Lidocaine injections

Hair Removal Methods Professional Electrolysis
#21

Right behind you kiddo …

Historically, in medicine, two issues (among others) were feared, not accepted for decades, caused fiery debates, enmity and punitive legislation. These subjects were STERILIZATION and PAIN relief with anesthetic! Imagine that?

For example, the medical profession argued against such simple techniques as hand-washing before surgery (few physicians believed the “microbe theory”). It took decades for sterile procedures to be adopted in medicine. Yikes!

Same with anesthetic. Indeed, inhalants were known to produce anesthesia (e.g., “Ether”), but surgeons would not opt for this for decades and instead, did surgery with little more than a “shot of whisky, tie the patient down, and plug your ears.”

Most electrologists have only experienced one or two negative results from using local (usually used incorrectly). Therefore their opinion is based on no depth of information … or perhaps the opinion of only one physician. (Yes! Physicians have different opinions based on their areas of expertise!) How can one have a single experience, hear only one opinion, and then speak with a voice of absolute authority?

And so, the fear, prejudice, and condemnation continues … only the patients lose out. I don’t expect anything to change either. People have their beliefs and are almost never able to change their mind, even in the face of overwhelming evidence, statistics and cold facts.

People get extremely angry when their ideas are challenged.

However, the many physicians and electrologists who have been using these techniques deserve to be heard by the profession; not shouted down, threatened and subjected to fear-based statements.

Local anesthetic is not rare in the profession. Dr. Ramelli (dermatology and my original “mentor”) in Long Beach, California, had five electrologists in his office for 35-years. They were booked all-day-long using local. Electrology 3000 in Texas also offers this and has a full compliment of electrologists working long hours and they are booked for 6-months+ out.

Wouldn’t it be “nice” to hear from these experts; listen to them in a calm dispassionate way? Don’t we owe it to ourselves to just listen without instantly forming an opinion?

I’m “all about” looking at everything with an open mind. It’s about the DATA! Isn’t that the basis of science?

As an addition to this writing, I’m also NOT a supporter of “secret methods!” This is another issue of course, but I ONLY support OPEN information for everyone. There is no need for “I’m better than you.” This attitude disgusts me and I have been at war against this foolishness my entire career.

If you have something “wonderful,” you OWE it to all of us to GIVE IT to us! If you have the most “modern advanced … blah blah blah,” well, just spell it out in clear terms so we can adopt your techniques if we wish.

Until ALL information is openly shared (and free to all), our profession will remain what it really is: a curious cottage industry of isolated practitioners making up their own rules and techniques.

#22

Well, meanwhile i actually know this colleague. The case went through the newspapers, including reports on the court procedure. She had been sentenced for “fahrlässige Tötung” (negligent homicide?).

Anyway, here in Germany only medically trained personal may perform such questions. So it is out of discussion in any ways except for those (few) electrologists who are also formally qualified as a medical practitioner.

#23

Certainly, I am not discounting personal experiences; they are important and very noteworthy indeed. However … well … let me illustrate the point:

In the last year, I have finished two male clients (back/shoulders) that had extensive previous electrolysis treatments. Both of these clients presented a significant amount of “pebbling” on the upper shoulders. Both clients were young men. One was from Georgia and the other from Virginia, where the work was performed. Both electrologists used the advanced “top-of-the-line” Apilus epilator. (“Pebbling” marks are permanent tiny mounds of scar tissue caused by improper treatment.)

So, here are a few possible conclusions:

  1. Young men are prone to getting “pebbling” on the upper shoulders.

  2. Electrologists in the American South (Georgia and Virginia) are likely to cause scars.

  3. The Dectro Apilus causes “pebbling” scars.

QUESTION: So, from these two significant experiences and visual evidence, which of the above conclusions are correct?

ANSWER: NONE of them!

The point being, you have to have a significant amount of data (of all kinds) to make a reasonable conclusion. A personal experience is important, but should not be the only evidence to determine your conclusions.

From the sources I mentioned in my previous post and from my own experiences, there are literally thousands and thousands of hours of SAFE electrolysis treatment with local anesthetic. An experience or an opinion cannot cancel-out these overwhelming data.

#24

I think the issue of pain control is a hugely important one in electrolysis.
It is a potentially painful procedure and as such we can’t ignore it.

