Can you use topical lidocaine while pregnant

Due to a lack of controlled trials, individual case reports and commentaries were included in the review. Prior review literature including papers by Goldberg and Maloney and Lee et al. The main concerns when using injectable anesthetic drugs in patients who are pregnant include the amount of placental transfer and possibility of teratogenicity Richards and Stasko, Heinonen et al.

However, it should be noted that fetuses who were exposed to mepivacaine during the first trimester had twice the risk of congenital abnormalities compared with control subjects Heinonen et al. Hagai et al. The rate of major congenital malformations in the group of exposed patients was 4. Lidocaine is a category B drug with a long history of uneventful use during pregnancy because the fetus can metabolize lidocaine that crosses the placental barrier Kuhnert et al. The major concerns of lidocaine use during pregnancy are the accidental arterial injection and high-dose use of the agent as these two scenarios can result in an increased risk of fetal cardiac and central nervous system toxicity.

Although lidocaine is found in fillers and used in many dermatology surgical procedures, the doses that are employed are far lower than the recommended maximum subcutaneous dosage of 4.

Fayans et al. Concerns arise from the serious risk of uterine artery spasms with the administration of increased doses of epinephrine. However, the doses that are used in dermatologic surgeries are relatively low and have not been causally associated with this side effect Richards and Stasko, Moore conducted a large study in of local anesthetic drugs in patients who were pregnant and underwent dental procedures. The results of this study labeled bupivacaine and mepivacaine as category C drugs because of concerns of fetal bradycardia and preterm labor in the case of mepivacaine use Moore, , Richards and Stasko, The most common topical agents that are used during dermatologic procedures include benzocaine, tetracaine, and lidocaine 2.

Benzocaine has been labeled as a category C drug because of the risk of methemoglobinemia in the infant. This is supported by a study of cases of methemoglobinemia that were linked to the use of a local anesthetic drug Guay, , Lee et al.

Methemoglobinemia is also of concern when used in high doses of prilocaine. However, 2. Tetracaine is classified as a pregnancy category C drug but is the preferred local anesthetic drug for periocular and eyelid procedures because of its lower risk of corneal irritation Lee et al. The most common minor procedures include skin tag removal with snipping, shaving, or cryotherapy, removal of other benign lesions such as seborrheic keratoses and dermatosis papulosa nigra, shave or punch removal of nevi, and removal of hemangiomas with electrocautery or radiation surgery.

These procedures have a long safety record in patients who are pregnant. The most common chemical peels include procedures with glycolic acid, lactic acid, salicylic acid, Jessner, and tricholoracetic acid. There is also a lack of safety data with regard to this modality.

Although there are insufficient safety data available, these peels are generally considered safe because of negligible dermal penetration Andersen, Lactic acid peels induce keratolysis.

Salicyclic acid, which is classified as a pregnancy category C drug, is a beta-hydroxy acid with comedolytic and keratolytic activity Fabbrocini et al. However, the reproductive outcomes of patients who are pregnant and treated with low doses of oral aspirin were studied and no significant effects on the health of the fetus were reported Bozzo et al. It is recommended that if salicylic acid is used to treat patients who are pregnant, the area of coverage should be limited.

A Jessner peel is a combination of resorcinol i. Again, there is a lack of reports on Jessner peels during pregnancy. Since this peel contains salicylic acid, it should be used cautiously because of the risks mentioned previously.

Trichloroacetic acid TCA peels should also be used with caution because of the possible dermal penetration as this agent can be absorbed through ocular and oral mucosal surfaces Lee et al. Zhou et al. However, TCA has been safely used to treat genital condylomata in patients who are pregnant Lee et al. Botulinum toxin type A has both cosmetic and medical applications Tan et al.

Current data suggest but not entirely confirm that the toxin does not attain significant systemic concentrations if correctly injected intramuscularly or intradermally. Furthermore, the size of the toxin molecule makes it unlikely to cross the placental barrier Tan et al.

There are no clinical trials on the effects of cosmetic botulinum toxin use in patients who are pregnant. However, there are a number of case reports in which the toxin has been used for various medical procedures in patients who are pregnant without adverse outcomes to the fetus. Two recent case reports demonstrated the safety of botulinum toxin A to treat achalasia in women who were pregnant.

Hooft et al. Wataganara et al. Again, no adverse outcomes to the fetus were reported and no evidence of infant neuromuscular blockade was noted at 5 days postpartum Wataganara et al. Robinson and Grogan reported on the safe administration of onabotulinum toxin A at 18 weeks of gestation to treat migraine prophylaxis in a woman with refractory migraine headaches.

No adverse effects were reported in the infant who was followed for 6. Bodkin et al. One patient who had a prior history of miscarriages had a miscarriage at 10 weeks at which time she was noted to have a twin pregnancy Bodkin et al.

Newman et al. No complications were reported with the delivery or health of any of her four children Newman et al. Two cases of cosmetic use of botulinum toxin were reported by de Oliveira Monteiro in two women at 6 and 5 weeks of gestation with no fetal adverse events.

