EMLA cream for local anaesthesia

This leaflet is about the use of EMLA cream. The cream is used to make an area of skin numb, which is called local anaesthesia. It may be used before taking blood with a needle or putting in a drip (cannula), or before a small surgical procedure that might be painful.

This leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

EMLA cream should only be used on undamaged skin. Do not put it on damaged skin.

Name of drug

EMLA cream
The cream contains 2.5% lignocaine and 2.5% prilocaine.

Why is it important to use this cream?

The cream will help reduce any pain or discomfort that your child may feel during a minor procedure, such as when blood is taken or a cannula (drip) is put in, or during a small surgical procedure such as removing a lump. If the cream is not applied, the procedure may have to be delayed or cancelled, or your child may feel pain or discomfort during the procedure.

What is EMLA cream available as?

EMLA cream comes in tubes containing 5 g or 30 g of cream.

When should I use EMLA cream?

  • The EMLA cream needs to be applied at least 1 hour before a procedure with a needle (taking blood, inserting a cannula) is due to be done, or 2 hours before a surgical procedure such as a skin graft.
  • The person giving you the cream will tell you when to apply it and where to apply it on your child’s body. They will probably ask you to apply the cream to more than one site.
  • If the procedure is delayed and the effect of the cream has worn off, ask your doctor or nurse for advice before applying any more.

How much EMLA cream should I use?

  • Your doctor or nurse will tell you how much EMLA cream to apply – this is the amount that is right for your child. They may tell you to apply a whole tube of cream to each site, more than one tube, or part of a tube.

It is important that you follow the doctor or nurse’s instructions about how much to use.

How should I use EMLA cream?

  • Squeeze the cream from the tube onto the area of skin to be numbed. Do not rub it in.
  • Place a waterproof dressing (plaster) over the cream to keep it in place. You will be given these with the cream.
  • Make a note of the time that you applied the cream.
  • Wash your hands properly with soap and water as soon as you have finished applying the cream.
  • Remove the cream after 4 hours if your child has not had the planned procedure. If your baby is less than 3 months old, you must remove the cream after 1 hour.
  • Take off the dressing and wipe off any cream with a tissue. The cream may have all soaked into the skin.

Do not apply the cream to skin that has a rash or eczema or is sore, bleeding or has a scab.

The cream must not be applied to the eyes, ears, nose, inside the mouth or near the back passage (anus) or genitals.

When should the cream start working?

EMLA cream should make the skin numb after about 1 hour. The skin will stay numb for 2–3 hours.

What if my child is sick (vomits)?

You do not need to worry. The EMLA cream will still work if your child is sick. Do not apply any extra cream.

What if I forget to apply it?

If you forget to apply the EMLA cream, or you applied it late, tell the person who is going to do the procedure. They may want to delay the procedure.

Do not apply extra EMLA cream. This will not make it work faster.

What if I apply too much?

It is unlikely that you will apply too much EMLA cream. If you think you may have used too much, contact your doctor or nurse.

EMLA cream can be dangerous if it gets inside the body. If your child feels lightheaded, dizzy, feels tingling or numbness around the mouth or tongue, has an abnormal taste, blurred vision or ringing ears, take them to hospital straight away.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side-effects that you must do something about

If your child gets a rash, any swelling or feels faint, lightheaded or short of breath after applying EMLA cream, they may be allergic to it. Wipe the cream off and take your child to hospital straight away.

If your child’s skin goes a blue-ish grey colour, contact your doctor or take your child to hospital straight away.

Other side-effects you need to know about

  • Your child may feel itching or tingling where the cream was applied. If this becomes too uncomfortable, take the cream off. Be sure to tell the doctor or nurse that you took the cream off early, as your child’s skin may not be numb enough to have the procedure. If possible, contact them as soon as possible for advice.
  • The skin may go pale, have red spots or some swelling. These effects should go away once the cream is removed. If there is still a problem after one day, contact your doctor.
  • These effects may be worse if your child has conditions such as dermatitis or mollusca. Be aware that redness and swelling may also be caused by the needle or surgical procedure.

Can other medicines be given at the same time as using EMLA cream?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
  • EMLA cream should not be used if your child is taking some medicines that you get on prescription. If your child is taking any other medicines, tell the doctor or nurse who gave you the EMLA cream. If you forget to do this, check before you apply the cream. This includes herbal or complementary medicines.

Is there anything else I need to know about this EMLA cream?

If you think someone may have swallowed some EMLA cream, contact your doctor straight away.

Do not apply the cream anywhere inside the body (inside the mouth or in ears, eyes, genitals or back passage) as it may get into the body from here. It must only be used on the skin.

  • Only use EMLA cream for your child. Never use it for anyone else, even if their condition appears to be the same, as this could do harm.

If you think someone else may have used the cream by accident, remove the cream from the skin straight away. If it has been in contact with the skin for some time, contact your doctor for advice.

  • If your child is anaemic, or has methaemoglobinaemia, porphyria or G6PD deficiency, tell your doctor or nurse before using the cream.
  • Make sure that the cream you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
  • Once you have opened a tube of cream, throw away any unused cream within 1 day.

Where should I keep this EMLA cream?

  • Keep the cream in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the cream.
  • Keep the cream in the container it came in.

Who to contact for more information

Your child’s doctor, pharmacist or nurse will be able to give you more information about EMLA cream and about medicines used to numb the skin (local anaesthetics).


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Publication Date

8/12/2011

Copyright Disclaimer

Version 1.2, February 2010. (November 2011) © NPPG, RCPCH and WellChild 2011, all rights reserved.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.