Journal of Clinical and Aesthetic Dermatology

APR 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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30 JCAD journal of clinical and aesthetic dermatology April 2017 • Volume 10 • Number 4 M Objective:The purpose of this s tudy was to compare the use of benzocaine, lidocaine, tetracaine (blT) cream with and without abrasive particles to see which type of cream is more ebective in r educing discomfort during cosmetic dermatologic procedures, specifically procedures using hyaluronic acid (ha) injectables. Methods: The study was conducted as a single- site, double-blind, paired study. Participants:Thirty-one subjects were enrolled. Men and women over 18, but not more than 75 years of age, were included. Participants were randomized to receive two types of blT creams in a split-face fashion to two opposite anatomical face locations that require a similar amount of filler. Results:The study found a statistically significant diberence (P<0.05) in the mean pain level as measured by the Vas and Wong-baker Faces Pain Rating scale when compared between baseline and the time when the procedure was started at the first needle stick. subjects expressed significantly less pain with baseline and more pain when the procedure was done. however, the authors found that the mean pain level at first needle stick is lower with the abrasive type of blT. Conclusion:The study demonstrated that subjects experienced a higher mean pain level (but not statistically significant) when using the blT with smooth texture compared to the blT with abrasive particles when applied before ha dermal filler injection. J Clin Aesthet Dermatol. 2017;10(4):30–36. a b s T R a C T o R i g i n a l R E s E a R C h Comparative Study of Compounded Anesthetic Benzocaine/Lidocaine/ Tetracaine (BLT) Cream with and without Abrasive Particles METAVEE BOONSIRI, MD; DEANNA DIAZ, MS; THEERAYUTH SUKMEE, MD; JOYCE OKAWA, RN; CHÉRIE M. DITRE, MD Cosmetic Enhancement Center, Penn Medicine Radnor, University of Pennsylvania, Radnor, Pennsylvania Minimally invasive cosmetic procedures are now growing in popularity. Injection of dermal fillers for soft tissue augmentation is one of the most popular cosmetic procedures. 1 Patient discomfort is an important consideration in aesthetic procedures, as is fear of needles because it may cause anxiety in patients who are awaiting procedures in the outpatient seating. More effective topical anesthesia is particularly sought after by patients undergoing these treatments. Furthermore, pain ranked third in determining patient satisfaction and willingness to undergo skin rejuvenation treatments. 2 Nowadays, anesthetic mixtures are commonly used before outpatient dermatologic procedures to improve tolerability. These local anesthetics may be associated with a narrow margin of safety in some patients. Since compounded topical anesthetics have become increasingly popular, there are several challenges related to their safety. 4 Application guidelines for these compounded topical anesthetic creams are still lacking at this time. Numerous lidocaine-containing products are available. One of the most popular formulations is the benzocaine, lidocaine, tetracaine (BLT) compounded mixture. BLT comprises active ingredients of 20% benzocaine, 8% lidocaine, and 4% tetracaine and is compounded by specialty pharmacies for physicians to purchase. There have been some concerns raised about the safety of BLT because of its higher concentrations of compounded Disclosure: The authors report no relevant conflicts of interest Author correspondence: Cherie Ditre, MD; E-mail: cherie.ditre@uphs.upenn.edu

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