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FDA Alert: Unsafe OTC Numbing Products Identified

If you perform treatments like microneedling, tattoo removal, or laser hair removal, the latest FDA warning deserves your immediate attention.

The FDA announced enforcement actions against several companies selling over-the-counter (OTC) topical anesthetics with dangerously high concentrations of lidocaine—far exceeding the 4% limit approved for OTC use. 

These products are widely marketed to aesthetic patients for pain relief, but they carry serious health risks and legal consequences.

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What Are the Risks?

When used improperly or at excessive doses, high-strength lidocaine products can cause:
  • Irregular heartbeat
  • Seizures
  • Breathing issues
  • Dangerous drug interactions
The risk increases when applied over large areas, to broken skin, or under occlusive dressings.

Products Called Out by the FDA

The warning applies to products used before, during, or after cosmetic procedures like laser hair removal, microdermabrasion, tattooing, and piercing. The FDA specifically identified:
  • TKTX products (including 40% lidocaine gel and 29.9% cream)
  • NumbSkin creams (up to 10.56% lidocaine)
  • Several other tattoo numbing sprays and creams from unapproved or foreign sources
Six companies received warning letters. Some products are now under import alert, and legal action may follow.

What This Means for You

If your practice uses or recommends any OTC numbing creams, this is your cue to:

What it takes:

Only use or recommend products with 4% lidocaine or less.
Avoid applying anesthetics over large areas or irritated skin, and don’t use occlusive wraps unless specifically approved.
Many patients bring their own products. Ask what they’re using, explain the risks, and provide safe alternatives.
Use the FDA’s MedWatch program to report any side effects and contribute to broader safety efforts.

Stay Informed, Stay Trusted

Jill Furman, Director of the FDA’s Office of Compliance, said it clearly:

“These products pose unacceptable risks to consumers and should not be on the market.”

Being proactive about safety isn’t just good medicine—it’s good business. Your patients trust you to know what’s safe and what isn’t.
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