Tattoo Numbing Cream for PMU - All You Need to Know
All the info on using a tattoo numbing cream for PMU and similar treatments: how it’s used, what ingredients it can contain, risks, pro tips + our recommendations!
Originally used in the tattooing industry, numbing cream is also widely used in PMU to make it as comfortable as possible for the clients.
The product comes in many variations which are used differently, and there are countless brands and formulas available.
No matter if you’re a PMU artist or a potential client, it’s useful to be familiar with this product.
We’ve prepared a detailed guide through how and why tattoo numbing cream is used for manual and machine permanent makeup, as well as related treatments and some skincare procedures.
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Why Is Numbing Cream Used for Permanent Makeup?
Just like tattooing, permanent makeup implies breaking open the skin and implementing pigments into it.
In the case of microblading, the skin is opened by making scratches on it with a thin blade. In the case of other permanent makeup treatments, the skin is punctured with a needle operated by a PMU machine.
The act of opening up the skin with either method can be painful, since a sharp tool reaches the dermis layer of the skin where nerve endings are located.
Numbing cream is used to eliminate the pain and make the treatment as comfortable as possible for the client.
How Does Numbing Cream Work?
When a topical anesthetic is applied to the skin, the active ingredients get absorbed and reach the nerve endings in the dermis layer of the skin.
This prevents the nerves from sending signals to the brain which causes the pain sensation.
It takes a certain amount of time for the active ingredients to get absorbed – that’s why topical anesthetics have to sit on the skin for 20-30 minutes* in the case of permanent makeup. This provides a numbing effect sufficient to block the pain.
The numbing effect is temporary and it wears off within 30 minutes to several hours.
*The amount of time it takes for a numbing cream to give a numbing effect depends on its formulation.
Types of Tattoo Numbing Cream
There are 2 types of tattoo numbing cream which are commonly used during permanent makeup treatments:
- Primary numbing – applied to unbroken skin (also called phase 1 numbing and pre-numbing)
- Secondary numbing – applied to the skin once it’s been broken.
Primary numbing is used for the so-called pre-numbing. The skin is numbed before it’s broken and this ensures there’s no pain when the initial marks are made.
With pre-numbing, there is no direct pathway for the active ingredients to reach the nerve endings – they have to pass through the epidermis, and this means that the numbing effect which can be achieved is limited.
Primary numbing usually comes in a cream consistency, so it’s creamy and relatively thick.
Some primary numbing formulas can be used on both unbroken and broken skin, but since their formula is usually primarily designed for pre-numbing, they may be less effective for secondary numbing.
Secondary numbing can be used once the skin has been broken. Since there is a direct pathway for the active ingredients to reach the nerve endings, the numbing sensation achieved is much more intense, and can potentially last longer.
Secondary numbing usually comes in the consistency of a gel or a liquid, which allows for easier, more localized application.
The effects of pre-numbing often wear off at some point during a PMU treatment, or they’re insufficient to begin with. That’s why it’s a common practice for PMU artists to use secondary numbing at some point during the procedure.
PMU treatments can last upwards of 1-2 hours, so prolonging the numbing is usually necessary.
Alternatively, artists can go through the first pass without pre-numbing, and go straight to secondary numbing on broken skin (if the client can handle the first pass without any anaesthetic cream).
Which Ingredients Do Numbing Creams Contain?
There are several anesthetic agents usually used for topical numbing creams:
- Lidocaine (also known as lignocaine)
Out of these 3, lidocaine is by far the most common one, since it’s been proven to provide the most intense numbing sensation. Plus, there’s the fact that lidocaine does not affect pigment implementation in any way.
Numbing creams used by PMU artists contain lidocaine as the only anesthetic agent, or they contain multiple agents, but lidocaine is almost always included.
Depending on the strength or concentration of the anesthetic agent, tattoo numbing creams can be over the counter, or prescription. PMU artists use former, since PMU falls under the category of cosmetic, not medical procedures.
The highest concentration of topical lidocaine in over-the-counter formulas is 5%. Creams with a higher lidocaine concentration than this aren’t suitable (or legal) for use by PMU artists, who are not medical professionals.
The anesthetic agent is the main ingredient in a numbing cream, but it’s not the only one.
A number of numbing creams also contain vasoconstrictors – namely, epinephrine – which temporarily shrinks blood vessels and constricts blood flow to the area, slightly prolonging the numbing.
This can be helpful during PMU, so epinephrine is often found in secondary numbing formulas.
