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EMLA Cream

EMLA Cream

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  • ✔️ Numbs skin effectively before injections and blood tests
  • ✔️ Contains lidocaine and prilocaine for dual anaesthetic action
  • ✔️ Suitable for adults and children aged 1 year and over
  • ✔️ Numbing effect lasts up to 2 hours after cream removal
  • ✔️ Ideal for needle-phobic patients needing procedural pain relief

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What Is EMLA Cream and How Does It Numb Skin?

 

If needles make you anxious, you are far from alone. EMLA cream is a topical anaesthetic that numbs the surface of the skin before injections, blood tests, cannula insertion, and other minor skin procedures. It contains two active ingredients — lidocaine 2.5% and prilocaine 2.5% — working together to temporarily block pain signals at the skin surface. Available over the counter in the UK, it offers a straightforward way to reduce discomfort without needing a prescription. You can find it alongside other creams and ointments at Cured Pharmacy.

EMLA cream has been used in clinical settings for decades and is well established in both adult and paediatric care. It is applied to intact skin under an occlusive dressing and left in place for at least 60 minutes before the procedure begins. The result is a noticeably reduced sensation in the treated area, making the experience far more manageable for people of all ages.

 

How Does EMLA Cream Work on the Skin?

 

The mechanism behind EMLA cream is rooted in how local anaesthetics interact with nerve fibres. Both lidocaine and prilocaine belong to the amide class of local anaesthetics. When applied to the skin, they penetrate the epidermal and dermal layers and act on the sodium channels of sensory nerve endings.

  • Lidocaine and prilocaine diffuse through intact skin into the dermis.
  • They block voltage-gated sodium channels in sensory nerve fibres.
  • This prevents the generation and conduction of nerve impulses.
  • Pain signals cannot travel to the brain, so the area feels numb.
  • The effect is temporary and fully reversible once the cream is removed and absorbed.

The eutectic mixture of the two agents lowers the melting point of the combination, allowing both to exist in liquid form at room temperature. This increases the concentration available for skin penetration compared to either agent used alone.

 

Who Is EMLA Cream Suitable For?

 

EMLA cream is suitable for a wide range of people who need to reduce skin pain before a procedure. It is commonly used in both community and clinical settings. That said, it is not appropriate for everyone, so it is worth checking before you use it.

  • Adults requiring numbing before injections, blood draws, or cannula insertion.
  • Children aged 1 year and over before vaccinations or blood tests.
  • People with needle phobia who need a practical way to manage procedural anxiety.
  • Patients undergoing minor skin procedures such as superficial surgical interventions on intact skin.

It should not be used on broken, inflamed, or infected skin, or on mucous membranes. People with known hypersensitivity to amide-type local anaesthetics should avoid it entirely. If you are unsure whether it is right for you, speak to your pharmacist before use.

 

How Does EMLA Cream Compare to Ametop Gel?

 

Feature EMLA Cream Ametop Gel (Tetracaine 4%)
Active ingredient(s) Lidocaine 2.5% + Prilocaine 2.5% Tetracaine 4%
Onset time 60–120 minutes 30–45 minutes
Suitable for children under 1 year No (without medical supervision) No (under 1 month)
Available OTC in UK Yes Yes

 

How Should You Store EMLA Cream and What Should You Know Before Using It?

 

Store EMLA cream below 25°C and keep it away from direct heat or sunlight. Do not freeze it. Once opened, use within the timeframe stated on the packaging. Keep it out of reach and sight of children at all times.

Before applying, make sure the skin is intact and clean. Applying EMLA cream to broken or damaged skin is not recommended and may increase systemic absorption. If you are using it for a child, follow the age-appropriate dosing guidance carefully. For broader skin care needs, you can also explore our skin care range at Cured Pharmacy.

This product is a medicine. Speak to your doctor or pharmacist before using if you have an underlying medical condition or are taking other medicines.

EMLA Cream specifications
Treatment category Topical anaesthetic
Mechanism of action Blocks voltage-gated sodium channels in sensory nerve fibres
Effective for Numbing skin before injections, blood tests, cannula insertion, minor skin procedures
Suitable for Adults and children aged 1 year and over
Active ingredient Lidocaine 2.5%, Prilocaine 2.5%
Pack sizes 5 g, 30 g
Strength Lidocaine 25 mg/g, Prilocaine 25 mg/g
UK classification Pharmacy (P) medicine
Drug class Amide local anaesthetic
Preparation Cream
Route of administration Topical (intact skin only)

Specifications of EMLA Cream

 

What Is EMLA Cream and What Is It Used For?

