Using Lidocaine Cream for Needle Pain

Some treatments are painful, like getting a needlestick (venipuncture), starting an IV, or putting a needle in a port. Your care team can help your child feel less pain. They may numb your child's skin before treatment with a medicine called lidocaine. 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 the needlestick will not feel painful. 

Your child might get lidocaine cream before getting shots (injections). For shots, they might feel pain or irritation from the medicine but not feel pain from the needlestick.

How to apply lidocaine cream 

You can put lidocaine cream on your child's skin. Lidocaine cream works best when you put it on your child’s skin 30 to 60 minutes before the treatment or procedure. 

Gather these supplies: 

• Lidocaine cream 
• Protective bandage – This is a clear plastic bandage that is sticky on one side.
• A glove – It does not need to be sterile.

Follow these steps:

1. If you see dirt on your child's skin, clean the skin with mild soap and water. 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 to clean the skin where the medicine will be placed because this removes the oils. 
2. Wash your hands with soap and water and dry them well. You may also use an alcohol-based gel or foam hand cleaner.
3. Put on the glove as directed. Take the cap off the lidocaine cream. Turn the cap around so the point faces the tube opening. Place the pointed end of the cap directly on the tube. 
4. Turn the cap on the tube. The point on the cap will puncture the opening of the tube so you can squeeze out the cream. 
5. Squeeze out the amount of the cream ordered and gently rub it into your child's skin where told with the gloved hand. Follow any instructions the nurse or doctor gave you about how much cream to use. Avoid putting the cream on skin that is cut, scraped, red, swollen, or sore. Do not put it on any part of your child's body where they will have radiation treatment. 
6. In the same spot where you applied the small amount of cream, squeeze out half of the tube of the remaining lidocaine cream onto the skin. Do not rub this cream into the skin. Leave it in a thick layer. 

How to apply a protective bandage

Your child needs a protective bandage to keep the cream in place. Follow these steps to apply the bandage.

1. Open the package with the protective bandage.
2. Take the center, cutout piece of paper off the bandage. Take the paper off the back of the center piece. The paper covers the sticky side of the bandage.
3. Put the sticky side of the bandage over the lidocaine cream. The center of the bandage should lie directly over the cream.
4. Remove the paper from the outer edges of the bandage. Press down gently on the edges of the bandage so they stick to the skin and form a seal.
5. Be sure the cream stays in a thick layer.
6. Write the date and time on the bandage.  You can also write the date and time on the label from the package and put the label on the bandage. With this information, the nurse can tell if enough time has passed to numb your child's skin.

If your child gets an IV, your nurse may ask you to apply the cream in 2 places on the skin. Use half of the tube on each place.

Wash your hands with soap and water when you finish.

Care after applying lidocaine cream

Once the cream is on your child's skin, you need to:

• Leave the bandage over the cream until just before treatment starts. Watch your child to make sure they don’t remove the bandage.
• Leave the cream on for 30–60 minutes.
• Keep the cream at room temperature (59–86°F, 15-30°C). Avoid heat and cold on the bandage. Temperature changes could make the cream work faster or slower than it should.

The nurse will remove the bandage and cream before treatment and clean your child's skin. 

Helpful tips:

• When removing the bandage with lidocaine cream, 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, speak to your doctor, nurse, or pharmacist. 
• Store the lidocaine cream at room temperature (59–86°F, 15-30°C).
• Throw away the cream if the expiration date on the tube has passed.

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 return to its usual color in time.
• Swelling, itching, or rash — These side effects should go away after 1 or 2 hours. If not, tell your child's doctor.

Tell your child's doctor right away if your child has any of these side effects:

• Lightheaded, dizzy, or sleepy
• Nervous or confused
• Hearing a ringing noise
• Blurry vision or seeing double
• Throwing up (vomiting) suddenly
• Feeling hot, cold, or numb all over
• Twitching or shaking

Remove lidocaine cream from your child's skin if they have any of these side effects. Call their doctor or nurse. 

If your child has breathing problems or seizures, call 911 or emergency services. Take the lidocaine cream off their skin.

For more information

Read helpful information about needlesticks and other ways to manage pain:

Questions?

If you have questions or concerns about lidocaine cream, please talk to your child's doctor or nurse.