Topical anaesthetics

We recommend using local topical anaesthetic cream both immediately before a procedure, and during a procedure. It is both for your  comfort and also to constrict the blood flow which leads to a better result. This information is designed to help you understand what is currently safe and legal in Australia, and learn about our recommended way of obtaining the essential part of permanent makeup procedure.

We, at Resilient Beauty Studio, have been working with compounding pharmacies to develop truly effective, and legal, numbing creams and gels. We’ve learned a lot, tested a lot, and we’re happy to continue to share the results with you, our customers.

It’s really important to get the base cream or gel right. Get them wrong and the skin won’t absorb the anaesthetic (= Pain). Pre-treatment numbing cream needs to be water-based, otherwise it won’t absorb. The pH of creams and gels needs to be close to 7 for the skin to absorb them quickly. Standard creams and gels are often acidic (low pH to preserve the anaesthetic), which can be a problem.

Topical anaesthetic and regulation of its use

The topical anaesthetics are deemed to be a medication in Australia and are controlled by federal and state & territory government regulation. Topical anaesthetics are considered a ‘high risk’ product and must be produced by a TGA-approved manufacturer. This can be identified by the ‘AUST R’ number. If your topical anaesthetic does not have an AUST R number or was not made by a compounding pharmacist it is illegal to use within Australia.

The main ingredients in topical anaesthetics can include one or more of the following: lidocaine (lignocaine), tetracaine, benzocaine, prilocaine and adrenaline (epinephrine). All these substances are regulated.

Topical anaesthetics with concentrations between 2 and 10% are classified under Schedule 2 of the Poisons Standard 2010 (and amendments). Topical anaesthetics containing epinephrine (adrenaline) in concentrations of 0.02 – 1% (used to stop bleeding and swelling) are classified under Schedule 3. Products with lower concentrations may also be regulated but are unlikely to have any significant anaesthetic effect during cosmetic tattooing procedures.

Ordering topical anaesthetic

As an outcome of strict regulations, we’re unable to supply our clients with anaesthetic cream – it needs to be obtained from the pharmacist as it is specifically for client’s personal use and applied themselves. To make this process easier, we have established an arrangement with a Compounding Pharmacy to be able to directly supply such anaesthetics for client’s use before and during their procedures.

Details of the product

Standard supply is:

1. Pre-procedure cream (10% anaesthetic strength)– 1 x 5gm tube –
2. During procedure gel (10% anaesthetic strength with epinephrine to control bleeding)– 1 x 5gm plunger

The order comes individually dispensed and packaged.

Ordering process

1. Please fill out online Patient Care Checklist – This form gives Compounding Pharmacy all the information they need to safely dispense the product. It provides information on the date and place you are having a procedure, which tells Compounding Pharmacy by when and where to send the product. There is an integrated payment page and patient care checklist to avoid any possible delays getting the product in time for your appointment.
2. This form is screened by Compounding Pharmacy pharmacist to ensure the product is suitable and safe to use without any adverse reactions. You may be contacted at this point if they are concerned
3. Compounding Pharmacy sends the product to you before your procedure date, which you put in the checklist information.

This process does need to happen with enough time for Compounding Pharmacy to make, dispense and deliver to you (minimum of 3 business days notice) via Australia Post Express Post or Aramax Couriers.

Specific caution on over-the-counter topical anaesthetic

We generally do not recommend obtaining over-the-counter topical anaesthetic as they contain limited amounts of main ingredients and therefore have limited effectiveness during permanent makeup procedure.

For example, A popular choice of over-the-counter topical anaesthetic is EMLA. This cream contains 2.5% lignocaine and 2.5% prilocaine. What you also need to be aware of is EMLA has a relatively high pH (approximately 9), which means it is more alkaline than other topical anaesthetics and may burn particularly sensitive body tissue. As a result, conducting eyeliner with EMLA is not recommended because of the risk of contact with the eye, which may result in injury resulting in the need for hospitalisation and extensive treatment (Alkaline chemical ocular injury from Emla cream, Brahma & Inkster, Eye (1995)).