A survey of physicians that was conducted by Morgan et al. Only one patient with a history of spontaneous abortions experienced a miscarriage after injection of botulinum toxin Morgan et al. However, doses that are used in cosmetic procedures are usually less than units.

Although the above cases demonstrate the general safety of botulinum toxin A, there is still insufficient data to make concrete recommendations on whether cosmetic botulinum toxin procedures should be conducted in women who are pregnant.

However, it should be noted that if patients who are pregnant are inadvertently injected with botulinum toxin during the first trimester of pregnancy, efforts should be made by the provider to alleviate patient anxiety because of the current lack of evidence on adverse outcomes on the fetus in published case literature.

If patients who are pregnant request a cosmetic botulinum toxin procedure, consent forms should state pregnancy as a contraindication to cosmetic botulinum toxin A treatment. There are 21 fillers that have been approved by the U. Food and Drug Administration including collagen, hyaluronic acid, calcium hydroxylapatite, and poly-L-lactic acid Chacon, There are no reported safety data on the use of cosmetic fillers during pregnancy.

Adverse events that are associated with the use of fillers in the general population include most commonly injection site reactions and rarely delayed onset foreign body granulomas, nodule formation, vascular compromise, hypersensitivity reactions, and cellulitis Lolis et al.

Because of the lack of safety evidence in patients who are pregnant, recommendations on the use of fillers in this population cannot be definitive. Steps should be taken to avoid the adverse events as discussed previously in any patient population.

The injector should consider the potential risks from inadvertent arterial injection of lidocaine mixed with the filler. Varicose veins that develop during pregnancy have a high probability of spontaneous improvement postpartum. Therefore, it is advisable to wait 6 to 12 months after pregnancy prior to pursuing this treatment.

There are very limited data on the safety of sclerosing solutions in women who are pregnant. However, these solutions can cross the placenta and sclerotherapy is an absolute contraindication in the first trimester and after week 36 of a pregnancy Rabe and Pannier, In , Abramovitz demonstrated that there was no difference in pregnancy outcomes between 45 patients who were treated with sclerotherapy compared with 56 control patients Abramowtiz, In , Reich-Schupke and colleagues demonstrated that there was no increased risk of adverse fetal outcomes and evidenced their findings with several case reports in which common sclerotherapy agents were used inadvertently during pregnancy Reich-Schupke et al.

The cosmetic use of lasers has not been studied in women who are pregnant. However, lasers have been used safely to treat medical conditions in patients who are pregnant. The safety of carbon dioxide lasers in the treatment of genital condylomata in patients who are pregnant is supported by several studies Adelson et al.

Neodymium-doped yttrium aluminum garnet lasers have also been safely used to treat genital condylomata in patients who are pregnant Buzalov and Khristakieva, Laser therapy for use in lithotripsy in women who are pregnant has also been safely pursued. Adanur et al. Carlan et al. Several other case reports also suggest that acne and pyogenic granulomas have been safety treated with laser therapy during pregnancy Lee et al. Laser therapy is relatively safe in patients who are pregnant when employed for the treatment of various medical conditions.

However, laser and intense pulsed light therapy are not indicated for cosmetic procedures during pregnancy due to the lack of safety data. Permanent hair removal by means of laser therapy or electrolysis is generally not recommended during pregnancy due to the lack of safety data.

There is a theoretical concern about electrolysis because amniotic fluid is a conductor of galvanic current. An overdose of numbing medicine can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. Overdose symptoms may include uneven heartbeats, seizure convulsions , slowed breathing, coma, or respiratory failure breathing stops. Lidocaine applied to the skin is not likely to cause an overdose unless you apply more than the recommended dose.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces. Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. This is not a complete list of side effects and others may occur.

Call your doctor for medical advice about side effects. Medicine used on the skin is not likely to be affected by other drugs you use. But many drugs can interact with each other. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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What is the most important information I should know about lidocaine topical? The most probable reason behind these negative impacts is the excessive use of lidocaine. If the normal dosage of Lidocaine is maintained, such severe outcomes are unlikely to occur. When it comes to the doctor, they prescribe this anesthetic for established medical needs as lidocaine quickly passes through the placenta.

Lidocaine can also be used as an epidural during labor and there are no side effects reported as such from the epidural use of lidocaine. Also, keep in mind to not to use numbing cream onto the wounds or cuts, or other places from where it can enter into the bloodstream. Immediately seek medical advice from your doctor if you see any side-effects occurring because of the application of lidocaine cream during pregnancy.

It is also advised to take consultation from your doctor before starting the use of numbing cream during your pregnancy period. Posted on June 21 Vaccinations play a vital role to keep a pregnant woman and her baby in pink of the health.

Get acquainted with Lidocaine Cream… Lidocaine has been placed in the pregnancy category B and there are few reports that mention some negative effects of the lidocaine on infants born to mothers using this anesthetic.