These active ingredients are built into a cream, ointment, gel or liquid base, and there can also be additional soothing ingredients, like various natural extracts.
How Is Tattoo Numbing Cream Used for PMU?
Before the PMU treatment starts, the area that will be treated (brows, lips, eyelids or the scalp) is usually pre-numbed:
- The area is cleaned with a disinfecting cleanser. Skin needs to be free of all makeup and product residues, as well as sebum – if there’s any greasy/oily residue, the anesthetic cream won’t be absorbed sufficiently and evenly.
- A layer of lidocaine cream thick enough to be opaque is applied evenly on the area. The artist should cover an area as small as necessary with numbing cream – numbing a larger area is unnecessary exposure to anesthetic cream.
- The cream is left on for 25-30 minutes, or as long as the instructions on it say. Some clients may need longer, but it’s not advised to leave the cream on for longer than the instructions say. The area can be occluded with cling.
- The cream is removed with a suitable tool and if the client is numb, the artist does the first pass.
- If the effects of numbing wear off after the first pass, secondary numbing is applied. The area is cleaned from pigment residues, and a small amount of secondary numbing gel is applied directly to the skin. It’s left on for no longer than a couple of minutes.
- If needed, secondary numbing can be reapplied towards the end of the procedure.
- Find more numbing tips here.
Tips on Making the Most of the Anaesthetic Cream
Here are a few tricks artists use to maximize the effects of lidocaine cream:
- The best way to make sure all grease is removed from the skin before pre-numbing is to clean it with rubbing alcohol, which can be drying but it works.
- Before numbing, exfoliate the area lightly with a spoolie to remove dead skin and allow the numbing agents to sink deeper. This is especially important when working on fuller natural brows which trap a lot of dead skin.
- Occlusion maximizes the numbing. Once primary numbing is applied, a piece of cling wrap is placed over it. The film traps moisture and heat, which opens the pores and allows the cream to sink in more easily.
- Another trick for opening up the pores is applying a hot towel over the cling wrap.
- Some artists prefer to skip pre-numbing entirely and go straight for secondary numbing. They use a needle or a microblading blade to gently puncture the skin, opening it up, and apply a secondary anesthetic.
Image source: Instagram @zensaskin
Since PMU artists are not medical professionals, the regulations on them using anaesthetic creams may vary per state/country.
Some jurisdictions allow PMU artists to use over the counter primary and secondary topical anesthetics without regulation.
Some prohibit the use of secondary numbing; some prohibit the artists from applying numbing creams on clients at all (in which case, the client is usually asked to buy and apply the numbing before the appointment).
Check with your local health authority and always follow all local guidelines.
How to Choose the Best Tattoo Numbing Cream for PMU
There’s no one answer – it’s all down to what formula(s) work best for the artist and their client.
The efficiency of lidocaine cream can vary from one client to another, but in general, here’s what to look for in a tattoo numbing cream for different PMU treatments:
Best Numbing for Brows
Most formulas work well for brows, but it’s good to have multiple lidocaine creams on hand – one that contains only lidocaine as a numbing agent, and one that contains tetracaine and/or benzocaine, too.
The go-to numbing for brows should be a lidocaine cream, since lidocaine is the agent that causes allergies the least often.
But in case a client doesn’t get a sufficient numbing sensation from it, the other 2 available components can do the trick.
In terms of consistency, although runny, watery formulas are absorbed more easily, they can be hard to work with, especially for inexperienced artists.
Thick, ointment-like creams provide hydration, which is a plus as it soothes the skin, but they can be problematic for microblading, as they soften the skin a bit and getting crisp strokes can be a challenge.
Image source: Instagram @sdlc.beauty
Best Numbing for Permanent Eyeliner
The numbing used for permanent eyeliner treatments should have a balanced pH, safe for use around the eyes.
That said, both the artist and the client should be careful to prevent the anesthetic cream from getting in the eyes. If this does happen, the eyes need to be rinsed for 2-3 minutes with water.
Thicker formulas are generally better for work on the eyelids, as runny ones can get into the eyes easily.
Strength is another factor to consider. The skin of the eyelids is very thin, so even weaker tattoo cream can numb it quite well. It also takes less time to numb than brows, so 20 minutes should be more than enough.
Image source: Instagram @lisahornsby_pmu
Best Numbing for Lip PMU
Lidocaine cream of more or less any consistency can work well on the lips.
