Evaluation of a novel topical anesthetic agent for cutaneous laser resurfacing: A randomized comparison study

BACKGROUND. A variety of topical anesthetic compounds are available for use prior to minimally or moderately painful cutaneous laser procedures. A novel lidocaine/tetracaine-based peel has recently been developed that is applied to the skin as a cream and, once air dried, is removed as a flexible film that may prove useful in providing adequate dermal anesthesia for dermatologic laser surgery. OBJECTIVE. To evaluate the clinical efficacy of a novel topical anesthetic peel preparation for induction of local anesthesia prior to full-face cutaneous laser resurfacing. METHODS. A series of 20 patients undergoing full-face single-pass CO2 laser resurfacing were enrolled in a double-blind institutional review board (IRB)- approved study protocol in which two different topical anesthetic products were compared. A 4 cm x 4 cm area of one cheek was randomized to receive the novel lidocaine/tetracaine-based cream peel (S-Caine) while a 4 cm 4 cm area on the contralateral side received EMLA cream with occlusion for 30 minutes prior to laser treatment. Patients rated the level of pain experienced during laser treatment on each side using a visual analog scale. Independent assessments of observed discomfort and side effects were recorded RESULTS. Pain scores were significantly lower using the novel lidocaine/tetracaine-based cream peel formulation compared with the EMLA cream. Side effects associated with application of the anesthetic peel were limited to mild transient erythema and skin blanching. CONCLUSION. A novel topical lidocaine/tetracaine-based cream peel provides safe and effective dermal anesthesia for single-pass CO2 laser skin resurfacing.