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What can be used instead of lidocaine if a person has an allergy to it?

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QUESTION:  What can be used instead of lidocaine if a person has an allergy to it?Lidocaine

ANSWER: Find out more information.  The questions to ask your client are: 

1)  Who told you that you are allergic to lidocaine?  The dentist? 

2)  What happened when you got the lidocaine?

3)  Have you ever had a reaction to a cream with lidocaine?


Anything is possible but allergic reactions to lidocaine are so rare as to be reported in the medical literature.  http://www.medscape.com/viewarticle/572120_4.  This study identified 1.4% of patients who reacted positively to lidocaine over the 5-year period of their study.

A rapid heart beat and sense of impending doom just after the dentist injects the local anesthetic is from epinephrine injected into the blood stream and not an allergic reaction to lidocaine.

If your client gets a rash or redness a day after they have applied a lidocaine product such as an anti-hemorrhoidal preparation, then they should be "patch-tested" by a doctor.  Histamine is released in an allergic reaction which results in redness and swelling of the area.

PERSONAL OBSERVATIONS OVER 43 Years:  I have yet to see a patient allergic to lidocaine.  I've heard of one case of latex allergy (gloves), several from Bacitracin, a few from A&D Ointment and so on.  However, a preservative in lidocaine, methylparaben, can and does cause dermatitis from the PABA metabolite.    What do I do?  I take a careful history to rule out any proven allergy to lidocaine.  Then I put a dab of the topical anesthetic with lidocaine only and cover it with a band-aid, check it after about 30 minutes and then send them home with instructions to remove it the next day and report to me if their skin is itchy or red.  If I determine that they were told by their dentist that they have an allergy, chances are I just proceed as normal (with caution) to apply the topical anesthetics and complete the procedure.  People can have sensitivity to local anesthetics but most often the skin gets red and swollen because the anesthetic numbs the nerves to BOTH pain and to the blood vessels.  Topical anesthetics are not absorbed rapidly as a rule and the small amount we use for permanent makeup is not going to cause problems.  The alternative to lidocaine is tetracaine (Numfast Green Cream).  There is no cross sensitivity between these anesthetics.


Q&A: What Areola Colors should I use?

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Areola-Chapman-with-painted-on-pigmentQuestion: Hi Linda, ...  I also do tattoo the nipples so they can look nicer, do you have the color specially for this purpose? My customers are mainly Asians.  Thank you very much for your time, TT
: Dear TT,

Areola: This photo shows an areola where I have painted on the desired colors first. I always start an areola with NUDE LIP and AREOLA Mix (the darkest color).  Then I put a little half-moon shadow below the nipple area in HONEY NuBrown.  I use a little NEUTRAL FLESH to highlight the nipple in a little half-moon above the nipple. Sometimes you want a very soft areola color and that is called BABY LIPS and AREOLA. Baby Lips softens the outer border of the areola and is excellent for fair clients with pale, pink areolas.  I always paint on the color and then start working over that. The 5 Slope® Needle is the best needle by far for Areola work, including the scars. I've also learned to tilt the 5 Slope® Needle at about a 15º angle as I work. SAVE! when you buy the Areola Kit-1 #9982 with 7 colors.  5 Slope® NeedleI've shared several Areola videos on youtube.com. Just search for my name there: Linda H Dixon MD (or Dr. Linda Dixon)  Note: Do not put in color over scars that are outside of the areola itself.


Fever Blisters (Herpes): How I handle them

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Valtrex_500mgFever_blisterYou've asked how I treat my patients with Fever Blisters who are to undergo a lip procedure.  I prescribe Valtrex 1500 mg in a single dose the day before or the day of the treatment.  That's 3 ea., 500 mg. tablets, at one time. If there is any hint of a breakout at Day 2 or 3, they need to repeat the same dose, Valtrex 1500 mg.  So I make the prescription refillable x 1. Valtrex comes in 500 mg tablets and the dose is 3 tablets at one time.  I no longer prescribe longer periods of taking Valtrex and I don't prescribe Acyclovir because it doesn't seem to work as well.  There's less chance that they'll forget to take their medicine when they only have to take it once, or maybe twice.  For the pain of a herpes breakout, there's nothing better than Numstick 5% lip balm.  I give all clients Numstick 5% lip balm to help the discomfort of lipcolor procedures. Keep several on hand for your lipcolor clients.  Also, Liprotek 7 has an anti-herpes ingredient in addition to a topical anesthetic for all known herpes clients. Fever blister outbreaks are inevitable in our profession because 20% of people with the herpes virus do not know they have it.  Rule:  Always get a history of fever blisters and document it on your chart.  No matter if it's been years since they had a breakout.  Treat everyone with herpes with Valtrex.  If someone breaks out without a known history of herpes, don't be surprised.  Just tell them to get treatment right away.  It's not your fault.

Brow Rehab™ Video

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Soft Focus Eyeliner/Shadow

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Pewter_eyeshadowPewter_bottleSoftening the eyeliner with a smudgy color or blurry border is become very popular.  The SHADOW FX needle lets you "paint it on and tap it in" in a few easy steps.YouTube  This client chose Pewter for her main color.  On her touchup visit, we put a little Camelot on the inner 1/3 toward the nose.  We'll see if she needs her eyeliner crisped up at her final visit.  If you know the handtool, you'll appreciate how the color flies into the skin with the SHADOW FX (Special Effects) needle.  25 points/Sloped Round Velvet Needle®.  Questions?  Call 888/664-9990

Dry Needling Wrinkles: Does it really work?

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Pesky_Wrinkle_Series_webwrinkleserumFebruary, 2010, I was doing Botox® injections on my patient and told her I'd like to try to help her with a "pesky wrinkle" on her Right upper lip.  She was a none smoker.  Long story short, I did microneedling once in February 2010 (see photo 2) and again in May 2010 (see photo 3).  She came in on January 5, 2011, and I couldn't find her "pesky wrinkle". (see picture 4 above right).  I'm sharing this case because it illustrated that dry needling of wrinkles takes patience to see results.  This patient is thrilled with the dry needling and I sent her home with the "Wrinkle Serum" to help maintain her skin in optimal condition.  Click here for Wrinkle Serum.  Most clients will appreciate dry needling of isolated wrinkles around their mouth.  And assure them that it can take time for tissue "remodeling" to occur from the healing process.  They can start using "Wrinkle Serum" morning and night (one drop applied to clean face) to help enhance their collagen deposition, help detox their skin, increase microcirculation and relax underlying tissues.  Seeing is believing.  I use the 5 Slope® Needle in my digital machine for dry needling wrinkles and scars (including areola scars and acne scars).  I run the needle down the middle of the wrinkle and also "sweep" normal tissue toward the wrinkle.  It is the platelets in the blood that release several "growth factors".  Platelets also attract fibroblasts that rebuild collagen.  You should get some bleeding but be careful to not "overwork" the skin.  Limited Time Special Pricing:  2 bottles for just $39.95.

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