Should you use Numbing Creams?
Numbing creams have exploded in popularity among tattoo clients, especially with the rise of TikTok transformations and marathon realism sessions. But what’s really in those creams? How do they affect your body, your skin — and even your relationship with the tattoo process itself?
Let’s break it down: medically, practically, and culturally.
⸻
🧬 What Is Lidocaine and How Does It Work?
Lidocaine is a local anesthetic that prevents your nerves from sending pain signals to the brain. That’s the simple version.
More scientifically: your nerves rely on sodium channels to transmit electrical impulses. When something stimulates your skin, sodium floods in, changing the nerve cell’s charge. That electrical impulse travels to the brain and triggers your “ouch” response.
Lidocaine “plugs” those sodium channels like jamming a key into a lock. No electrical signal = no pain signal.
⸻
🧴 Forms of Lidocaine in Tattooing
There are a few ways lidocaine shows up in the tattoo world:
• Injection – Administered by licensed medical professionals for procedures. Some tattoo shops now hire nurses to inject it pre-session.
• Topical Creams – Applied 30–60 minutes before the tattoo and often wrapped in plastic to aid absorption.
• Topical Sprays – Used after the skin is broken (think: Bactine Max, Vasocaine) for mid-session relief.
⸻
⚠️ What’s Legal — And What’s Not
The FDA regulates how much lidocaine can be in over-the-counter (OTC) products:
• 5% max for OTC creams/sprays
• Up to 10% with a prescription
Here’s where it gets dicey: Some products sold online (especially on Amazon or international websites) exceed those limits, and not all labels are honest about what’s inside.
The FDA has issued official warnings about this — it’s not fearmongering.
⸻
🧠 Why It Can Be Dangerous: Lidocaine Toxicity
Lidocaine can become toxic when:
• Used in too high a concentration
• Applied to too large a surface area
• Used under plastic wrap (which increases absorption)
And yes — it’s especially tempting to do this during long tattoo sessions.
I once spoke to a nurse (yep, a nurse) who didn’t even realize she likely experienced mild lidocaine poisoning. She described feeling irrationally angry at the end of her tattoo — disoriented and mad for no clear reason. It hit me later: she was likely experiencing CNS excitation, a classic early-stage toxicity sign.
⸻
🩺 Symptoms of Lidocaine Toxicity
• Dizziness, confusion, slurred speech
• Numb tongue or metallic taste
• Irregular heartbeat or low blood pressure
• Rage or sudden irritability
• Seizures or respiratory distress (in severe cases)
Toxicity progresses in two stages:
1. Excitatory Phase – agitation, restlessness, anxiety, even rage
2. Depressive Phase – slowed breathing, unconsciousness, possible cardiac arrest
⸻
⏱️ Efficacy: How Long Does Lidocaine Actually Last?
• Onset: 20–120 minutes (if wrapped properly)
• Peak effect: 1 to 1.5 hours
• Duration: Typically 30–60 minutes once tattooing begins — despite what the label claims
Why does the effectiveness drop so fast?
Because lidocaine is water-soluble. Green soap and water (used constantly while tattooing) dilute or wash away any residual effect. That “2-hour numb” claim? Cut it in half at best.
⸻
🧬 What If It Doesn’t Work on You?
If lidocaine never works for you, you’re not crazy — you might have a gene mutation.
• The SCN9A gene controls sodium channels. Mutations here can make you resistant to lidocaine.
• People with MC1R mutations — commonly found in redheads — also tend to need 20–30% more anesthetic and have different pain perceptions.
I suspect I fall into this group myself. Lidocaine never really works on me, no matter how or when I use it.
⸻
🔁 Can You Build Resistance Over Time?
Yes — sort of.
While lidocaine isn’t addictive or habit-forming, your nerves can become less responsive over time. Overuse can also inflame or damage the skin, making absorption harder and increasing the risk of allergic reactions.
⸻
🧑🎨 My Perspective: The Downside of Numbing Creams
• Rubbery skin: Makes it hard to stretch and tattoo cleanly
• Puffed-up texture: Especially when products contain epinephrine (a vasoconstrictor)
• Uneven saturation: Ink doesn’t sit right or heals poorly
• No client feedback: Numb clients can’t tell you when something feels “off,” which can be dangerous during complex work
⸻
🌍 The Cultural Side: Why Pain Matters
Tattooing has always involved pain — and that pain is part of its power.
From Polynesian tapping to Japanese tebori, pain was part of the ritual, the respect, the transformation.
Pain can:
• Solidify the experience — it makes it real
• Build trust — between client and artist
• Reveal your threshold — and help you push it
This doesn’t mean you need to suffer to “earn” your tattoo. It means numbing should be a conscious, informed decision, not a way to bypass the process entirely.
⸻
✍️ Final Thoughts
Numbing has its place. But it shouldn’t be your default. Know your body. Know the risks. Respect the process.
Tattooing is about more than the image — it’s about presence, intention, and transformation. Pain isn’t the enemy. Sometimes, it’s the portal.
By: Andrew Heath
