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I have had this on going issue with a compounded (made by the chemist for me) Anesthetic cream and how long it should be left on. My current Electrologist is adamant that the cream she uses should go on for no more than half an hour and use very sparingly.
I have experimented with my own compounded Anesthetic which is far stronger and leaving it in place for thirty minutes does nothing, At 1` hour its better but at two I get really good coverage if I apply enough.

My Electrologist claims she has never heard of putting these creams on any longer than 45 minutes prior but a quick look through the net tells a far different story. The suggestion by one Electrologist is that the longer you leave it the better it reacts. Looking at a few of the other types of creams on the market and they all say the same..the longer the better. But I have heard different things from different sources about whether this is true or not.

Liz

I'm getting my arm electro'd for SRS this year. My electrologist only used a topical anesthetic on me once. For whatever reason it made the pain worse for me, so not doing it again. But I came early to the session and had it applied 15 mins in advance. I still had full feeling of everything. But she said anywhere from 15-30 mins in advance was good to go. I didn't feel it kick in later, so I'm assuming it just didn't work on me.

Topical anaesthetic generally has great difficulty penetrating the skin.  45min to an hours application is usually acceptable.

The other problem is that the duration of effect is going to be quite short relative to the tune most people take for electro as well.

Mine will apply it fairly thickly for up to an hour before hand, she also covers it with cling wrap so it doesn't dry out. She works on other areas first as it is only applied to my upper lip. Once it is cleaned and sterilised to start the electro there's only a window of about 20 to 30 minutes before it wears off.

Hi Elizabeth,

First of all, I have never had much luck with topical anesthetics, no matter how I apply them.  That said, I can tell you that the cream should be on at least an hour beforehand.

The manufacturer's product insert for prescription EMLA (2.5% lidocaine and 2.5% prilocaine), says a "thick layer" of cream should be applied to intact skin and covered with an occlusive dressing for at least one hour.  An "occlusive dressing" can be Tegaderm dressing or plain old plastic wrap from the kitchen. "Thick layer" means 2.5 grams of cream for 20-25 cm2 of skin. For "major dermal procedures", they recommend 2 grams of cream per 10 cm2 of skin, allowing it to stay in contact with the skin for "at least two hours".

"Dermal analgesia can be expected to increase for up to 3 hours under occlusive dressing and persist for 1 to 2 hours after removal of the cream." (Yeah, right.  I think 30 minutes is closer to the mark.)

"Occlusion is not necessary for absorption, but may be helpful to keep the cream in place."

Hope that helps.

~Terri

Quote from: Maybebaby56 on June 02, 2016, 04:42:26 PM
Hi Elizabeth,

First of all, I have never had much luck with topical anesthetics, no matter how I apply them.  That said, I can tell you that the cream should be on at least an hour beforehand.

The manufacturer's product insert for prescription EMLA (2.5% lidocaine and 2.5% prilocaine), says a "thick layer" of cream should be applied to intact skin and covered with an occlusive dressing for at least one hour.  An "occlusive dressing" can be Tegaderm dressing or plain old plastic wrap from the kitchen. "Thick layer" means 2.5 grams of cream for 20-25 cm2 of skin. For "major dermal procedures", they recommend 2 grams of cream per 10 cm2 of skin, allowing it to stay in contact with the skin for "at least two hours".

"Dermal analgesia can be expected to increase for up to 3 hours under occlusive dressing and persist for 1 to 2 hours after removal of the cream." (Yeah, right.  I think 30 minutes is closer to the mark.)

"Occlusion is not necessary for absorption, but may be helpful to keep the cream in place."

Hope that helps.

~Terri

Thanks Terri I certainly agree with everything you have to say. The stuff I am using which has been componded by a chemist is  Bezocaine 20%, Lidocaine 6%, Tetracaine4%, DMSO 10% Poloxander 20% transdermal Gel.

So as you can see by the levels of the anesthetic it should be enough. I think the biggest issue is stopping it from liquefying once you have a dressing on it. The natural heat from my skin turns this to liquid in about 15 minutes which seems to prevent it from absorbing correctly. I am going to experiment without a dressing and of different periods of time...when the stuff is intact in its made up form you can feel it starting to numb the area but then it turns to liquid and the sensation fades.

I have read exactly the same stuff as you about how this stuff works and that an hour is the minimum you would want to have it on. I have experiments with up to two hours and got the best result. There is another person on this board using this stuff and they are having similar issues.

There is nothing on the market to even match what this stuff is and it should work..I just need to figure out the best way to apply it. Once it is developed to a point where it works each and every time I will share the final formula with everyone and if they want to use it they can get their Dr's to write the script.

I think I am getting close, the chemist is looking for an agent to add to the mix so it won't liquefy once put on. I feel strongly that if I can get it to stay on it will work really well.

Liz   

Quote from: Ms Grace on June 02, 2016, 03:56:20 PM
Mine will apply it fairly thickly for up to an hour before hand, she also covers it with cling wrap so it doesn't dry out. She works on other areas first as it is only applied to my upper lip. Once it is cleaned and sterilised to start the electro there's only a window of about 20 to 30 minutes before it wears off.

