This medication contains 2 amide-type local anesthetics, lidocaine and prilocaine. It is used on normal, unbroken skin or on the outer genital area to prevent pain before certain procedures such as inserting a needle, skin grafts, or skin laser surgery. It works by temporarily numbing the skin and surrounding area. Do not use this product in the ears.

What is Emla cream used for?

Emla is a local anaesthetic cream that's used to numb the skin before potentially painful procedures such as:

In adults:

  • Injections, inserting IV catheters or taking blood.
  • Minor skin surgery, for example skin grafts.
  • Cleansing (debridement) of leg ulcers.
  • Surgical removal of genital warts.
  • Injections of local anaesthetics into the genital area.

In children:

  • Injections, inserting IV catheters or taking blood.
  • Minor skin procedures or surgery.

How does Emla work?

  • Emla cream contains two active ingredients, lidocaine and prilocaine, which are both medicines called local anaesthetics. They are used to numb areas that would otherwise feel pain.
  • Pain is caused by the stimulation of pain receptors at the ends of nerves. The stimulation causes sodium to enter the nerve ending, which causes an electrical signal to build up in the nerve. When this electrical signal is big enough, it passes along the nerve to the brain, where the signal is interpreted as pain.
  • Lidocaine and prilocaine temporarily block this pathway of pain signals along nerves by stopping the sodium entering the nerve ending at the site of the pain. This prevents an electrical signal building up and passing along the nerve fibres to the brain.
  • When Emla cream is applied to the skin, the lidocaine and prilocaine prevent pain signals passing from that area to the brain. This means otherwise painful procedures can be performed without causing pain, although you may still feel pressure and touch.

How do I use Emla cream?

  • Emla cream is applied to the area that needs numbing and a dressing is usually then put on top. The cream is not rubbed into the skin and the cream and dressing are removed just before the medical procedure starts.
  • Your doctor, pharmacist or nurse will either apply the cream themselves, or show you how much to use and where to apply it. They will also tell you how long to leave the cream on for. All this will depend on the procedure that will be performed. It's important to carefully follow the instructions given by your doctor or nurse.
  • Wash your hands after applying the cream, unless your hands are the area being treated.
  • Take care to avoid getting the cream in the eyes, as this could numb the eye and prevent its protective reflexes. If you accidentally get the cream in your eyes, rinse well with lukewarm water or saline solution and protect the eye until sensation returns.
  • DO NOT apply the cream to cuts, grazes or wounds (except leg ulcers), or areas where there is a skin rash or eczema.
  • DO NOT apply the cream in or near the eyes, inside the nose, ears, mouth or anus (back passage), or to the genitals of children.

Who shouldn't use Emla cream?

  • People who are allergic to other amide anaesthetics, eg bupivacaine, ropivacaine.
  • People who are allergic to any ingredients of the cream.
  • The cream shouldn't be used on babies who were born prematurely (before 37 weeks gestation).
  • The cream shouldn't be used on babies under 12 months of age who are being treated with medicines that can cause a disorder of the red blood cells called methaemoglobinaemia, for example sulphonamide antibiotics such as sulfamethoxazole.

Emla should be used with caution in

  • People who lack the enzyme glucose-6-phosphate dehydrogenase in their blood (G6PD deficiency).
  • People with the red blood cell disorders methaemoglobinaemia or anaemia.
  • People taking medicines that can cause anaemia or methaemoglobinaemia.
  • People taking antiarrhythmic medicines to treat an irregular heartbeat, for example amiodarone or mexiletine.
  • People with atopic dermatitis (eczema).

Can I use Emla cream while pregnant or breastfeeding?

  • Emla should be used with caution during pregnancy and only on the advice of a doctor. Make sure your doctor knows if you are or think you could be pregnant before using it.
  • Lidocaine and prilocaine pass into breast milk, but in amounts that are probably too small to be harmful to a nursing infant. However, you should make sure your doctor knows if you're breastfeeding before using it. If you are breastfeeding you should not apply this cream to the skin on or near the breasts, to prevent the child accidentally ingesting it.

What are the possible side effects of Emla cream?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with Emla cream. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

  • Paleness, redness or swelling of the skin at the application site.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Mild burning, tingling, itching or sensation of warmth at the application site (this is a common side effect when the cream is applied to the genitals or to leg ulcers).

Rare (affect fewer than 1 in 1000 people)

  • Disorder of the red blood cells called methaemoglobinaemia in children. Symptoms include bluish-grey skin due to a lack of oxygen. If this happens to your child you must consult a doctor immediately.

Allergic reactions.

  • Small red dots on the skin where the cream was applied. This is more likely in children with atopic dermatitis or mollusca contagiosa.

For more information about any other possible risks associated with Emla, please read the information provided with the cream or talk to your doctor, nurse or pharmacist.

Can I use Emla cream with other medicines?

It's important to tell your doctor, nurse or pharmacist what medicines you are already using, including those bought without a prescription and herbal medicines, before you use Emla cream, so they can check that the combination is safe.

There may be an increased chance of a blood disorder called methaemoglobinaemia if Emla is used by people who are being treated with other medicines that can cause this side effect, for example those listed below:

  • acetanilid
  • aniline dyes
  • benzocaine
  • chloroquine
  • dapsone
  • metoclopramide
  • naphthalene
  • nitrates and nitrites
  • nitrofurantoin
  • nitroglycerin
  • nitroprusside
  • pamaquine
  • para-aminosalicylic acid
  • phenacetin
  • phenobarbital
  • phenytoin
  • primaquine
  • quinine
  • sulphonamide antibiotics, eg sulfamethoxazole.

Emla cream should not be used in babies under 12 months of age who are being treated with any of the medicines listed above.

There may be an increased risk of side effects if large amounts of Emla cream are used by people already using other local anaesthetics, or structurally-related medicines, such as tocainide or mexiletine.

Emla should be used with caution in people taking medicines to treat an irregular heartbeat, for example amiodarone, because if sufficient quantities of Emla are absorbed into the body it may increase the risk of side effects on the heart.