When conducting skin treatments, addressing pain ― whether minor or more serious ― may make an uncomfortable procedure more tolerable for patients. Dr. Peter Lio outlines some steps physicians can follow to make patients more comfortable.
When conducting aesthetic or dermatologic medical procedures, addressing painÂ â whether minor or more seriousÂ â may make an uncomfortable procedure more tolerable for patients. Peter Lio, M.D., of Northwestern University Feinberg School of Medicine, outlines some steps physicians can follow to reduce pain and discomfort patients may feel during an aesthetic or dermatology office visit. These recommedations were highlighted in a presentation made at the 2018 American Academy of Dermatology Summer Meeting.Â REFERENCEPeter Lio, M.D., “Pain-Free Dermatology: Minimizing Discomfort in Procedures for Children & Adults: Practice Tips.” American Academy of Dermatology 2018 Summer Meeting, Chicago, Ill., July 27.
COOLING THE SKIN
Decreasing the skin’s temperature can reduce pain, possibly by as much as 25%. To cool the skin, use an evaporative refrigerant spray, such as ethyl chloride, or wrapping ice cubes in latex or aluminum foil. (©AlbinaGlisic/Shutterstock.com)
These are mainstays in dermatology. To avoid pain from the injection, consider a topical anesthetic at the injection site. ©MBLifestyle/Shutterstock.com)
WARM LIDOCAINE (37C)
To decrease pain, administer lidocaine as a slow, deep dermal injection of about 37C. Use a buffered, warm lidocaine with a 30g needle to inject small amounts into the tissue while withdrawing the needle. (©Brumhildich/Shutterstock.com)
Apply a 1:1 mix of 2.5% lidocaine and 2.5% prilocaine approximately 60 minutes before the procedure. The mixture will penetrate up to 10mm into the tissue, providing a layer of analgesia. In some cases, the mixture can cause a temporary drop in the patient’s blood-oxygen level. New research indicates liposome lidocaine could provide faster numbing onset at 30 minutes. (©MolekuulBe/Shutterstock.com)
After any freezing procedure, apply a 4% lidocaine topical anesthetic. (©EvgenyVarlamov/Shutterstock.com)
Producing a vibration in the general injection area can limit pain. The effect is amplified if you combine vibration and cooling. (©WayHomeStudio/Shutterstock.com)
Divert the patient’s attention away from the procedure if needed. Auditory devices work well for adults and children. The sedative midazolam may be needed for difficult cases. (©Aradaphotography/Shutterstock.com)