Pre-procedure topical anesthetics like BLT cream are effective in the numbing of the epidermis prior to laser, cosmetic, and dermatological procedures. Some procedures that these anesthetics are used for include laser hair removal, dermal filler and Botox injections, and laser tattoo removal.

BLT Cream – Triple Anesthetic Cream for a Variety of Procedures

Triple anesthetic creams can provide effective cutaneous anesthesia as early as 15 minutes after application. BLT cream contains three active ingredients: benzocaine, lidocaine and tetracaine. It is one of the most potent topical anesthetic creams available for laser treatments and other cosmetic procedures. Patients almost always prefer a topical anesthetic. Topical anesthesia helps improve patient outcomes by making procedures easier for both the patient and the practitioner.

This cream can also be used by dentists before injections of Botox for treating TMD and bruxism, orthodontic therapy, and other conditions affected by maxillofacial muscles.

BLT Cream Compounding

Our benzocaine lidocaine tetracaine cream is compounded in either a hydrophilic cream or plasticized ointment base. Our product is thick, never runny and milled thoroughly two times to ensure premium quality. Healthcare professionals throughout the country who perform skin procedures trust our high quality topical anesthetic products. Different formulations are available based on your needs and can include varying ingredient strengths.

Articles

“Topical Triple-Anesthetic Gel Compared With 3 Topical Anesthetics” – Cosmetic Dermatology

“Toxicities and Maximum Recommended Doses of Topical Anesethetics” – International Journal of Pharmaceutical Compounding

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More Information About Benzocaine, Lidocaine, Tetracaine Cream

While most healthcare practitioners will use BLT Cream appropriately and safely, some are not aware that its anesthetic effects are significantly greater than over-the-counter numbing creams. These are just a few important points to remember when using BLT Cream.

• Compounded topical anesthetics are to be applied by TRAINED PRACTITIONERS ONLY. They are not intended for patients to use at home. Compounded topical anesthetic creams are significantly stronger than commercially available numbing creams. The most frequent cause for systemic toxicity from topical anesthetics is when patients apply the cream themselves under occulsion prior to laser hair removal of the legs. Patients should never be given a compounded topical anesthetic to take home. In addition, all compounded topical anesthetics are for patients and NOT FOR RESALE.
• Compounded topicals are not for use on extended areas of the body. For large treatment areas either break treatment up into multiple sessions, or limit application of the cream to select areas that are most sensitive and forgo application to less sensitive areas.
• NEVER occlude the area where you apply any compounded topical anesthetic. This method is sometimes used with lower-potency anesthetic creams, but can elevate serum concentrations of anesthetic to dangerous levels. Occlusion is not necessary with compounded topical anesthetics.
• Topical anesthetics should only be applied to intact skin. Disruption of the stratum corneum significantly enhances transepidermal absorption of BLT cream. This may be beneficial in some situations but will increase systemic levels of the anesthetics. Contact with broken skin can lead to increased systemic absorption of the anesthetic ingredients and result in toxicity.
• Early recognition of the warning signs of toxicity is essential. These warning signs may include numbness of the tongue, lips, and mouth, a metallic taste, light-headedness, tinnitus, slurred speech, muscle twitching, restlessness, and anxiety. Once it is suspected that a patient is experiencing any of these signs or symptoms, the topical anesthetic must be immediately washed off and appropriate measures taken to treat anesthetic overdose.
• Methemoglobinemia: Some local anesthetics have been associated with methemoglobinemia. The risk is greater for patients with congenital or idiopathic methemoglobinemia. Very young patients, especially infants under twelve months old, are more susceptible. Certain drugs besides local anesthetics also increase the risk of methemoglobinemia. Signs of methemoglobinemia may occur immediately or may be delayed hours after exposure, and are characterized by a brownish, cyanotic skin discoloration and/or abnormal coloration of the blood.
• Contact with Eyes: Always make sure to avoid topical anesthetic coming in contact with the eyes. Contact can cause severe irritation. Immediately wash eyes if contact is made with the anesthetic. See this article: Benzocaine/Lidocaine/Tetracaine Cream – Report of Corneal Damage and Review
• Benzoyl Peroxide Interactions: Benzoyl peroxide chemically reacts with topical anesthetics, causing a significant reduction in their numbing effect. Make sure that the skin area is devoid of any previous treatment with benzoyl peroxide or thoroughly wash skin before application. See this article: Decreased efficacy of topical anesthetic creams in presence of benzoyl peroxide
• Additive Effects of Local Anesthetics: The systemic toxic effects of local anesthetics can be additive when combined. Using a topical anesthetic with an infiltrative anesthetic or other topical anesthetics can potentially increase systemic concentrations to dangerous levels.

Efficacy of BLT Cream

Topical anesthetics have been shown to be effective in a variety of studies that used testing with painful stimuli like prick testing. Although in testing the effectiveness of a topical anesthetic it may be better to use a laser as the test can be more easily reproduced. Testing of topical anesthetics like EMLA cream with laser-induced pain have demonstrated that they can produce a total sensory block similar to injected anesthetics. One issue with OTC topical anesthetics is that they often take too long to start working or require lengthy occlusion times – which can be dangerous  if used by mistake on a large area of skin.

While there are over-the-counter and prescription numbing creams that are commercially available, there are none that combine benzocaine, lidocaine, and tetracaine in one cream. There are a variety of medical situations where a stronger anesthetic effect is warranted and needles may be undesirable. Many patients have an aversion to needles, which can be painful themselves especially in sensitive areas of the skin.

BLT cream and other topical anesthetics can not be used effectively on the soles of the feet or on the palms as there is insufficient penetration of the anesthetic ingredients. Topicals that are made to be used on the skin should not be applied to any mucous membranes as absorption will increase significantly and possibly result in systemic toxicity. Other topical anesthetics are specifically made for application to the oral mucosa.

It is important to remember that systemic absorption is a risk of using all topical anesthetics. No topical should be applied to a large area of the skin. For example – never apply topical to an entire leg for laser hair removal. Application should always proceed in sections. If a large area of skin needs to be treated then only small areas should be numbed with the benzocaine lidocaine tetracaine cream and treated at a time. Topical anesthetics will also have an additive systemic effect when combined with injectable anesthetics – this is an important consideration if any injectable will be used.