Not brave enough to trust the cream on my top lip got scarring there and it really hurts with the laser I am getting a part Facial Block to have one side of my top/bottom lip and chin done in one session. This last round of laser has zapped yet another round of follicles in my entire face leaving only greys. My top lip has been mainly dark hair with about 1/4 grey but from the corner of my lip straight down my chin and across and inch or two is the thickest grey area left. This is the area we are going after with the injection and as far along my Jawline as I can tolerate...the injection has the most effect on the chin. I had one a week ago that i couldn't use and I could feel nothing at all and chewed the inside of my cheek up unknowingly. So I know that will work for me.

Liz

Quote from: luna nyan on June 02, 2016, 03:51:14 PM
Topical anaesthetic generally has great difficulty penetrating the skin.  45min to an hours application is usually acceptable.

The other problem is that the duration of effect is going to be quite short relative to the tune most people take for electro as well.

1-2 hours prep for about 30 minutes of effective pain control, when you put it like that, it kind of sucks big time...but very true....once the stuff is wiped off it begins to stop working

Liz

Quote from: FTMax on June 01, 2016, 05:07:18 PM
I'm getting my arm electro'd for SRS this year. My electrologist only used a topical anesthetic on me once. For whatever reason it made the pain worse for me, so not doing it again. But I came early to the session and had it applied 15 mins in advance. I still had full feeling of everything. But she said anywhere from 15-30 mins in advance was good to go. I didn't feel it kick in later, so I'm assuming it just didn't work on me.

Hmmmm my experience tells me that even with Emla cream it needs that full hour to have any effect at all...so you managed ok?

Liz

Quote from: ElizabethK on June 04, 2016, 05:17:37 PM
I think I am getting close, the chemist is looking for an agent to add to the mix so it won't liquefy once put on. I feel strongly that if I can get it to stay on it will work really well.

Liz

One possibility is after you put the cover over the jell, put a moist cloth over the cover. The evaporation will cool the skin down and may keep the mix from liquefying as fast. With the amount of time you are numbing the area, you might need to wet the cloth again.

Quote from: Dena on June 04, 2016, 05:48:57 PM
One possibility is after you put the cover over the jell, put a moist cloth over the cover. The evaporation will cool the skin down and may keep the mix from liquefying as fast. With the amount of time you are numbing the area, you might need to wet the cloth again.

Dena that is a fine idea!

I have just completed another experiment and this time I did not cover the area and left it for just on two hours. I wiped and then proceeded to stick a syringe needle into the area...it worked. I can't believe how different it feels, there is a definite cold sensation over the area which remains at the 45 minute mark after taking it off...when I first took it off I managed to draw blood with the needles and felt only a slight prick which is far far better than it ever has worked.

I like the idea of a compress over the sealed dressing to keep it from liquefying...I think that is a great idea.

Ok so the next experiment will be sealed and covered with a cold compress. I understand the need to cover to help the absorption but even without coverage it penetrates far better than with a cover because it is not turning to liquid.

I am also going to run some more tests to see what the minimum time requirement is. With the original formula it was to be on no longer than 3/4 of an hour.  But they refused to make the original compound and reduced Anesthetic percentages accordingly. But even still there is plenty in there to numb you up if applied for the correct length of time which I think is most likely around the hour mark.

I am absolutely stoked to actually get it working properly and I feel I could tolerate 30 minutes of Electrolysis at this level of Numbness. Yahoo :icon_bumdance-nerd: :icon_bumdance-nerd: 

It is now 1hr 15min since removing the cream...I still have a clear sensation of cold and altered touch. If I dig my nail in a little I get a dull sensation....  ???

It has never worked like this before

Quote from: ElizabethK on June 04, 2016, 08:15:08 PM
I have just completed another experiment and this time I did not cover the area and left it for just on two hours. I wiped and then proceeded to stick a syringe needle into the area...it worked.

I admire your dedication. I'd not be comfortable doing that.

Quote from: ElizabethK on June 04, 2016, 08:15:08 PM
I like the idea of a compress over the sealed dressing to keep it from liquefying...I think that is a great idea.

Ok so the next experiment will be sealed and covered with a cold compress. I understand the need to cover to help the absorption but even without coverage it penetrates far better than with a cover because it is not turning to liquid.

I believe cold makes topical anesthetics less effective and you're not actually supposed to heat them because its not safe (and probably works so much better). Worth a try though.

I wonder if covering it with some kind of fabric/bandage under the wrap would help. It might adsorb into the fabric and get slowly released. Perhaps even slices of those long band-aids cut in slices so the dressing in them goes edge to edge. If it worked you could peel them off one at a time.

At the 2hr 15min mark I could still feel its presence but had almost normal sensation

At 3hrs 15min I have only a ghost of a sensation.