The difficulty is the availability of effective methods.
Topical is often less than effective and sometimes short-lived for practical purposes.
I ask people to apply (not ‘rub in’) about a centimetre thickness and occlude it completely - for at least 60, and preferably 90 minutes before treatment.
What do you recommend Michael?
I sometimes use sub-cutaneous, injected Lidocaine - so far for bikini treatments. It can make the difference between the ability for a client to continue with her treatment or not.
It is prescribed face to face by a nurse-prescriber and the client either brings the Lidocaine to me or I order it using the prescription.(I am a R.N.)
Nurse-prescribers are not allowed to keep a stock of product but so far I have been lucky in that my prescriber has had a few ampules left over.
I personally don’t see why a specialist electrolysist couldn’t have training to inject L.A. but I know that some colleagues think this is the thin edge of a dangerous wedge. I see their point also, given that Europe is confining cosmetic injections to medics only - not dentists and not nurses. The UK may well follow suit.
Giving electrolysists a licence to inject is unlikely to fly.
So what is the business model for the use of effective analgesia/anaesthesia?
Have an in-house doctor? An on-call doctor? Our businesses would have to be big and very profitable.

#25

Your comments are intriguing Scottish Lass.

Some years ago I worked with a laser firm that also made microdermabrasion units. I learned, from their business, that there are two important terms commonly used: “push” and “pull.”

In the early days of microdermabrasion, the manufacturers had to “push” the product on reluctant estheticians and dermatologists. At “the tipping point,” the public perceived the advantages of this technique and demanded their practitioners get on board with the program. At this stage, the clients create the demand. And, as they say, “the rest was history.”

I was at the national dermatology show and was shocked when a very famous dermatologist purchased a microderm unit from “us” for $25,000. I spoke with this physician.

I said, “Doctor, you do know that this machine only removes the very outer dead layer of the epidermis and basically does very little indeed. Okay, ‘nothing’.”

He said, “Yes, I know, but my patients demand it!”

And, this is what is meant by “pull!” Because of client demand, the purchaser now “pulls” the product … no more need to “push it.” (At this point, every “Tom, Dick and Harry” starts making a machine too!")

As more electrologists begin to utilize local anesthetic, the client base will eventually see these advantages and demand this service. At that point we will reach “the tipping point,” and therapists will have to get on board. Regulatory laws will, out of necessity, change.

We still live in a capitalist economy where the consumer is king. In our system, people always get what they want! Laws have never created a job or a procedure. In our capitalist system; laws regulate what’s already being done … to protect the consumer when appropriate.

#26

During my “next to last” trip to New Zealand, I met with the NZL medical board. After some discussion the decision was made, to my total astonishment, that the board would allow independent electrologists to use and administer local anesthetic if the association could develop an appropriate 100-hour board certified course for the procedure. They had a year to work on it with physicians and academics.

The folks in the association were thrilled and full of boundless enthusiasm and already had physicians on-board to help write the course. However, within that year nothing was done and the idea died. I returned the next year and found that people had forgotten about the whole thing.

I learned that, for most of us, everything has to be presented to our “folks” as a completed document. Procedures must already be approved by “authorities,” and then people will “act.” Nothing significant gets done by committee … I mean absolute ZERO!

People are terrified to move out of their “comfort zone,” but they WILL if everything is done for them already. And, that’s fine … because that’s just the way it is! I understand these dynamics.

Case in point: To date, I have sold more than 5,000 books on telangiectasia work! Every now and then some spirited electrologist wants to present her ideas to some “board” so that she has approval to do the procedure. Letters are written, expectations get high and then the whole thing collapses after she gets ONE “uncertain” or negative response. (Most negativity comes from her association itself!)

So, please tell me … somebody … just WHO is buying my book? FIVE THOUSAND books sold? Are people buying two or three books? Frankly, I don’t get it. Do you think “somebody” is actually doing this procedure without official authorization? Oh my GOD! Curious minds want to know!

One thing to think about: WHEN did any government “board” EVER create a new procedure or a new job? If you expect government to come up with new ideas … well, you are going to have a LONG wait!

#27

May I ask how large is the area injectible lidocaine can numb? and how long does it last ? can one numb the entire chest? how?

I’m asking because I started laser/IPL/Aurora on some areas on my upper body… the technician also gives botox/fillers shots I assume she should know how to give other injections… and I’ll call to consult her tomorrow.

