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Safe Use Of Topical Anesthetics
However, it is imperative to recognize that anesthetics are drugs with a pharmacological effect, and they must be used safely.
The anesthesia process is an important part of the permanent makeup procedure and, in some cases, determines the final result. When a client doesn’t feel pain, he or she is calmer, so the artist can work with more confidence and few to no interruptions thus creating quality results.
If your client feels pain, you can’t work as smoothly. You may not be able to make the number of taps and passes necessary for sufficient implantation of pigment, and you will have to perform a mandatory retouch. On the other hand, when too much anesthetic is used, there will be an interference in color fixation. Finding the perfect balance is key to achieving effective pain management and good results.
Today I am going to give you information that will help you create the best experience for your client.
The level of anesthesia that is achieved depends on several factors. They include:
- the product, the brand, and the ingredients the product contains;
- the level of pain tolerance of the client - which will vary from person to person;
- absorption of the anesthetic in the skin – another variable;
- the procedure used to apply the anesthetic – depends on the practitioner;
- the management of the client, in which the trust generated facilitates relaxation and fluid workflow.
Of course, there are several factors beyond the anesthetic itself which influence how the patient handles the procedure.
FACTS YOU SHOULD KNOW:
To do permanent makeup, regardless of the technique used, topical anesthetics (applied superficially on the skin) are much safer than injectables. When an intradermal anesthetic is injected, the risks of inflammation, bleeding, and migration of the pigment increase. Additionally, the injection of anesthetic into the skin is limited to medical personnel.
Topical anesthetics are available in many pharmaceutical forms that include gels, creams, ointments, lotions, and sprays.
Mechanism of action:
Topical anesthetics reversibly block nerve conduction near the site of administration, producing a temporary elimination of pain sensation in a limited area.
The nerve impulse conduction is blocked by decreasing the permeability of the nerve cell membrane to sodium ions, competing with the calcium binding sites that control sodium permeability. This change in permeability results in a decrease in depolarization and an increase in the threshold of excitability. This ultimately prevents the action potential of the nerve from transmitting the sensation of pain from the skin to the brain.
Most anesthetic agents that exist as solids are absorbed superficially through intact skin.
The beginning of the action is fast, with an initial response obtained in approximately 1 minute and an effect that lasts approximately 15-20 minutes. Anesthetic agents are metabolized in the liver and their metabolites are excreted by the kidneys. They should be used in small doses.
GENERAL RECOMMENDATIONS:
- Use a micro-brush for the application of topical anesthetics. Avoid the use of cotton swabs, because they absorb the anesthetic. The micro-brush allows facilitates a precise and controlled application of the anesthetic, especially in the area of the eyes.
- The concentration of the topical anesthetic is key. For eye makeup procedures, concentrations of 3-5% lidocaine are recommended. Higher concentrations can interfere with the fixation of the pigment. Furthermore, they are exclusive to medical professionals for use in other types of procedures.
- Do not apply too much anesthetic and do not apply it in advance of the procedure. Excessive application and prolonged wait time generate an effect opposite to the desired one. It is better to apply the product in minimum quantities several times than to apply too much in a single application.
- Do not let your client feel pain. Re-apply the product every time you make a pass with pigment.
- Do not ask your client if he or she feels pain. When you ask them if they feel pain, their mind immediately thinks about the pain. It is recommended that you ask them if they feel good, prompting them to think about feeling good.
SOFTAP ANESTHETICS
Softap offers two types of topical anesthetics: Block Aid and Minnerva II.
A combination of the two products facilitates a greater anesthetic effect while producing vasoconstriction, which reduces the risk of bleeding.
PHASE I. BLOCK AID

The purpose of this anesthetic is to prepare the skin for the procedure, generating a fast and effective action.
Composition: 3% Lidocaine USP & 2% Tetracaine USP.
Presentation: Cream.
Instructions for use:
- Apply only on the application site, rubbing gently.
- After application to the area, a 5 to 10 minute wait time for absorption is recommended before preparing the skin for phase II.
- It is recommended Block Aid be re-applied after each pigment application before using Minnerva.
PHASE II. MINNERVA II

Composition: 4% USP Lidocaine and .04% mg Epinephrine HCL, antioxidants, and a complex pigment retainer.
Presentation: Gel
Instructions for use:
- Use after the Block Aid application.
- Prepare the skin by making light taps with the needle without pigment in the area to be treated. (check the attached guide for lips instructions)
- Apply Minerva II with a micro brush for greater precision.
- A 2 minute wait time is recommended before starting to implant color. You will notice it has started to take effect when the skin changes slightly in color, becoming a little pale. This indicates the effect of vasoconstriction is present.
- It is recommended that Minnerva II be applied when you need to maintain the vasoconstrictor effect.
TIPS
- Apply Block Aid several times to maintain an ideal anesthetic effect.
- Apply Minnerva II when you need to reduce bleeding - but always prepare the site with Block Aid before applying Minnerva II. This will prevent the burning sensation that occurs when Minnerva II is re-applied during the procedure.
- The trust you generate with your client is fundamental. When they feel safe, they are calmer.
- Prior to a lip procedure, OR when the client has a low tolerance to pain, suggest they take an analgesic 30 minutes before their procedure. This will help reduce the sensation of pain. The client should be advised to take whatever medication they routinely take for pain management. It is important you do NOT recommend any particular kind to avoid any complications.
In order to avoid interference with the fixation of the pigment and obtain a better result:
- Avoid the use of anesthetics with concentrations greater than 5%
- DO NOT apply anesthetic in large quantities.
- Practice a soft technique, work rhythmically without interruption, and stretch the skin correctly.
SAFE USE OF TOPICAL ANESTHETICS
- Topical anesthetics are approved by the FDA to temporarily relieve pain in small areas only.
- The topical anesthetic is for external use only.
- Topical anesthetics cannot be applied inside the eye.
- The use of anesthetic eye drops is not recommended as it masks the sensation of foreign body irritation.
- Use a micro-brush as an anesthetic applicator for precise application.
- If the topical anesthetic accidentally comes into contact with the eye, the client may feel a burning sensation. It should be irrigated immediately with artificial tears.
- If an anesthetic that has come into contact with the eye is not removed completely during the eyelid procedure, a corneal abrasion can occur. This is a potential complication with any brand of anesthetic.
- Symptoms of corneal abrasion include pain, sensitivity to light, foreign body sensation and blurred vision. If your client has any of these symptoms apply natural tears and seek immediate medical help. Do not try to treat with other ophthalmological drops or pain tablets.
- If you are going to perform a procedure on the eyelids, your client should remove contact lenses. Should any anesthetic enter the eye, this will prevent the product getting between the surface of the lens and the cornea.
Additional products to have close by when applying topical anesthetics to the eye include:
- Micro Brushes
- Q-tips
- Artificial Tears
Remember that a good anesthetic, a gentle technique with minimal trauma, and a good relationship with your client will help you create better results. Below you will find the step-by-step guide to the correct application of anesthetics.
Download the guide
Dr. Sandra Piedad Cardona
POST COMMENTS


Jan Connell
After applying Blockaid do I wipe if off before applying pigment? Then the same with Minerva? Thank you

Jan Connell
I will try the Blockaid by tapping gently before I use then apply Manerrva. Do I wipe it off before I apply color? I lost a client yesterday because she wouldn’t numb. 🙏 Thanks!
Hi Jan. Yes you need to wipe the block aid after you leave it on the skin for 5-10 min. Prepare the skin by making light taps with the needle without pigment and then apply Minnerva and leave it for 2-5 min and then start applying color. Re-apply block aid and minnerva after each pass; in that case wait only one minute before you continue.