Quote from: AnonyMs on June 04, 2016, 10:26:51 PM
I admire your dedication. I'd not be comfortable doing that.

I believe cold makes topical anesthetics less effective and you're not actually supposed to heat them because its not safe (and probably works so much better). Worth a try though.

I wonder if covering it with some kind of fabric/bandage under the wrap would help. It might adsorb into the fabric and get slowly released. Perhaps even slices of those long band-aids cut in slices so the dressing in them goes edge to edge. If it worked you could peel them off one at a time.

At this stage even if I don't cover it the result is way better. They have changed the ointment so they could add a better type of gel that will keep it all together but even as a cream without any wrapping its about 100 times more effective because it doesn't turn to liquid.

Never thought about the gauze strip idea but worth some thought...I just don't know if I even need the extra plastic wrap..its pretty effective without it.

Liz

I had a crazy idea. If you are doing an extended session, apply the cream to half your face. Apply the other have shortly before starting the session. Have the work done on the first half first then move to the second half when the cream start wearing off. You should be relatively pain free most of the session if you get the timing right.

Quote from: Dena on June 04, 2016, 10:55:08 PM
I had a crazy idea. If you are doing an extended session, apply the cream to half your face. Apply the other have shortly before starting the session. Have the work done on the first half first then move to the second half when the cream start wearing off. You should be relatively pain free most of the session if you get the timing right.

I think that might actually be dangerous. That strength of topical anesthetic should probably be kept to a relatively small area.

Quote from: ElizabethK on June 04, 2016, 10:49:21 PM
At this stage even if I don't cover it the result is way better. They have changed the ointment so they could add a better type of gel that will keep it all together but even as a cream without any wrapping its about 100 times more effective because it doesn't turn to liquid.

Would you mind posting the new formulation?

Here it is in the form I currently have it. The biggest difference is the Gel Percentage against the reduced Anesthetic agents from the original formula.

Should only be used at a max of 2 grams per application(From the compounding Chemist). Should be left on no longer than an hour(when using in these quantities) but I get the idea that you shouldn't need it on longer than an hour with the high percentage of Anesthetic.

Personally I have not tested it properly at the one hour mark yet but the results at 2 hours have been great to say the least. I have not covered it as they recommend due to it melting but we are working on that. I douibt they would recommend this if you have a heart issues.   

Liz

I missed the gel in the previous post. Its this?

Poloxander 20% transdermal Gel

I can't find that with google. Is it a typo? I found Poloxamer gel which is used for this sort of thing

https://en.wikipedia.org/wiki/Poloxamer

It looks like Poloxamer is a class of gels rather than being a specific one. Would you mind finding out exactly what it is, brand name and all, so I can get the same thing if I ever need it.

Typing straight of the bottle

Benzocaine 20% Lidocaine 6% Tetracaine 4% DMSO 10% Poloxamer 20% Gel, so yes, sorry, it was a typo...I also ment to paste the the above info into that post but as you can see got side tracked.

My Compounding Chemist was all set to argue with me about the strengths of the Anesthetic but called her Tech Support who told her not to reduce the Anesthetic level any more considering it was for Electrolysis. The levels asked for were expected and acceptable because of the procedure.

Hope this helps

Liz

Thank you, Elizabeth!   This is very timely information for me, as this chicken is calling to set up my first appointment to get plucked tomorrow.

Eep!

As always, I appreciate the great information shared on this site.

Quote from: Michelle_P on June 05, 2016, 04:28:39 PM
Thank you, Elizabeth!   This is very timely information for me, as this chicken is calling to set up my first appointment to get plucked tomorrow.

Eep!

As always, I appreciate the great information shared on this site.

I hope it helps but be prepared to be told the amounts of Anesthetic are way to high...I was told by the chemist to use no more than two grams at a time which should be enough to cover each cheek. They advise to cover and leave for 45-60min. Your Dr may have other instructions but I do know that it is very strong...I have had far better results leaving uncovered simply because when covered it turns to liquid from the heat coming off the face...The formula is not quite complete as we are still trying to wrok out how to get it covered and not melt...then you can use way less and cover it to make the stuff you do have on work even better.

I would also suggest you try Emla cream but test it out on yourself first to see how long and how much it takes to get the right effect. Covering and giving enough time is important...with Emla cream you need enough on so you cannot see the skin.

Good Luck and I hope it goes well

Liz

Quote from: ElizabethK on June 06, 2016, 02:22:50 AM
I hope it helps but be prepared to be told the amounts of Anesthetic are way to high

I bet they would change their tune on that if they tried electrolysis themselves. Its not nearly high enough.

Quote from: AnonyMs on June 06, 2016, 06:16:54 AM
I bet they would change their tune on that if they tried electrolysis themselves. Its not nearly high enough.

Oh yeah the Chemists were really having a go at me about how high it was...they rang their tech support who basically explained how painful Electrolysis was and that it was more than appropriate...The chemist told me this last time we spoke.

Liz

Thanks!  I've got my first hour in The Chair next Monday.  (I'm a big chicken...)