Topical anaesthetics numbing creams sold by tattoo artists and laser technicians

Topical anaesthetics commonly known as numbing creams may be applied during skin penetration procedures to reduce pain sensation. Skin penetration procedures can include:

  • tattooing
  • body piercing
  • laser treatments
  • tattoo removal.

Their use is regulated nationally by the Therapeutic Goods Administration (TGA) and in South Australia under the Controlled Substance Act 1984 (the Act).

Artists and technicians need to be aware of their legal responsibilities in relation to topical anaesthetics, and the potential hazards with their use.

Active ingredients in topical anaesthetics

The main active ingredients in topical anaesthetics include any number of the following:

  • lidocaine (also called lignocaine)
  • prilocaine
  • tetracaine.

At the concentrations used to numb pain sensation in skin procedures, these topical anaesthetics are all Scheduled medicines in Australia and therefore restrictions on their sale apply.

Selling of scheduled medicines

Scheduled medicines may only be sold or supplied to members of the public by persons authorised or licensed under the Controlled Substances Act 1984, and administered in accordance with the Act.

Tattoo artists and laser technicians are not authorised to sell or supply Scheduled medicines to members of the public.

The illegal sale, supply or administration of a medicine to members of the public is an offence under the Controlled Substance Act 1984 which carries a maximum penalty of $10,000 or imprisonment for 2 years.

Classifications of medicines

Schedule 2 - Pharmacy medicine

Medicines in Schedule 2 of the Standard for the Uniform Scheduling of Medicines and Poisons (the SUSMP) are labelled as “Pharmacy Medicine” - these medicines are available for purchase in a pharmacy.

As an example, numbing creams for topical use that contain more than 2% but less than 10% lidocaine (lignocaine) are Schedule 2 Pharmacy Medicines.

Schedule 4 - Prescription Only Medicines

Medicines in Schedule 4 of SUSMP are labelled as “Prescription Only Medicine”- these medicines are available from a pharmacist on a prescription from a doctor.

Numbing creams with more than 10% lidocaine (lignocaine) are Schedule 4 medicines and are only available on a prescription from a doctor.

Labelling of scheduled medicines

Scheduled medicines registered for use in Australia will be clearly labelled as either:

  • Pharmacy Medicine
  • Pharmacist Only Medicine
  • Prescription Medicine. 

Approved for use in Australia

Medicines accepted by the TGA for supply in Australia have either an AUST R number or AUST L number on the label. 

You can also check the Australian Register of Therapeutic Good (ARTG) to see if the product you are selling is allowed to be lawfully supplied in Australia. 

Products purchased over the internet from overseas supplies are not likely to have been approved for use in Australia. 

The potential hazards with topical anaesthetics

Topical anaesthetics work by blocking the pain sensation in the skin. They are usually in a cream or gel. Some of the anaesthetic can get absorbed into the blood stream through the skin.

If they are applied in large amounts or to large surface areas of the body, or areas where the skin is already irritated or damaged, high concentrations of the anaesthetic can pass into the bloodstream and cause serious side effects or toxicity. Some people have allergies to these anaesthetics and even small amounts can be toxic. Life-threatening adverse effects can occur such as:

  • irregular heartbeat
  • seizures
  • breathing difficulties
  • coma
  • death.

Advice to clients

It is best that your clients obtain advice from their health professional when considering use of a topical anaesthetic or numbing cream before a skin procedure, particularly for procedures which involve large areas of the body.