Instructions for Applying Numbing Cream before a Procedure

Important information:

Needles can be stressful for children and their parents. Feeling anxious about the pain or the procedure is normal. Numbing creams, comfort positions, and distractions can make the experience more manageable. While numbing creams won’t remove all the pain, they significantly decrease how much your child feels.

  • Numbing creams like EMLA® (lidocaine and prilocaine), L-M-X-4® (lidocaine 4%), and AneCream® (lidocaine 4%) are applied to the skin to help reduce pain.

  • EMLA is a prescription cream and may need to be ordered by your pharmacy. L-M-X-4 and AneCream are available over the counter.

  • These creams work best when used exactly as directed and covered properly. Follow the instructions for the cream you were told to use. 

Patient instructions:

EMLA® (lidocaine and prilocaine)

  1. EMLA cream is available by prescription only. Your healthcare provider will order it. Call the pharmacy ahead to be sure they have it in stock.

  2. Read the package carefully for storage and safety instructions. Always keep out of reach of children.

  3. Follow your healthcare provider’s instructions on how much cream to use and where to apply it.

  4. Wash your hands with soap and water for 15 seconds before and after applying the cream.

  5. 60 minutes before the procedure: Apply a thick layer of EMLA cream to clean, dry skin where instructed. Do not rub the cream in.

  6. Cover the cream with plastic wrap, like Glad Press 'n Seal®, or Tegaderm™ dressings (if provided).

  7. Seal the edges with tape to create a leak-proof dressing. This step ensures the cream works effectively.

  8. A nurse will remove the cream before the procedure. 

L-M-X-4® or AneCream® (lidocaine 4%)

  1. Purchase L-M-X-4 or AneCream over the counter from a pharmacy or online. You do not need a prescription, but you should call the pharmacy before picking up to be sure they have it in stock. These creams come in 5, 15, and 30-gram tubes. Your provider may suggest the appropriate size.

  2. Read the package carefully for storage and safety instructions. Always keep out of reach of children.

  3. Follow your healthcare provider’s instructions on how much cream to use and where to apply it.

  4. Wash your hands with soap and water for 15 seconds before and after applying the cream.

  5. 30 minutes before the procedure: Apply a thick layer of L-M-X-4 or AneCream to clean, dry skin where instructed. Do not rub the cream in.

  6. Cover the cream with plastic wrap, like Glad Press 'n Seal®, or Tegaderm™ dressings (if provided).

  7. Seal the edges with tape to create a leak-proof dressing. This step ensures the cream works effectively.

  8. A nurse will remove the cream before the procedure. 

Tips for comforting your child:

  • Be honest with your child about the procedure. Avoid statements like "it won’t hurt" or "don’t be a baby."

  • Explain that the cream helps reduce pain by "turning off the feelers on your skin."

  • Use distraction, like toys, music, or videos, before and after the procedure to help shift your child’s focus.

If you have questions, contact your healthcare provider.

 

Reviewed December 2024 by Michele Bythrow, MSN, CRNP