used only when other treatments are not available. Always talk to your healthcare provider first. Health problems like seizures have occurred in children younger than 3 when it was not used as recommended. Do not use it to treat infants and children with teething pain. Pregnancy Lidocaine cream is considered generally safe for pregnant people to use. However, the drug does cross through the placenta and although the developing fetus is able to metabolize it, caution is warranted. High doses, in particular, are to be avoided. A 2.5% lidocaine cream is considered safe but, as is the case when used in other people, it's important to keep it out of the eyes. It is not known whether lidocaine ointment is passed to an infant through breast milk, but because other drugs are found in nursing mothers’ milk, caution should be exercised when lidocaine is given to someone who is nursing. Older Adults Lidocaine cream comes in different strengths and it should be used in smaller doses for older adults, depending on their age and physical condition. This precaution is needed because an individual person's physical makeup, along with the concentration of lidocaine and formulation of the drug, all have significant effects on the amount of lidocaine that gets absorbed into the blood. Lidocaine should also be used with caution in people with severe shock or heart block. Even over-the-counter use of topical anesthetics like lidocaine cream should be supervised by a healthcare provider to avoid toxic effects and, in rare cases, death. Side Effects of Lidocaine Cream Lidocaine cream use can lead to side effects. Call your healthcare provider if you experience any of the following after applying a lidocaine cream: Skin rash Itching or hives Swelling of the face, lips, or tongue Breathing problems Changes in vision Confusion, excitability, nervousness, restlessness Dizziness, drowsiness Chills or feeling hot Headache Irregular heartbeat Nausea, vomiting Seizure Tremor The type of lidocaine used by dentists is not available over the counter. Do not swallow lidocaine cream or put lidocaine cream in your mouth. Lidocaine can cause numbness of the mouth and throat, which can lead to trouble swallowing and even choking. If a substantial amount is swallowed, enough can be absorbed into the bloodstream to affect vital organs, primarily the brain and heart. Lidocaine Cream and Methemoglobinemia Rarely, frequent use of lidocaine can reduce the ability of iron in red blood cells to carry oxygen to tissues. This serious and even life-threatening condition is known as methemoglobinemia. Because the blood is not able to carry enough oxygen to tissues, people with this condition appear very pale or even blue, feel very tired, and have shortness of breath. What to Know About Lidocaine Overdose Combination Products Some products contain lidocaine in addition to other medications, such as additional pain relievers or steroids. These products include: BLT (benzocaine, lidocaine, and tetracaine) Denela Cream (lidocaine and prilocaine) EMLA (lidocaine and prilocaine) Evolution 10 (lidocaine and a local anesthetic) Icy Hot Lidocaine (menthol and lidocaine) LidaMantle (lidocaine and hydrocortisone) Be sure to check with your healthcare provider before using a combination product, especially if you are pregnant or have other health considerations. Before using lidocaine ointment or cream, let your healthcare provider know if you have any of the following:Heart problemsInfected, open, or damaged skinAn unusual or allergic reaction to lidocaine, other medicines, foods, dyes, or preservativesAlso let them know if you are:Pregnant or trying to get pregnantBreastfeeding A Word From Verywell Lidocaine cream can offer pain relief and a number of over-the-counter products are available. Be sure to read the labels when choosing a product so you know the medications in the cream as well as the concentration strength. Frequently Asked Questions Does lidocaine cream help with nerve pain? Yes, lidocaine cream has been used to treat diabetic neuropathy, trigeminal neuralgia, and other nerve-related conditions. However, some studies suggest it is not as effective when treating chronic pain and needs to be combined with other therapies. Learn More: Diabetic Neuropathy Medications Is there a prescription-strength lidocaine? Yes, lidocaine patches are available by prescription. Products like Dermalid and Lidoderm may be used in specific circumstances, like treating chronic pain (post-herpetic neuralgia) after a shingles diagnosis. Learn More: Post Herpetic Neuralgia: Treatment, Symptoms, and More Can you use lidocaine cream to treat hemorrhoids? Many over-the-counter products used for hemorrhoid relief contain lidocaine. It relieves pain, while other ingredients help with itching and promote skin healing. Learn More: The 7 Best Over-the-Counter Hemorrhoid Treatments of 2022 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Amneal Pharmaceuticals LLC. Lidocaine – lidocaine ointment USP, 5%. Memorial Sloan Kettering Cancer Center. Lidocaine (Topical). Trivedi MK, Kroumpouzos G, Murase JE. A review of the safety of cosmetic procedures during pregnancy and lactation. Int J Womens Dermatol. 2017 Feb 27;3(1):6-10. doi:10.1016/j.ijwd.2017.01.005. Barash M, Reich KA, Rademaker D. Lidocaine-induced methemoglobinemia: a clinical reminder. J Am Osteopath Assoc. 2015 Feb;115(2):94-8. doi: 10.7556/jaoa.2015.020 National Capital Poison Center. Lidocaine Can Cause Harmful Effects. Derry S, Wiffen PJ, Moore RA, Quinlan J. Topical lidocaine for neuropathic pain in adults. Cochrane Database Syst Rev. 2014 Jul 24;2014(7):CD010958. doi:10.1002/14651858.CD010958.pub2. MedlinePlus. Lidocaine Transdermal Patch. By Mali Schantz-Feld Mali Schantz-Feld is a medical journalist with over 25 years of experience covering a wide range of health, medicine, and dental topics. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit