Reducing discomfort/pain with dermatologic aesthetic procedures

Just came across this site by accident. Very informative. I am 57 with cheek wrinkles (not deep) and marionette lines and was considering laser treatments but I am terrified of the pain. Many places apply numbing cream but with my experience (tattoo) this barely touches the pain. Is there something else they would use to lessen the pain? Thank you.

Thank you! And who likes pain? Unless it’s for a soul cycle/spin hour, not too many people I know. 🙂 Especially if it involves needles or lasers, so consequently good clinics really do their best to make their patients as comfortable as possible during dermatologic aesthetic procedures. It’s never going to be completely pain free, but here are some ways it can be made a lot more comfortable. You want to be in a clinic where your overall health is important! Here’s some information to consider. Most importantly, it’s fine to ask your doctor/PA-C/ARNP or nurse provider about these.

Topical Numbing (Cream):

  • These really vary office to office. These are compounded by an FDA certified specialty pharmacy, and some versions are better than others. You could ask an office for a tiny amount to take home to test on your cheek or forearm. Test at 20 min, 40 min and 60 min. How numb are you?
  • Many clinics offer this type of numbing for 20-60 minutes, at the clinic, for aesthetic patients.
  • The at the clinic part is important, because too much topical numbing done by patients themselves, has caused deaths. It’s true! Too much can cause a heart arrhythmia.
  • Applying the cream should be done by a doctor, nurse or certified medical assistant. They should be medically trained. Again, deaths have been reported when these are not used correctly, even at clinics.
  • They often contain a small amount of something that temporarily constricts blood vessels (epinephrine), which also helps to prevent bruising.
  • If you have an allergy to these, be sure to let your provider know.

Injectable Numbing:

  • This is done usually for procedures that go deeper like the deeper lasers, acne scarring subscision, or any kind of surgery.
  • Medical trained personnel calculate how much is safe for your body weight, age, and kidney/liver function. You won’t know they are doing this usually, but they are.
  • And if you have had a reaction to these in the past, it’s important to let your providers know.
  • If the lidocaine or other “caine” injectible is buffered, it makes it much more comfortable. Ask your doctor.
  • Injecting slowly also makes is easier.

Oral Pain or Anxiety Medications (I’m going to be honest here):

  • We and most good offices don’t use these OR require a verifiable person to drop off and pick up you as a patient.   UBER/LYFT DOES NOT QUALIFY.
  • Most of the time, these are not needed!
  • There have been many problems over the years with these. Some people try to cheat on the driver issue, some try to get more than they really need for the procedure, and some take more than they are supposed to… etc.
  • Mental and physical impairment on these is not perceived by the patient taking them. Another reason they are dangerous.

Conscious Sedation (IV):

This are not usually offered in most office for minor procedures. The dangers outweigh the benefits, and most offices (not surgery centers) don’t have the personnel who can administer it properly. Board certified anesthesiologists or nurse anesthetists are needed. This is the type of sedation you would have, for example, with a colonoscopy.

Hope this helps,
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
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Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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