How to Use Lidocaine Cream for Needle Pain

What is lidocaine cream?

Lidocaine cream is a medicine that numbs the skin. It helps your child feel less pain when they have treatments that use a needle.

Doctors and nurses use lidocaine cream before treatments such as:

• Shots (injections), such as vaccines
• Blood draws
• IVs (a small tube placed in a vein to give medicine)
• Ports (a small device under the skin for giving medicine)

The cream only numbs the top layer of skin. Your child might feel some pressure, but they should not feel pain from the needle. Sometimes the medicine in a shot can sting or cause irritation, but the needle stick itself should not hurt.

Lidocaine cream works best when you put it on your child’s skin 30–60 minutes before the treatment or procedure. 

Supplies needed

Gather these supplies: 

• Lidocaine cream 
• Disposable gloves (if recommended by your care team)
• A clear plastic bandage that is sticky on one side

How to apply lidocaine cream

Follow these steps in order:

1. Check your child’s skin: If it looks dirty, wash the area gently with mild soap and water. Do not use alcohol or acetone to clean the skin. These can remove natural oils that help the cream work.
2. Wash your hands: Use soap and water, an alcohol-based gel, or foam hand cleaner. Dry your hands well. Wear gloves if your care team has instructed you to do so.
3. Open 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. The point on the cap will puncture the opening of the tube so you can squeeze out the cream.  
4. Apply the cream: Squeeze out the amount that your health care provider told you to use. Gently rub it into your child's skin where the needle will go. Avoid putting the cream on skin that is cut, scraped, red, swollen, or sore. Do not use it on skin that will get radiation treatment. 
5. Add more cream: In the same spot, squeeze out a thick layer of cream (about half the tube). Do not rub this layer in. If your child needs 2 spots numbed, use half of the tube on each spot.
6. Cover with a bandage: Use the protective bandage to keep the cream in place. This bandage may be called a Tegaderm^®.

What to do next

• Wash your hands with soap and water after applying the bandage.
• Wait. Leave the bandage and cream on for 30–60 minutes, or as your care provider tells you. 
• Watch your child to make sure they do not remove the bandage.

Before the treatment, remove the bandage and cream. Then, clean your child's skin. 

Safety reminders for lidocaine cream

Help keep your family safe by following these tips:

• Keep lidocaine cream out of the reach of children. 
• Keep the cream at room temperature (59–86°F or 15–30°C). Do not let the area get too hot or cold. Temperature changes could make the cream work faster or slower than it should.
• If you use only half of the tube, you may save the rest for the next time your child needs it. Throw away leftover lidocaine cream when you do not need it anymore or if it is past the expiration date.  
• Lidocaine cream could numb your child's skin for up to 90 minutes after it is removed. Watch your child so that they do not scratch, rub, or touch anything very hot or cold that could cause injury.  
• Keep lidocaine cream away from your child’s ears, eyes, mouth, cuts, and open wounds.
• Do not let your child wash the area while the bandage is on.
• After removing the bandage, fold it 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, talk to your health care provider. 

Do not use lidocaine cream:

• If your child is allergic to lidocaine or other medicines that numb the skin 
• 2½ hours before an IV or port if your child will get certain medicines that could cause blisters, such as MRI contrast dye. Your child needs to be able to feel any irritation that happens so providers can treat any blisters that form. Wait until the numbness from lidocaine cream is gone before giving these medicines. 

When to call your care team

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 turns white or red later where you put the cream
• Mild swelling, itching, or rash that goes away after 1 or 2 hours

Remove the cream and call your care provider right away if your child has any of these side effects:

• Lightheaded, dizzy, or sleepy
• Nervous or confused
• Hearing a ringing noise
• Blurry or double vision
• Throwing up (vomiting) suddenly
• Feeling hot, cold, or numb all over
• Twitching or shaking
• Swelling, itching, or rash that lasts more than 2 hours

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

Questions to ask your care team

• How does lidocaine cream work?
• When should I use lidocaine cream to numb my child’s skin?
• How much lidocaine cream should I use?
• Where should I put the cream?
• How long should I leave the cream on?
• What should I do if my child has a reaction?