 

EMLA cream is a topical local anaesthetic containing lidocaine 2.5% and prilocaine 2.5%. It is used to numb intact skin before procedures that would otherwise cause pain or discomfort. Common uses include preparation for intravenous cannulation, venepuncture, vaccination, and superficial skin surgery. It is also used in some clinical settings before procedures such as split skin grafting on anaesthetised skin.

The cream works by penetrating the skin layers and temporarily blocking nerve signals. It is licensed for use in adults and children aged 1 year and over. For children between 1 and 12 months, use is only appropriate under medical supervision due to the risk of methaemoglobinaemia — a condition where the blood's ability to carry oxygen is reduced.

 

What Do You Need to Know Before Using EMLA Cream?

 

Before using EMLA cream, it is important to check whether it is appropriate for you. There are several situations where it should not be used or should be used with caution.

Do not use EMLA cream if you:

  • Are allergic to lidocaine, prilocaine, or any other amide-type local anaesthetic.
  • Have congenital or idiopathic methaemoglobinaemia.
  • Are applying it to broken, infected, or inflamed skin.
  • Are applying it to mucous membranes (e.g. inside the mouth or genitals) unless specifically directed by a healthcare professional.
  • Are using it on a baby under 1 year without medical advice.

Use with caution if you:

  • Have glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Have severe hepatic impairment.
  • Are pregnant or breastfeeding — seek advice from your doctor or pharmacist first.

Known drug interactions:

  • Antiarrhythmic drugs (e.g. mexiletine, tocainide) — additive cardiac effects possible.
  • Other local anaesthetics — risk of additive toxicity.
  • Drugs associated with methaemoglobinaemia (e.g. sulphonamides, dapsone, nitrates) — increased risk, particularly in children.

 

How Should You Use EMLA Cream?

 

Using EMLA cream correctly is key to getting the numbing effect you need. Follow these steps carefully for best results.

  1. Wash and dry the skin area where the cream will be applied.
  2. Apply a thick layer of EMLA cream — do not rub it in.
  3. Cover the cream with the occlusive dressing provided (or a similar airtight dressing).
  4. Leave in place for the recommended time (see table below).
  5. Remove the dressing and wipe away the cream just before the procedure.
  6. The numbing effect lasts for approximately 1–2 hours after removal.
Indication Age Group Dose Application Time
Venepuncture / cannulation Adults 1.5–2 g per site 60 minutes minimum
Venepuncture / cannulation Children 1–12 years 1–2 g per site 60 minutes minimum
Minor skin procedures Adults 1.5–2 g per 10 cm² 60–120 minutes
Superficial surgical procedures Adults Up to 10 g over larger area 120 minutes

If you are using EMLA cream on a child, always follow the age-specific dosing guidance and do not exceed the recommended amount. For additional pain relief options, browse our full range at Cured Pharmacy.

 

What Are the Possible Side Effects of EMLA Cream?

 

Like all medicines, EMLA cream can cause side effects, although not everyone experiences them. Most reactions are localised to the application site and resolve quickly.

Common side effects (may affect more than 1 in 10 people):

  • Temporary paleness (blanching) of the skin at the application site.
  • Redness (erythema) after the dressing is removed.
  • Mild swelling or oedema at the treated area.
  • Burning or itching sensation during or after application.

Less common side effects:

  • Methaemoglobinaemia — particularly in infants or those with G6PD deficiency.
  • Allergic contact dermatitis.
  • Systemic effects (e.g. dizziness, headache) if large amounts are absorbed — rare with correct use.

If you notice any signs of a serious allergic reaction — such as difficulty breathing, swelling of the face or throat, or a widespread rash — stop using the cream immediately and seek urgent medical attention.

 

How Should You Store EMLA Cream?

 

Correct storage helps maintain the effectiveness and safety of EMLA cream. Follow these guidelines:

  • Store below 25°C.
  • Do not freeze — freezing can alter the cream's consistency and effectiveness.
  • Keep the tube tightly closed when not in use.
  • Store away from direct sunlight and heat sources.
  • Keep out of the reach and sight of children.
  • Do not use after the expiry date printed on the packaging.
  • Do not dispose of medicines via wastewater or household waste — return unused product to your pharmacist.

If you are managing a child's care and need related products, our baby and toddler range includes a variety of items suitable for younger patients. Always check with a pharmacist if you are unsure about storage or disposal.

Written and reviewed by our qualified team

Your safety and success are our highest priorities. Our medical team rigorously evaluates every product and piece of advice we provide, ensuring you receive only the most effective, science-backed solutions available.

Frequently Asked Questions

Where can I buy EMLA cream online in the UK?

You can buy EMLA cream online in the UK from Cured Pharmacy, a GPhC-registered online pharmacy, without a prescription. It is classified as a Pharmacy (P) medicine, meaning it is available over the counter for adults and children aged 1 year and over. Simply add it to your basket and it will be dispatched promptly to your door.