#28

Funnily enough, it’s the “SPEED” of laser that makes use of local anesthetic unsuitable for laser hair removal. I mean, laser “zaps” the entire chest whereas, if you were doing electrolysis on the chest, it goes much slower and therefore the use of local is appropriate.

If one were doing electrolysis on the chest, the technician would use no more than about 6cc - 9cc (of diluted lidocaine). This area would be treated in about 30-minutes and, by then, more than 50% of the lido will have been metabolized (half-life) out of the body (with the molecule still attached to the nerve synapse receptors thus causing about 2-hours of good anesthesia, but near zero blood level). In a sense you are using common 1% lido at only 6cc - 9cc per hour, administered in two diluted doses at 30-minute intervals.

At the end of the 30-minutes, another adjacent area can be infiltrated with a similar dose. This amount, over the entire hour, is an infinitesimal percentage of the recommended maximum dose recommended during an hour-long procedure.

Point is that you cannot “numb” and ENTIRE chest (or back) at one time. Such an application would call for a “tumescent procedure” (as is sometimes used with liposuction) … this is a procedure not usually recommended and somewhat risky (commonly used by dermatologists that want to do lipo without an anesthesiologist).

Bottom line (my opinion): you cannot use local anesthetic reasonably well for laser treatments. Electrolysis YES!

#29

what about injectibles, do you think they can be effective with laser ?

#30

or are you including both topical and injectible lidocaine in your response ? I only used Lidocaine for my face last time… and it helped… I’m wondering if injectible lidocaine is stronger and better… so should I ask her to inject right before we do an area ?

#31

Hummm … okay.

I don’t think she will (or can) inject the area before laser … unless, as I said, you are doing a small area: about the size of your hand. That’s about it for the maximum safe dose of infiltrated “Lido/Xylo.”

Topical would be a much better choice for laser … but again, not in questionable doses. You can have bad reactions from even the most seemingly innocuous products.

In my opinion injected (or oral) medication is safer than the trans-dermal meds, primarily because you know the EXACT dose the body is getting. With trans-dermal you can never be sure of the amount absorbed (and patients often get “carried away” and use too much). This is now being demonstrated, for example, in hormone therapy too.

#32

In UK I do not think our electrolyisis do lidocain injections instead they recommend a cream such as Elma if you have discomfort.

I over heard my electrolysis discussing it with her TG client who has laser and electrolyisis treatments.

I asked her about it afterwards and considering getting some for my upper lip it makes my eyes water the closer she gets to the nose lol.

#33

EMLA is near perfect solution to pain management for laser. I used EMLA 5 times on chest and torso during laser treatments. The last 3 treatments didn’t require pain management even on highest settings because by that time, hair was sparse to cause unbearable pain. Even for the lip area, EMLA should provide more drastic comfort than ice packs.

#34

Pain does affect treatment, certainly in my own case. Haven’t tried EMLA, but earlier this year I saw an electrolysist for the shaft of my penis. She sold me a tube of Dr. Numb, supposedly a 5% lidocaine creme.

So I slathered it on, wrapped my junk in glad wrap and drove to four appointments. All of which still hurt a lot! Maybe it was a “bad batch” but I’m not sure that creme did much at all. Sometimes the pain was just at the edge of intolerable – but her approach was to completely clear small areas, so I hung in for four weekly sessions until the work was even and all the way around. I hoped they would get easier, but they didn’t.

Now, I’m several months past when I was supposed to have a followup and the area has mostly filled back in with regrowth. I know I should make an appointment, but I just don’t!

If there was some more effective pain management, I would never have gone AWOL and become a… disillusioned hair-removal fugitive.

It would be a different story if I found an LA practitioner offering better pain management options.

#35

I think I know who in LA you’re seeing, and if it’s the same person I’m thinking of, yes I got regrowth too but she does a great job and other electrologists have even complimented me on how good my skin looks and said she did a fabulous job.

There are some in LA who will use Lidocaine injections though they may not do it on the penis, not to mention I don’t know which LA electrologists will do those areas. Some I know of in LA who use lidocaine are Dana Elise and Layla. There was Robin Harris who worked in a place with people legally allowed to give Lidocaine, but we had issues with setting that up so may not do it with Robin