Optimal application times of a eutectic mixture of local anaesthetics (EMLA®) cream bedore dermabrasion of vitiliginous skin

Abstract

The analgesic effect of EMLA® cream was studied in 45 patients with vitiligo in which the epidermis was removed by dermabrasion before transplantation of autologous, cultured melanocytes. The pin-prick test was also used to evaluate the anaesthetic effect. The duration of EMLA® application required to obtain optimal analgesia was found to be dependent upon the site treated. In areas with thick skin such as the dorsal aspects of the feet and the fingers, up to 4 and 6 h, respectively, were needed to obtain a good analgesic effect. When such long application times are used it is very important to apply sufficient amounts of EMLA® and to lightly massage the area every hour to check that the cream is evenly distributed and has not been displaced, which can easily happen over joints. On the face, the EMLA cream was applied 1-2 h before dermabrasion. Here, the dermabrasion must be performed within 15 min after removal of the cream, because of the rapid absorption of the local anaesthetics from the epidermal reservoir.