How does EMLA cream work in the body?

EMLA cream contains lidocaine and prilocaine, two amide-type local anaesthetics that penetrate intact skin and block voltage-gated sodium channels in sensory nerve endings. This prevents pain signals from being generated and conducted to the brain. The effect is entirely localised and temporary, wearing off within 1–2 hours after the cream is removed.

How do I apply EMLA cream step by step?

Follow these steps for correct application:

  1. Clean and dry the skin area.
  2. Apply a thick layer of cream without rubbing it in.
  3. Cover with the occlusive dressing provided.
  4. Leave for at least 60 minutes (up to 120 minutes for deeper procedures).
  5. Remove the dressing and wipe away the cream just before the procedure.

The numbing effect will last approximately 1–2 hours after removal.

How long does EMLA cream take to work?

EMLA cream typically takes 60 minutes under an occlusive dressing to provide adequate numbing for procedures such as venepuncture or cannulation. For deeper or more extensive skin procedures, an application time of up to 120 minutes may be required. Do not remove the dressing early, as this will reduce the numbing effect.

What is the correct dose of EMLA cream for adults?

For venepuncture or cannulation in adults, apply approximately 1.5–2 g of EMLA cream per site under an occlusive dressing for at least 60 minutes. For minor skin procedures, up to 10 g may be applied over a larger area for 120 minutes. Always follow the instructions in the patient information leaflet and do not exceed the recommended dose.

Can EMLA cream be used on children?

EMLA cream can be used in children aged 1 year and over to numb skin before injections, vaccinations, or blood tests. It should not be used in babies under 1 year without specific medical supervision, due to the risk of methaemoglobinaemia. Always use the age-appropriate dose and do not apply to large areas of skin in young children.

What are the side effects of EMLA cream and how do I manage them?

The most common side effects are temporary skin reactions at the application site, including redness, paleness, mild swelling, or a burning sensation. These usually resolve on their own within a short time after the cream is removed. If you experience signs of a serious allergic reaction — such as difficulty breathing or widespread rash — stop use immediately and seek urgent medical help.

Who should not use EMLA cream?

EMLA cream should not be used by people who are allergic to lidocaine, prilocaine, or any amide-type local anaesthetic. It is also contraindicated in people with congenital methaemoglobinaemia and should not be applied to broken, infected, or inflamed skin. Speak to your pharmacist if you are pregnant, breastfeeding, or taking other medicines before use.

Can I use EMLA cream before a tattoo?

EMLA cream is sometimes used before tattooing to reduce discomfort, though this is not a licensed indication. It may temporarily alter skin texture, which some tattoo artists prefer to avoid. Always speak to your pharmacist and your tattoo artist before using it for this purpose to ensure it is appropriate for you.

What are the alternatives to EMLA cream?

The main alternative available in the UK is Ametop gel, which contains tetracaine 4% and may act faster (within 30–45 minutes) than EMLA cream. Both are available over the counter and work by blocking nerve signals in the skin. Your pharmacist can help you decide which is more suitable based on your specific procedure and circumstances. You can also explore our broader pain relief range for other options.

How long does the numbing effect of EMLA cream last?

After the occlusive dressing is removed, the numbing effect of EMLA cream typically lasts for 1–2 hours. The duration can vary depending on how long the cream was applied and the thickness of the skin at the application site. Plan your procedure to take place within this window for the best effect.

Can EMLA cream be used on the face?

EMLA cream can be applied to intact facial skin for certain minor procedures, but it must be kept away from the eyes and mucous membranes. Take care to ensure the occlusive dressing does not slip near the eye area. If you are unsure about facial application, consult your pharmacist or healthcare provider before use.

Does EMLA cream interact with other medicines?

EMLA cream can interact with antiarrhythmic drugs such as mexiletine, other local anaesthetics, and medicines associated with methaemoglobinaemia such as sulphonamides, dapsone, and nitrates. These interactions are more clinically significant in children and people with certain enzyme deficiencies. Always tell your pharmacist about all medicines you are taking before using EMLA cream.

What is the latest research on EMLA cream?

EMLA cream has been extensively studied since its introduction and remains one of the most widely used topical anaesthetics in clinical practice. Research continues to support its effectiveness for procedural pain management in both adults and children, including its use in vaccination programmes. It is referenced in NHS clinical guidelines and the British National Formulary as a standard option for topical anaesthesia.

How should I store EMLA cream at home?

Store EMLA cream below 25°C, away from direct sunlight and heat. Do not freeze it, as this can affect the cream's consistency and performance. Keep the tube tightly closed and out of reach of children, and check the expiry date before each use. For other products you may need at home, browse our first aid range at Cured Pharmacy.

How Should You Use EMLA Cream?

