The Difference Between Normal and Abnormal Sensation
When you apply a tattoo numbing cream, a mild tingling or warming sensation is a common and often expected sign that the product is beginning to work. The active ingredients, such as lidocaine or prilocaine, are blocking the nerve signals in the superficial layers of your skin, which can feel like a slight buzz or warmth. However, an intense, painful, or persistent burning is a sign that something is wrong and requires immediate attention.
The Pharmacology of Numbing Creams
Numbing creams, or topical anesthetics, work by interfering with the nerve signals in your skin to temporarily block the sensation of pain. The primary active ingredients are typically 'caine'-based compounds, with lidocaine being the most common.
How Topical Anesthetics Work
The active agents in numbing cream, such as lidocaine, block the influx of sodium ions into nerve cells. Normally, when a nerve is stimulated (by touch, pressure, or a needle), it sends a signal to the brain by opening sodium channels. Lidocaine blocks these channels, preventing the signal from being transmitted to the brain, thus numbing the treated area.
Concentration and Risk
Over-the-counter (OTC) numbing creams generally contain 4% to 5% lidocaine. Prescription-strength versions may contain higher concentrations but must be used under a physician's supervision. The FDA has issued warnings about unapproved topical pain relief products containing dangerously high concentrations of lidocaine, which can increase the risk of systemic absorption. If absorbed in large amounts, these potent anesthetics can cause systemic toxicity, affecting the central nervous system and cardiovascular system.
Common Causes for a Burning Sensation
Several factors can cause an adverse reaction to a numbing cream, from a simple sensitivity to a serious medical issue.
Allergic Reactions
One of the most common reasons for a burning sensation is an allergic reaction to one or more of the cream's ingredients. This can be a form of allergic contact dermatitis, causing skin symptoms such as a severe burning or stinging sensation, redness, itching, swelling, or hives. A patch test on a small, inconspicuous area of skin 24 to 48 hours beforehand is highly recommended to rule out an allergy.
Misuse and Over-application
Applying excessive amounts of numbing cream, or leaving it on for a duration longer than recommended, can increase the chances of skin irritation or a burning feeling. The cream's active ingredients are meant for localized, temporary use. Prolonged contact can cause the skin to react poorly. The FDA specifically recommends against applying heavily or for prolonged periods.
Improper Occlusion
After applying numbing cream, the treated area is often covered with plastic wrap (occlusion) to help the cream penetrate the skin. However, leaving the plastic wrap on for too long or using it incorrectly can trap heat and increase the absorption of the active ingredients, leading to increased irritation and a burning sensation. It is important to follow the product's instructions carefully.
Application on Damaged Skin
Topical anesthetics should not be applied to skin that is already irritated, broken, or scraped. Applying the cream to an open wound or compromised skin significantly increases the risk of systemic absorption and the potential for a toxic reaction. Always ensure the application area is clean, intact, and dry.
Poor Product Quality
Substandard or unregulated numbing creams may contain harsh, untested ingredients or concentrations of anesthetics that are unsafe for topical application. The FDA has warned consumers to avoid certain unapproved products, especially those sold online with unsubstantiated claims. Buying from a reputable source is crucial.
How to Identify and Respond to a Burning Sensation
How to Respond to Burning
If you experience a burning sensation that is more than mild tingling, take the following steps immediately:
- Remove the cream and any covering, such as plastic wrap, from the area.
- Gently wash the skin with lukewarm water and a mild, fragrance-free soap to remove any residue.
- Apply a cool, damp compress to the area to soothe the irritation.
- Do not scratch, rub, or apply further products to the irritated skin.
- If the burning persists or worsens, or if other symptoms like swelling or a widespread rash appear, seek medical attention immediately.
Comparison of Normal vs. Severe Reaction
| Feature | Normal Tingling/Warmth | Severe Burning Reaction |
|---|---|---|
| Sensation | Mild, temporary tingling or warmth | Intense, painful, or persistent burning, stinging |
| Timing | Starts shortly after application and fades with numbness | May start shortly after or intensify over time |
| Appearance | Mild redness, if any | Significant redness, swelling, hives, or skin discoloration |
| Accompanying Symptoms | None, other than the expected numbing | Itching, blistering, headache, dizziness, or confusion |
| Underlying Cause | Anesthetic blocking nerve signals | Allergic reaction, misuse, or poor-quality product |
Prevention is Key
Preventing an adverse reaction is always better than treating one. Here are some best practices:
- Always Patch Test: Before applying the cream to a large area, perform a patch test on a small, less sensitive area of skin, like your inner elbow.
- Follow Application Instructions: Adhere strictly to the product's directions for application amount and duration. Do not use more than recommended or leave it on for longer than specified.
- Choose Reputable Products: Avoid unknown, unapproved, or high-concentration products from unverified online retailers. Stick to well-known brands and consider consulting with a dermatologist or your tattoo artist for recommendations.
- Communicate with Your Artist: Inform your tattoo artist that you plan to use numbing cream. They may have preferences or be able to offer guidance on approved products.
Conclusion
While numbing creams can offer a more comfortable tattooing experience, it's essential to understand the potential risks and to use them with caution. A burning sensation is a significant warning sign that should not be ignored. By understanding the underlying pharmacology and following proper application techniques, you can minimize the risk of an adverse reaction. If intense burning, swelling, or systemic symptoms occur, immediately remove the product and seek medical help. Prioritizing safety through patch testing, proper usage, and choosing reputable products is paramount for a positive and safe outcome.
For more information on the dangers of unapproved topical anesthetic products, consult the FDA's official warning.
