Background: The ideal topical anesthetic agent is one that provides 100% anesthesia in a short period of time, work on intact skin without systemic side effects, and invokes neither pain nor discomfort. The quest to find such an agent continues today. Because a topical anesthetic agent will induce anesthesia painlessly, the need for an effective agent is clear. This will serve to eliminate painful injections with lidocaine prior to many dermatologic procedures.
Objective: To provide a review of topical agents used in the past, to present products that are being used today, and to look to the future of topical anesthesia. CONCLUSIVE: During the last three decades a variety of methods have been employed to administer topical anesthesia. Presently, EMLA (eutectic mixture of local anesthetics) is the most often used method among practicing dermatologists. However, iontophoresis and the anesthetic patch are equally effective with a few notable advantages over EMLA. Liposomal agents show promise as we enter into a new millennium.