Something for your pain?

Something for your pain?

The FDA has issued a warning regarding topical anesthetics and the risk of life-threatening side effects. This is the second warning in 2 years regarding this issue, the first coming in February 2007 following the deaths of two women who used extensive topical anesthetics in preparation for cosmetic procedures. The latest warning was prompted by a study published in Radiology, which compared oral acetaminophen or ibuprofen vs lidocaine gel applied to the skin of the breasts to reduce discomfort during mammography. In the study, 4% lidocaine gel was applied by a nurse from the clavicles to the inferior costal margins and laterally to the mid axillary lines and then covered with plastic wrap to ensure consistency of application. Discomfort from mammograms was significantly lower in the lidocaine gel group and the authors postulate that decreased discomfort may improve the likelihood of future mammographic screening (Lambertz CK, et al. Radiology 2008;248:765-772). The FDA's previous warning in 2007 followed on the heels of two reports of young women undergoing laser hair removal who applied either lidocaine or tetracaine topical preparations to the lower extremities and then covered the application with plastic wrap. Both women developed seizures, fell into a coma, and eventually died due to excessive blood levels of the topical anesthetic. Many of these topical products are available over the counter. The FDA strongly advises consumers not to: make heavy application of topical anesthetics over large areas of skin, use concentrated formulas, apply to broken or irritated skin, wrap the treated skin with plastic wrap or other dressings, or apply heat to skin treated with these products.