Some treatments, such as starting an IV or putting a needle in a port, are painful. We want to help your child have less pain whenever possible. One way to do this is to numb the skin first, using a medicine called lidocaine (“LIE-doe-kane”).
Lidocaine is available in a cream you put on your child’s skin. The medicine in the cream only goes into the skin’s top layer. Your child will feel pressure from the needle going through the skin, but will probably not feel pain. Besides getting lidocaine cream before procedures, your child might get it before some types of shots (injections). For shots, they might feel some pain or irritation from the medicine, but not feel pain from the needle.
Lidocaine cream works best when you put it on the skin 30 to 60 minutes before the treatment or procedure. This article tells you how to use lidocaine cream safely.
How to use lidocaine cream
Gather these supplies:
- Lidocaine cream
- Protective bandage – This is a clear plastic bandage that is sticky on one (1) side.
- A glove – It does not need to be sterile.
Follow the steps below.
- Wash your hands with soap and water and dry them well. You may also use an alcohol-based gel or foam hand cleaner.
- The nurse will tell you where to put the cream. Do not use it on skin that is cut, scraped, red, swollen, or sore. Do not put it on areas where your child is having radiation treatment.
- Follow any instructions the nurse or doctor gave you about how much cream to use. It will be about half the tube.
- You may clean your child’s skin with mild soap and water if you see dirt on it. It is best to leave the natural oils on the skin to help the medicine work as well as possible. Do not use alcohol or acetone, because this removes the oils.
- Put on the glove and take the cap off the lidocaine cream. Turn the cap around so the point faces the opening of the tube. Place the pointed end of the cap directly on the tube.
- Turn the cap on the tube. The point on the cap will puncture the opening of the tube so you can squeeze the cream out.
- Squeeze out a small amount of the cream, and gently rub it into your child’s skin with the hand wearing the glove.
- Then, squeeze half the tube of the remaining cream onto the skin where you just applied the small amount of cream. Do not rub this cream into the skin. Leave it in a thick layer.
Using the protective bandage
Your child will have a protective bandage to keep the cream in place. Follow the steps below to put on the bandage.
- Open the package with the protective bandage.
- Take the center cutout piece of paper off the bandage. Take the paper off the back. This paper covers the sticky side of the bandage.
- Put the sticky side of the bandage over the lidocaine cream. The center of the bandage should be directly over the cream.
- Take the paper off the outer edges of the bandage. Seal the edges of the bandage onto the skin.
- Be sure the cream stays in a thick layer.
- Write the date and time on the bandage, or on the label that is in the package. Put the label on the bandage. This tells the nurse when enough time has passed for your child’s skin to be numb.
If your child is getting an IV, we will ask you to put the cream in 2 places on the skin. You should use half of the tube on each place.
Wash your hands with soap and water when you are finished.
After lidocaine cream is on the skin
Here are some important things to do once the cream is on your child’s skin.
- Leave the bandage over the cream until just before treatment starts. You might need to watch your child so they leave the bandage on.
- Leave the cream on for 30–60 minutes.
- Keep the cream at room temperature and avoid heat and cold on the bandage. They could make the cream work faster or slower than it should.
The nurse will take off the bandage and cream before treatment and clean your child’s skin as usual.
- If you take off the bandage with the lidocaine cream on it, fold it in half so the sticky side sticks to itself. Throw it away in the trash.
- If you get lidocaine cream on your skin, wash it off with soap and water. If you have concerns about the lidocaine cream getting on your skin, call 901-595-3300 and ask to speak to the pharmacist. You can also ask for your child’s primary clinic doctor or nurse.
- Store the lidocaine cream at room temperature (56–89 degrees F).
- Throw away any cream if the expiration date on the tube is past.
Keeping your child safe with lidocaine cream
The lidocaine cream could keep your child’s skin numb for as long as 90 minutes after it is removed. This happens because your child’s skin absorbs the medicine. Your child might say they can’t feel anything in the area. They might scratch, rub, or put very hot or cold objects there. Watch that they do not hurt themselves before the numbness wears off.
Keep all lidocaine cream out of reach of children. If you use only half of the tube, you may save the rest for the next time your child needs it. It is important to remember:
- Keep lidocaine cream away from the ears, eyes, mouth, and open wounds.
- Throw away any lidocaine cream as soon as the medicine is no longer needed.
- Do not let your child wash the area while the bandage is on.
Lidocaine cream should not be used:
- By anyone who is allergic to lidocaine (xylocaine) or other local anesthetics (pain relievers)
- For an IV or port that we will use to give certain medicines within 2½ hours. These medicines are ones that could cause blisters, such as MRI contrast dye. Your child needs to be able to feel any irritation so we can treat blisters quickly if they happen. If your child had lidocaine cream earlier, it needs to wear off before they get any medicine that could cause blisters.
Side effects of lidocaine
All medicines have side effects. Some lidocaine side effects are mild, and you do not need to tell your child’s doctor about them. These include:
- Skin turning white where you put the lidocaine cream. It might turn red later but will go back to its usual color in time.
- Swelling, itching, or rash. These side effects should go away after one (1) or 2 hours. If not, tell your child’s doctor.
Tell your child’s doctor right away about the following side effects.
- Feeling lightheaded, dizzy, or sleepy
- Feeling nervous or confused
- Hearing a ringing noise
- Having blurry vision or seeing double
- Throwing up (vomiting) suddenly
- Feeling hot, cold, or numb all over
- Twitching or shaking
Take the lidocaine cream off your child’s skin if they have any of these side effects. Next, call 901-595-3300 and ask to speak to your child’s doctor or nurse. After office hours, ask for the doctor on call. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0.
Call 911 if your child has breathing problems or seizures. Take the lidocaine cream off the skin.
Other ways to have less pain
There are ways besides lidocaine cream to make your child more comfortable. These ways do not use medicines. They include:
- Comfort positions – These are creative ways to help your child stay calm and still when the nurse or doctor needs to use a needle. Comfort positions can help your child feel more in control and successful. To learn more, read “Do You Know… Using Comfort Positions During Stressful Events.”
- Relaxation can lower anxiety, help muscles relax, and help your child feel less pain. Deep breathing and listening to soothing music are some ways to help your child relax.
- Distraction helps your child focus on something besides pain. Counting, singing, and reading are examples of distraction.
For more helpful ideas, ask for a copy of the article “Do You Know… What You Can Do to Help Your Child in Pain.”
If you have questions or concerns about lidocaine cream, please talk to your child’s doctor or nurse. If you are inside the hospital, dial 0. In the local area, call 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once you are connected.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).
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