Topical Anaesthetics for Cosmetic Tattooing

There are legal limits for what can topical anaesthetic can be purchased over-the-counter. Cosmetic tattooists wishing to obtain topical anaesthetic for treatment purposes need to be aware of the legal requirements for supply and use to operate in a legal capacity and avoid serious penalties.

THink MBC has been working with compounding pharmacies to develop truly effective, and legal, numbing creams and gels. We’ve learned a lot, tested a lot, and we’re happy to continue to share the results with you, our customers.

It’s really important to get the base cream or gel right. Get them wrong and the skin won’t absorb the anaesthetic (= Pain). Pre-treatment numbing cream needs to be water-based, otherwise it won’t absorb. The pH of creams and gels needs to be close to 7 for the skin to absorb them quickly. Standard creams and gels are often acidic (low pH to preserve the anaesthetic), which can be a problem.

These formulations can be obtained from Keperra Compounding Pharmacy (KCP) or you can work with your own compounder to develop an equivalent. With KCP you can ask for the THink Formulations. Note we have no commercial relationship with KCP, other than buying our anaesthetics from them.

The main contact for topical anaesthetics at KCP is Tahnee Simpson.

Keperra Compounding Pharmacy

15 Dallas Parade, Keperra, Queensland 4054
T : (07) 3354 3992
E : info@compoundingpharmacy.com.au
W : www.compoundingpharmacy.com.au

  

ORDERING TOPICAL ANAESTHETICS FROM KCP

Technicians need to contact Keperra Compounding Pharmacy (KCP 07 3354 3992) and register their clinic/salon. KCP will provide a website link which the technician will provide to their customers. This website link enables your customers to order and pay for their anaesthetic directly from the Pharmacy.

Payment needs to be made by the client (customer) directly to the pharmacy on the website. The client will provide all the required information to KCP, including the Salon name and the treatment being performed. KCP will assess the client information as part of their risk assessment and supply the topical anaesthetic.

Once KCP receives the required online consent form and payment, they will arrange delivery to the registered clinic prior to the procedure respecting the date of procedure provided. Note you should allow two days plus the amount of time usually taken for a delivery via Australia Post (from Brisbane).

Please note the numbing cream will be delivered with your customers name on it.


TOPICAL ANAESTHETIC EDUCATION: ONLINE SHORT TRAINING COURSE

All the information you need in one place. We highly recommend undertaking the Topical Anesthetics in Skin Penetration Training Course, developed by THink Aesthetics for educating technicians (cosmetic tattooists, tattoo artists, skin therapists, laser techs, etc). This short training course has been reviewed by Keperra Compounding Pharmacy. Students who successfully complete an optional test as a part of the training will receive a certificate showing they have complete the short course.

Treating technicians need to be aware of where to get topical anaesthetics that can be used legally, how they work, and what the risks are. We recognise that technicians are usually not chemists or pharmacists and do not necessarily need to understand the detailed workings and chemistry of anaesthetics. This course provides the essential to keep you and your client safe, and your client as comfortable as possible. 

P.S. USE CODE: TOPICALFUN to get the course for only $59 (usually $149).


ANAESTHETICS AND REGULATION IN AUSTRALIA

Topical anaesthetics are controlled by federal and state & territory government regulation and cosmetic tattooists need be very careful what they use, and how it is supplied, is legal. Health authorities are now conducting audits of premises to check what is being used. 

Further information is available from Aesthetics Practitioners Advisory Network (APAN).

Topical anaesthetics are essential to keeping your clients as comfortable and pain-free as possible. This information is to help you understand what is currently safe and legal in Australia.

The main ingredients in topical anaesthetics can include one or more of the following: lidocaine (lignocaine), tetracaine, benzocaine, prilocaine and adrenaline (epinephrine). All these substances are regulated.

Topical anaesthetics with concentrations between 2 and 10% are classified under Schedule 2 of the Poisons Standard 2010 (and amendments). Topical anaesthetics containing epinephrine (adrenaline) in concentrations of 0.02 – 1% (used to stop bleeding and swelling) are classified under Schedule 3. Products with lower concentrations may also be regulated but are unlikely to have any significant anaesthetic effect during cosmetic tattooing procedures.

In addition to the Poisons Standard, topical anaesthetics are controlled under the Therapeutic Goods Act (1989). As topical anaesthetics are considered a ‘high risk’ product they are highly regulated and must be produced by a TGA-approved manufacturer. This can be identified by the ‘AUST R’ number. If your topical anaesthetic does not have an AUST R number or was not made by a compounding pharmacist it is illegal to use within Australia. This really limits your options, with a few weaker topical anaesthetics (less than 5%) being TGA-approved. EMLA is one of these.

What if I want to use a stronger topical anaesthetic?

Your client will need to obtain the anaesthetic from the pharmacist as it is specifically for their personal use. We (THink) have established an arrangement with a compounding chemist to be able to directly supply such anaesthetics to your client for use in your procedures.

Specific caution on EMLA:

A popular choice of over-the-counter topical anaesthetic is EMLA. This cream contains 2.5% lignocaine and 2.5% prilocaine. What you also need to be aware of is EMLA has a relatively high pH (approximately 9), which means it is more alkaline than other topical anaesthetics and may burn particularly sensitive body tissue.

Conducting eyeliner with EMLA is not recommended because of the risk of contact with the eye, which may result in injury resulting in the need for hospitalisation and extensive treatment (Alkaline chemical ocular injury from Emla cream, Brahma & Inkster, Eye (1995)).

Final Words of Caution:

  • Check the anaesthetics you are using, including the ingredients and concentrations. Regulations change, and health authorities are now conducting inspections.
  • Ensure the anaesthetics you use are obtained legally. There are on-line shops still selling topical anaesthetics that should not.
  • All anaesthetics are not made equal, literally. Even with the same ingredients, performance varies according to the quality of the ingredients and skill of the compounding pharmacist.
  • If you are unsure if you are using the correct anaesthetic consult with a suitably qualified medical practitioner or your qualified cosmetic tattoo trainer, who should be fully familiar with the current legal requirements, as well as developments in the available anaesthetics.
  • Read and follow any instructions provided with the anaesthetic.
  • Check with your client for any allergy or sensitivity (consent form).
  • Observe carefully for any side effects or other contraindications after topical anaesthetic application and during procedures. Talk to your client and check all is well.
  • Keep up to date with changes in regulations and industry information. What was acceptable when you were trained may be different now or change in the future.

Each state and territory also have their own acts which should also be considered.

Queensland
Health (Drugs and Poisons) Regulation 1996 

New South Wales
Poisons and Therapeutic Goods Regulation 2008

Victoria
Drugs, Poisons and Controlled Substances Act 1981 

Tasmania
Poisons Act 1971

Australian Capital Territory
Medicines, Poisons and Therapeutic Goods Act 2008

South Australia
Controlled Substances (Poisons) Regulations 1996

Western Australia
Poisons Act 1964

Northern Territory
Poisons & Dangerous Drugs Act

There's lots to learn!

Online training course

It's what you don't know that gets in the way of providing the best treatment possible for your clients.

From ingredients, to the legalities and what to look out for during a treatment - what you need to know for numbing for skin penetration procedures is all in our topical anaesthetics short online course.

This course has been put together by THink Aesthetics and reviewed by KCP.