I am looking for feedback for the use of topical anesthetics in Q-switch laser applications such as tattoo removal and pigmented lesions. Any experiences you can share?

Hello Ian, not sure this will be much help as mine is a vascular laser but I use Emla cream for a topical anesthetic. It's only really effective if left on for at least 30 mins and better if an occlusive dressing is put on top (such as tegaderm). Works better for some than others but can macerate the tissue especially on the plantar area of the foot.

I don't use a Q-switch, I have a Fotona XP Focus (warts/verrucae, onychomycosis, thread veins/naevi)

Other than Emla I use 3% scandonest plain local infiltration in particularly sensitive areas such as the fingers.

Thank you j, I have tried Emla in the past but I found out it doesn't reach the dermis where most ink tattoos are placed. This results in desensitized epidermis but the client still experiences pain all be it reduced in intensity. Anyone had any experience with any other topical anaesthetics? Ideally non prescription. Has anyone heard about or used a self occluding cream called called Pliaglis, made by Galderma?

We find that using BLT Cream - Benzocaine, Tetracaine, Lidocaine - 20/10/4% is the most comfortable for the patient and also works the fastest.

You can also use Ela-Max 5, but have you tried using the EMLA in combination with a zimmer cooler or any type of cryogen spray - or just a cooling spray? 1064 Q-switched lasers do not have a very deep depth penetration as compared to many other modalities.

We also use the BLT in 20/6/6% under occlusion for 30 minutes. We have had very good results with this. We have tried the pliaglis from galderma-found it to be messy and expensive and we didn't think it worked as well without the benzocaine.

I agree. BLT cream works well. Get your compounding chemist to make it up

BLT is good. But tattoo removal is uncomfortable no matter what. I try to get it done as quickly as possible and use a chiller to cool the skin prior to treatment as well as blow cool air on the skin during the treatment with the chiller. I also apply an ice pack immediately after the treatment for a few minutes. This seems to minimize the discomfort considerably.

I think that the most effective and safe formula is the combination of tetracaine and lidocaine 2,5% and 2,5%
I used it in my practice as plastic surgeon in many treatments
I have better result than emla in 30 minutes without occlussion
I buy it from a pharmacist in thessaloniki- greece
It is very cheap
100 grams only 35 euros

You will find the best tattoo removal laser from AESLASER.

AES-LASER96, the stand model Q switched ND-YAG LASER as below:
http://www.aeslaser.net/products_show.asp?id=196

Lead time is 7 working days.
Delivery time is 3 working days to USA.
Warranty is 1 year for free, but maintenance always.

Also Co2 fractional laser, diode laser, IPL, thermage, Cryolipolysis all in www.aeslaser.net

- See more at: http://medicalspamd.com/ipl-laser-treatments/post/2133772?lastPage=true#sthash.paY4J2hZ.dpuf