Adverse effects of topical anesthetics for dermatologic procedures.

INTRODUCTION: Topical anesthetics are frequently used to decrease the pain associated with a variety of procedures including cutaneous surgery, cosmetic treatments and laser surgery. They are also routinely used in children prior to invasive procedures, such as venipuncture. The ideal topical anesthetic should safely increase patient comfort associated with these procedures with minimal potential for adverse effects. AREAS COVERED: Topical anesthetic formulations have evolved over the past several decades to include formulations with improved efficacy and side effect profiles. However, significant adverse events are still possible. EXPERT OPINION: Medical practitioners can mitigate the risk of side effects and toxicity with careful selection of anesthetic type, concentration, body location and dermatologic procedure. Compounded formulations should be used with caution in medical settings only on limited body surface areas without occlusion. This review presents a detailed analysis of products available, reported complications and an outline for appropriate use of topical anesthetics in combination with dermatologic procedures.