Permanent makeup and anesthesia: choosing the right one

In the permanent makeup industry, application anesthesia is widely used, which can be divided into primary and secondary. Primary anesthesia is applied exclusively to intact skin during the preparation phase. Secondary is applied only after the first punctures.
The choice of an anesthetic is an important task for a permanent makeup master. How to choose an anesthesia cream, what to pay special attention to? We have prepared a special material on anesthetics.

Advantages of topical anesthesia

The absence of pain and discomfort at the reception of a permanent makeup master is 50% of the success of the result of the work. Relief of pain with the help of anesthesia is mandatory when applying tattooing of the lips and eyelids, because these parts of the face are hypersensitive areas. Eyebrow tattoo is not such a painful procedure, therefore, at the request of the client, it can be carried out without the use of anesthetics. In this case, the master must take into account that the sudden shudder of the client may adversely affect the result of the work. The advantages of application anesthesia include:

• The onset of the action of the drug 10-15 minutes after its application
• Preservation of action of a preparation till 4 o'clock.
• The anesthetic will not get into the patient's blood, but only into the depth of the skin
• The anesthetic does not interfere with the control of the depth of insertion of the needle

At the same time, masters must remember that the speed of action of the anesthetic depends on the part of the body on which it is applied, on the thickness of the skin and the speed of blood flow. Creams containing a combination of lidocaine and prilocaine do not make sense to keep on the patient's face for more than 30-40 minutes, as the anesthetics will begin to wash out.

Toxicity issues

Despite the ease and safety of application anesthesia, there are also contraindications for this method of anesthesia. The cases when it is necessary to refrain from the use of anesthetics include: acute skin diseases, lactation and pregnancy, fever, individual intolerance to the drug or its individual components, open inflammation and damaged skin. Also, the master should always keep in mind that application anesthesia can cause systemic toxicity, which is accompanied by various symptoms - from trembling, muscle twitching, nausea, impaired consciousness, orientation to apnea (stop breathing).
What increases the risk of developing symptoms of systemic toxicity?

• Elderly age
• Heart failure
• Cardiac ischemia
• Low plasma protein concentration
• metabolic diseases
• liver disease
• metabolic or respiratory acidosis
• Administration of drugs that inhibit sodium channels

All local anesthetics have a systemic effect on the central nervous and cardiovascular systems. For example, lidocaine in small concentrations increases blood pressure and has an anticonvulsant effect. However, with an increase in the dose of the drug, the pressure begins to fall, the risk of developing convulsive seizures becomes possible.
Doctors point out the fact that an allergic reaction can occur to absolutely any ingredient of the anesthetic, so when choosing an anesthetic, one should give preference to drugs that have been registered in Ukraine.

How to choose an anesthetic?

Primary anesthesia
Primary anesthesia preparations are available in the form of a cream, emulsion or gel. The main active ingredient is lidocaine. When choosing an anesthetic, pay attention to the fact that lidocaine in the composition is not higher than 5-6%, since exceeding this value will make the skin harder. Most masters use products with a concentration of lidocaine up to 10%, which is acceptable.
Secondary anesthesia
Secondary anesthesia preparations should have a liquid consistency. The watery structure of the anesthetic makes it easier for the anesthetic components to penetrate deep into the skin and provide instant “freezing”. A good indicator would be the content of vasoconstrictor substances. They reduce the production of lymph, which has a positive effect on the distribution of pigment in the skin.
To select the optimal anesthetic, the zone and technique of applying permanent makeup should be taken into account. When working in the eyebrow area, it is better to use anesthetic creams and water-based gels. The liquid consistency of the drug will ensure deep penetration of the anesthetic into the layers of the skin. To work with the upper eyelid, thick texture anesthetics should be preferred. They are more suitable for this delicate area, as they do not spread and do not get into the eyes.

The composition of the anesthetic cream should be as pure as possible: without preservatives and ether anesthetics that increase the risk of developing allergies (novocaine, tetracaine, benzocaine). An example of the composition of an anesthetic cream per 100 g: lidocaine - 2.5 g, prilocaine - 2.5 g; PEG-54 hydrogenated castor oil - 1.9 g; carbomer - 1.0 g; sodium hydroxide - 0.52 g; purified water - up to 100 g.
The emulsion of lidocaine 2.5% + prilocaine 2.5% is considered the standard in skin anesthesia, since lidocaine and prilocaine enhance each other's action. With an increase in concentration above 5%, the power does not increase, and the risk of developing toxic reactions increases. Clinical trials have proven that the emulsion of lidocaine + prilocaine 5% relieves pain 2 times better than single-component lidocaine, even at a concentration of 40%. In the lidocaine + prilocaine emulsion, the concentration of anesthetics in each fat drop reaches 80%. It is important that the ratio of lidocaine and prilocaine should be 1:1.