SAFE USE OF TOPICAL ANESTHETICS
The anesthesia process is an integral part of the permanent makeup procedure and sometimes determines the final result. Clients are calmer when they don’t feel pain, so the artist can work more confidently and with few interruptions, thus creating quality results.
One of the biggest concerns clients have when getting permanent makeup is pain, so naturally, this will create feelings of stress. You can offer a procedure with minimum discomfort; this is vital for both your client and you. However, it is imperative to recognize that anesthetics are drugs with a pharmacological effect; therefore, they must be used safely.
If your client feels pain, you can’t work as smoothly. You may be unable to make the number of taps and passes necessary for sufficient pigment implantation, 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 will give you information to help 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;
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, several factors beyond the anesthetic itself 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, injection of anesthetic into the skin is limited to medical personnel.
Topical anesthetics are available in many pharmaceutical forms, including gels, creams, ointments, lotions, and sprays.
Mechanism of action:
PMU Topical anesthetics reversibly block nerve conduction near the administration site, 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 excitability threshold, ultimately preventing 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 action begins fast, with an initial response obtained in approximately 1 minute and an effect lasting about 15-20 minutes. Anesthetic agents are metabolized in the liver, and the kidneys excrete their metabolites. The anesthetics should be used in small doses.
Use a micro-brush for the application of topical anesthetics. Please avoid the use of cotton swabs because they absorb the anesthetic. The micro-brush facilitates a precise and controlled application of the anesthetic, especially in the area of the eyes.
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The concentration of the topical anesthetic is critical. For eye makeup procedures, 3-5% lidocaine concentrations 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.
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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. Using the product in minimum quantities several times is better than applying too much in a single application.
Numbing Combo -Block Aid and Minnerva II
Do not let your client feel pain. Re-apply the product every time you make a pass with pigment
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Do not ask your client if they feel pain. When you ask them if they feel pain, their mind immediately thinks about the pain. You should ask them if they feel good, prompting them to think about feeling good.
Softap offers two types of topical anesthetics for Microblading and PMU: Block Aid and Minnerva II. Combining the two products facilitates a more significant anesthetic effect while producing vasoconstriction, reducing the bleeding risk
PHASE I. BLOCK AID
Instructions for use:
1. Prepare the skin by making light taps with the needle without pigment in the area to be treated.
2. Apply only on the application site, rubbing gently.
3. After application to the area, a 5 to 10-minute wait time for absorption is recommended before preparing the skin for phase II.
4. Block Aid should be re-applied after each pigment application before using Minnerva.
PHASE II. MINNERVA II
This product is recommended for the temporary control of pain, inflammation, and bleeding due to its anesthetic and vasoconstriction effect.
Composition: 4% USP Lidocaine and .04% mg Epinephrine HCL, antioxidants, and a complex pigment retainer.
Instructions for use:
1. Use after the Block Aid application.
2. Apply Minerva II with a micro brush for greater precision.
3. A 2-minute wait time is recommended before starting to implant color. You will notice it has begun to take effect when the skin changes slightly in color, becoming a little pale. This effect indicates vasoconstriction is present.
4. It is recommended that Minnerva II be applied when you need to maintain the vasoconstrictor effect.
1. Apply Block Aid several times to maintain an ideal anesthetic effect.
2. 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.
3. The trust you generate with your client is fundamental. When they feel safe, they are calmer.
4. Before a lip procedure, when the client has a low tolerance to pain, suggest they take an analgesic 30 minutes before their procedure; this will help reduce the pain sensation. The client should be advised to take whatever medication they routinely take for pain management. It would be best if you didn't recommend any particular kind to avoid complications.
5. 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
1. The FDA approves topical anesthetics to relieve pain in small areas only temporarily.
2. The topical anesthetic is for external use only.
3. Topical anesthetics cannot be applied inside the eye.
4. The use of anesthetic eye drops is not recommended as it masks the sensation of foreign body irritation
5. Use a micro-brush as an anesthetic applicator for precise application
6. If the topical anesthetic accidentally comes into contact with the eye, the client may feel a burning sensation. The eye should be rinsed immediately with artificial tears
7. A corneal abrasion can occur if an anesthetic that has come into contact with the eye is not removed entirely during the eyelid procedure; this is a potential complication with any brand of anesthetic.
8. Corneal abrasion symptoms include pain, light sensitivity, 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.
9. 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 from getting between the surface of the lens and the cornea.
Additional products to have close by when applying topical anesthetics to the eye include:
1. Micro Brushes
3. 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.
I hope that what I do, inspires you for your next Procedure!
Dr. Sandra Cardona
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