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Is Local Anesthesia Really Your Best Option?

Young woman getting an injection by her eyebrow

Local anesthesia is a very commonly used anesthesia for minor procedures that do not require the patient to be put to sleep or to be fully anesthetized. It is given in a variety of ways, but it generally will numb a certain spot, last for the length of the procedure, and then the feeling will return relatively quickly. If you have ever had dental work done then you are familiar with local anesthesia: the dentist almost always wants the patient to be awake during the surgery (wisdom teeth removal and oral surgery are exceptions) and a quick shot or a quick rub of ointment will numb the affected area of the mouth, allowing the dentist to drill, scrape, and extract without the patient feeling anything more than pressure.

Now, some local anesthetics are stronger than what’s used at the dentist’s office–and some are more mild. It depends on the needs of the individual and the procedure being done. 

What Are the Two Main Types of Local Anesthesia?

There are two main types of local anesthesia, and they will be used as the doctor or clinician deems fit. (And in some cases, the patient may have input into which kind of local anesthetic is used. It depends on the nature of the procedure.)

Topical Anesthetics

A topical anesthetic is a local anesthetic that is applied directly to the skin (in our dental example, it is placed directly on the gums). It can also be placed in the mouth, throat, nose, or even on the surface of the eye. Topical anesthetics include liquids, creams, gels, sprays and patches. 

Topical anesthesia only affects a very localized area, and the anesthetic does not go very deep into the tissue. Reasons why you might get a topical anesthetic include:

  • Preparing you for a larger shot (a dentist might rub topical anesthetic on your gums to numb them so when he goes in with a needle, it won’t hurt). 
  • When getting stitches (or removing stitches) some topical anesthetic might be used. For example, if you’re only getting a finger stitched up the doctor won’t want to flood your body with heavier doses of anesthesia. 
  • When getting an IV, those needles can be large and painful, so a patient might get a cream or salve local anesthetic applied to the area first.
  • When getting a catheter. This can be a painful and uncomfortable procedure, so the nurse will likely ease the pain with a topical anesthetic.
  • When getting laser treatments, topical anesthesia is sometimes used to reduce the laser sensation.
  • Cataract surgery is an example of when topical anesthesia could be applied directly to the eye.
  • Endoscopy is sometimes done with a topical anesthetic (though sometimes done with heavier anesthesia depending on the nature of the endoscopy).

You May Be Familiar With Topical Anesthesia From Over-the-Counter Products

Not all topical anesthetics require a prescription and can be purchased over the counter. This includes things like gels, creams and sprays that help ease the pain of a sore anywhere on the body, including inside the mouth and on open wounds. There is also burn cream that can be used to treat minor burns (although be careful about following directions when applying cream to burns, especially sunburns). Rashes from plants or bug bites can be treated with an over the counter topical anesthetic, as can hemorrhoids. 

Injection Anesthesia

When a topical anesthetic simply won’t do the full job, anesthesia can be injected into the skin for pain management. Going back to our dentist example: the dentist will numb the gums with a topical anesthesia, but then give one or more injections of a stronger anesthesia that will allow them to drill into the tooth without you feeling great pain.

Injections are also given for dermatological reasons such as skin biopsies, mole and wart removal, and removal of growths under the skin.

Some injection anesthesia is given with a needle directly into the pained area, as with the dentist example, but some anesthesia is given through an IV: the nurse or clinician will insert an IV into the patient, usually in the arm or hand, and then they can be free to give as many injections as are necessary into the IV instead of continually poking the patient with injection after injection. 

How Will I Respond to Anesthesia?

Anesthesia will typically only take minutes (or less) to start to work, and you will feel numbness in the region where it was applied–either injected or applied topically. 

You should not feel any sensation of pain, and if you do please tell your clinician, but it is common to feel pressure as the procedure is taking place. This is because the pain-sensing nerves are deadened, but the muscles are still working and sensing motion. If you do feel pain during a procedure immediately tell your clinician as they will likely need to apply more anesthesia to the area. 

One of the benefits of local anesthesia, as opposed to the type of anesthetic that knocks you out completely (that you would get for surgery or major procedures) is that the local anesthesia will wear off fairly rapidly. We’ve all experienced the dentist–we have a numb mouth for a few hours and we may drool a bit, but the numbness goes away and while there may be some residual pain, you won’t have to worry about the wooziness or dizziness that comes with the more potent anesthesia. 


Local anesthesia is a wonderful solution for relieving pain when getting a medical procedure. It allows you to be awake and alert while the doctor is working, and you can respond to questions that are being asked. It rarely makes your mind clouded, and the effects of the numbness dissipate in hours, sometimes even less. 

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