What is EMLA (ouchless shot cream)?

What is EMLA?

EMLA is a cream that is used to numb the skin prior to a procedure, such as starting an IV or giving a vaccine. It is effective in older infants, children, and adults.

 How does EMLA work?

EMLA contains lidocaine and prilocaine, medications that have been used for many years as anesthetics in medical and dental offices. EMLA contains these medications in a cream form. An area of skin is cleaned and then cream is applied directly to the skin. A dressing to hold the cream in place covers the spot. (Putting the cream and dressing on is not painful: it's like putting a Band-Aid on.) After1-2 hours, the cream numbs the skin tissue underneath. The dressing is removed and the cream is wiped off. Your child can then have his or her procedure with a lot less pain.

There is now a faster-acting preparation of EMLA cream that works in about 15-30 minutes.

 How effective is EMLA?

Several studies have shown that EMLA greatly reduces the pain children feel with injections. Most children will feel a pressure sensation, as if their skin was being pressed with a thumb, but won't feel the sharp stab or prick of the needle. Some children feel absolutely nothing. (Some children will still cry anyway, though, if they see the needle coming!)

 Can any child get EMLA?

EMLA is safe and effective in most children. However, we don't recommend EMLA for:

  • Infants under the age of one month. (They have very thin skin and could absorb too much of the medicine into their bloodstream.)
  • Children with severe liver or kidney disease
  • Children with G6PD deficiency
  • Children with very severe skin disorders
  • Children who are allergic to lidocaine or prilocaine

 Are there any side effects to EMLA?

Not many, and they are pretty rare. Occasionally children can have a little redness, swelling, or itching on the skin where the cream was placed. This goes away once the cream is taken off. EMLA is toxic if eaten or if too much is applied accidentally, so of course we treat it with the same respect we give all medications.

 How can I get EMLA for my child's next shots?

EMLA costs about $15 a dose. If your child is over 1 year old, you can get it at your pharmacy with your benefit card and put it on at home before you come to the office. Our nurse can give you instructions on how to do this. Or if you prefer, we can apply the cream in our office and bill your insurance. (Note: Some insurers will not pay for EMLA and EMLA administration. You'll want to call your insurance company first.)