Topical Local Anaesthetics
Local anaesthetics can sometimes be applied to the skin, where they can absorb through the skin and may be helpful for pains arising in the skin or very close to the surface. One role for this is to make injections and other procedures more tolerable particularly in children ("magic cream") - we use two different preparations of local anaesthetic for this. However, these are not really suitable for use in the ongoing managemement of pain.
Recently, a patch preparation of Lidocaine, the same local anaesthetic which will often be used for injections by dentists, has become available. Its trade name is Versatis, and it consists of a 5% medicated adhesive plaster. This can be helpful for some nerve pains arising in or close to the skin. We would not expect it to be helpful for pains arising deeper under the surface, such as back pain.
Versatis is an expensive treatment, and so it is sensible to use it appropriately. It is recommended to use it for periods of 12 hours on and then 12 hours off. If the area of skin that is painful is small, it is very reasonable to cut the 15x10cm patch into smaller segments to match the painful area and then to keep the remainder on its backing plastic in its packet, and then to use further sections on successive days.
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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
Page updated 19/02/2016