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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Medication

Topical Lidocaine

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Back to work
N/A
Success rate
80-95% (for temporary pain relief)
Recurrence
N/A

What it is

What is Topical Lidocaine?

Topical lidocaine is a local anesthetic medication applied directly to the skin or mucous membranes to provide temporary relief from pain and discomfort. It works by blocking nerve signals in the applied area, which numbs the skin and reduces the sensation of pain. For anorectal conditions, it is available in various formulations, including creams, ointments, and gels, and is a common ingredient in many over-the-counter and prescription preparations for hemorrhoids, anal fissures, and general anal pain.

Am I a candidate?

Who are Good Candidates for Topical Lidocaine?

Topical lidocaine is ideal for individuals seeking temporary, symptomatic relief from acute pain associated with a variety of anorectal conditions, such as:

  • Anal Fissures: To relieve the severe pain associated with bowel movements, which can help break the cycle of sphincter spasm and allow for healing.
  • Thrombosed External Hemorrhoids: To reduce the acute pain and discomfort from the thrombosed hemorrhoid.
  • Post-Hemorrhoidectomy Pain: To manage pain in the immediate postoperative period.
  • General Anal Pain or Pruritus: For temporary relief of pain or severe itching from other causes.

It provides symptomatic relief but does not treat the underlying condition.

Recovery

How is This Therapy Used?

A small amount of the cream, ointment, or gel is applied to the affected perianal area. For conditions like anal fissures, it is most effective when applied 10-15 minutes before a bowel movement to numb the area and reduce pain during defecation. It can be reapplied up to 3-4 times daily as needed for pain relief. The area should be gently cleaned and dried before application. It is often used in conjunction with other treatments, such as stool softeners and sitz baths, to manage the underlying condition.

Risks & considerations

What are the Risks?

Topical lidocaine is generally very safe when used as directed. Side effects are rare but can occur. Potential risks include:

  • Local Irritation: Some individuals may experience mild burning, stinging, or redness at the application site.
  • Allergic Reaction: Rarely, an allergic reaction (contact dermatitis) can occur, causing a rash, itching, or swelling.
  • Systemic Toxicity: This is very rare with topical application but can occur if the medication is applied to large areas of broken skin or used in excessive amounts. Symptoms of systemic toxicity include dizziness, blurred vision, numbness around the mouth, or, in severe cases, seizures or cardiac arrhythmias.

To minimize risks, patients should use the smallest effective amount and avoid applying it to large, raw areas of skin for prolonged periods.

Sources

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