I use Emla cream. It works quite well at the beginning of a session, and I might not even feel the first few zaps at all. But she has to wipe it off to do the work. As soon as it is wiped off, the skin starts to regain feeling, at different rates for different parts. Around my mouth, it wears off in only a minute or two! She can do maybe a dozen zaps there before it is too painful to continue. Other parts of my face last longer, but nothing seems to last a full hour.
On my doctor's advice, I take Advil and Tylenol before a session. (Disclaimer: Don't combine medications without medical advice.) They really don't do a damn thing during the session, but they do help to dull the pain afterwards.
I am dreading getting my upper lip done. I know from my laser sessions that it is the most sensitive area. I expect that I will book 15 minute appointments for that area instead of the 60 minute appointments that I do now.
I use headphones and music to help me meditate through the session and it helps. But there is only so much mindfulness you can do when she hits a live nerve!
I don't think there is any option in my area for lidocaine injections. It is a 20-minute drive from either my doctor or my dentist to my electrologist, and I understand that the stuff wears off in about that time.
Bottom line: yes it @#$% hurts!