Using EMLA cream correctly ensures you get the full numbing effect before your procedure. Always apply it to clean, intact skin only — never to broken, inflamed, or infected areas. Follow these steps carefully:

If you are applying EMLA cream to a child, take extra care to use the correct dose for their age and weight. Do not apply to large areas of skin in young children, and keep the dressing secure to prevent accidental ingestion.

What Is the Correct Dose of EMLA Cream?

The dose of EMLA cream depends on the procedure being performed and the age of the patient. Always use the minimum effective amount and do not exceed the recommended dose for your age group or indication.

Do not apply more cream than recommended. Using excessive amounts, particularly over large skin areas or under occlusion for extended periods, increases the risk of systemic absorption and side effects.

When Is the Best Time to Use EMLA Cream?

Timing is everything with EMLA cream. You should apply it at least 60 minutes before your procedure to allow adequate numbing to develop. For deeper procedures or larger skin areas, applying 90–120 minutes beforehand gives a more reliable result. Plan ahead — if your appointment is at a set time, work backwards to calculate when to apply the cream. The numbing effect lasts approximately 1–2 hours after the dressing is removed, so do not apply it too far in advance or the effect may begin to wear off before your procedure starts.

How Long Can You Use EMLA Cream For?

EMLA cream is intended for single-use application before individual procedures. It is not designed for continuous daily use or long-term application. Each application should be limited to the recommended time under occlusion — typically no more than 120 minutes for adults. If you need to use it repeatedly for ongoing procedures such as regular blood tests, speak to your pharmacist or GP to ensure it remains appropriate for your situation. Do not exceed the recommended dose. If in doubt, speak to your pharmacist.

What Are the Most Common Side Effects of EMLA Cream?

Most people who use EMLA cream experience only mild, localised reactions at the application site. These are generally short-lived and resolve on their own once the cream is removed and the skin returns to normal temperature and circulation.

  • Temporary paleness (blanching) of the skin at the treated area.
  • Redness (erythema) after the dressing is removed.
  • Mild swelling or puffiness at the application site.
  • Burning or itching sensation during or shortly after application.

What Are the Less Common Side Effects of EMLA Cream?

Less common reactions are rare when EMLA cream is used correctly on intact skin in the recommended amounts. However, they can occur, particularly if the cream is applied to large areas, left on for extended periods, or used in young children.

  • Allergic contact dermatitis — a skin rash that may be itchy or blistered.
  • Methaemoglobinaemia — particularly in infants under 12 months or those with G6PD deficiency; symptoms include pale or bluish skin, shortness of breath, and fatigue.
  • Mild systemic effects such as dizziness or headache if significant absorption occurs.

What Are the Serious Side Effects of EMLA Cream?

Serious side effects from EMLA cream are uncommon when it is used as directed. However, you should be aware of the signs that require urgent attention. Methaemoglobinaemia is the most clinically significant risk, particularly in young children and those with certain enzyme deficiencies. Symptoms include a bluish tinge to the lips or fingernails, unusual tiredness, rapid breathing, and confusion. Severe allergic reactions, though rare, can also occur. Signs include swelling of the face, lips, or throat, difficulty breathing, and a widespread skin rash.

What Should You Do If You Experience Side Effects?

If you notice any mild local reactions such as redness or temporary paleness, these are expected and do not usually require any action beyond removing the cream. If the reaction is more severe — for example, a spreading rash, significant swelling, or any difficulty breathing — remove the cream immediately and seek urgent medical attention. For signs of methaemoglobinaemia in a child, call 999 or go to your nearest A&E department without delay. Do not reapply the cream until you have spoken to a healthcare professional.

Can EMLA Cream Interact With Other Medicines?

Yes, EMLA cream can interact with certain medicines, and these interactions can increase the risk of side effects. The most important interactions to be aware of include antiarrhythmic drugs such as mexiletine and tocainide, which may have additive effects on cardiac conduction when combined with lidocaine or prilocaine. Medicines that can cause methaemoglobinaemia — including sulphonamides, dapsone, and nitrates — may increase this risk when used alongside EMLA cream, particularly in children. Other local anaesthetics used at the same time may also increase the overall anaesthetic load. Always tell your pharmacist about every medicine you are taking, including over-the-counter products and supplements, before using EMLA cream. If you are concerned about any side effects, contact your pharmacist or GP immediately.

Patient Information Leaflet

Important - Before taking any medication, it is always important to read the Patient Information Leaflet (PIL)

Written and reviewed by our qualified team

GPhC Number: 2233073
Tarun Kumar

Reviewed by:

Tarun Kumar

Superintendent/ Clinical Lead

📖 Find out more about our team of medical content authors and how we ensure the accuracy of our content with our content guidelines.

Content last updated: 31 Mar 2025

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