The lidocaine/tetracaine peel: a novel topical anesthetic for dermatologic procedures in adult patients.

BACKGROUND The 7% lidocaine and 7% tetracaine (LT) peel is a self-occlusive, topical local anesthetic that has been proven safe and effective for use in conjunction with many dermatologic procedures, including cryotherapy, collagen injections, and various laser treatments. The product is applied directly to the skin as a cream that dries within 20 to 30 minutes of air exposure to form a flexible film membrane that is easily peeled off before surgery. OBJECTIVE The objective was to review the safety and efficacy of the LT peel in controlled, randomized trials involving adults undergoing both minor and major dermatologic procedures. METHODS All published studies involving the LT peel were reviewed, and the results of each were analyzed and collated to provide practical guidelines for clinical use. CONCLUSION Studies comparing the LT peel with placebo or a 1:1 eutectic mixture of local anesthetics (EMLA) cream have shown the LT peel to have superior anesthetic efficacy in adult patients undergoing a variety of cutaneous procedures. The LT peel is safe and well tolerated, with side effects limited to localized, transient skin reactions that do not appear to interfere with clinical outcome. It is an effective topical anesthetic for dermatologic procedures that is convenient to use and promotes a positive patient experience.