Since the lips tend to swell a lot during lip blushing procedures, some artists advise using a formula that contains epinephrine for lip PMU.
Image source: Instagram @boldbeautyink
Best Numbing for PMU Removal
The same advice applies to PMU removal as it does for PMU implementation in terms of what lidocaine cream consistency is best for the brows, eyelids and the skin around the lips.
One thing that’s inarguably undesirable in a numbing cream used for PMU removal is epinephrine.
When removing PMU, blood and lymph flow are desirable, as they’re needed to wash out the unwanted pigments. Epinephrine would block them and pigments would be harder to remove.
Are There Any Risks Associated with Tattooing Cream?
If they’re used properly, adhering to proper dosage, tattoo numbing cream is quite safe. However, there are certain risks associated with improper usage of tattooing cream, and certain contraindications. Let’s go through them:
Numbing agents are quite foreign to our bodies, so there’s a chance of an allergic reaction when numbing cream is applied to a person’s skin for the first time, or a different brand or formula is used.
In general, agents of the ester type (benzocaine, tetracaine) cause allergies more often than amine agents (lidocaine). Allergic reactions to epinephrine are extremely rare, but they can occur.
Numbing creams should always be patch tested – a small amount of topical anesthetic should be tested on a hidden spot before a significant amount is used on the client’s face at the actual appointment.
If the body is exposed to higher than recommended doses or concentrations of tattoo numbing cream for too long, there’s a risk of potentially fatal cardiotoxicity and central nervous system toxicity.
These are extreme cases of course, but numbing cream should be used as sparsely as possible and left on the skin for as little time as possible.
Symptoms of overexposure to anaesthetic cream include:
- Numbing around the mouth (unless that’s where the cream was applied)
- Double vision
- Tinnitus (ringing in the ears)
These symptoms have also been connected with overexposure to epinephrine.
Most anaesthetic creams have an alkaline pH value which can cause damage to the cornea if the product gets into the client’s eyes. If this does happen, the eyes should be rinsed immediately.
Breastfeeding as a Contraindication
Once absorbed by the body, lidocaine is excreted through breast milk, so anesthetic cream should not be used on women who are nursing.
What Other Treatments Can Numbing Cream Be Used For?
Topical anesthetics find their use in many treatments and procedures which involve different forms of trauma to the skin. Some of them are:
Apart from permanent makeup, micropigmentation treatments like freckle tattoos, scalp micropigmentation, scar camouflage, areola pigmentation and similar all require numbing cream.
Image source: Instagram @stjohnink
Numbing Cream for Tattooing
Obviously, since tattooing engages a similar color implementation method to permanent makeup, numbing creams can be used for this form of body art. In fact, PMU artists borrowed numbing cream from this industry, not the other way round.
Numbing Cream for Piercings
Numbing cream can be used for certain types of piercings, but its effects are limited. Topical anesthesia can only numb the outer layers of the skin, not the tissue underneath, so the piercing of the needle will still cause some pain.
Most piercers don’t have the habit of using numbing cream, since it complicates the procedure without much effect.
Numbing Cream for Microneedling
Professional microneedling is done by poking the skin with a cluster of needles over and over again to afflict controlled trauma and trigger the regeneration process.
Numbing cream is frequently used to eliminate the pain of the poking. Occlusion definitely helps!
Image source: Instagram @cleanskinlondon
Numbing Cream for Waxing
Anaesthetic cream can be applied to the skin before waxing to minimize the pain, however, due to the potentially harmful effects of applying numbing creams too often to large areas of the skin, you shouldn’t make a habit out of it.
Numbing Cream for Laser Hair Removal
Anesthetic cream is widely used to help minimize the pain of laser hair removal.
Although these treatments are done as a series, which means a large area will be covered with numbing cream on several occasions relatively close together, there is no maintenance afterwards, unlike with waxing.
So there is less total exposure to numbing cream and risk of adverse effects is lower than it is with waxing that you repeat every couple of weeks indefinitely.
Image source: Instagram @zensaskin
Numbing Cream for Injections
It’s a common practice to use numbing cream before the application of dermal fillers, since the needle is inserted several times. But for quick procedures where the needle is only inserted once numbing is generally not used.
Numbing cream can be used for Botox injections, but this isn’t that common.
Tattoo Numbing Cream for PMU – Main Takeaways
PMU artists use tattoo numbing cream to make the implementation of pigments as comfortable as possible for their clients. They can be used for pre-numbing unbroken skin, or for prolonging the numbing effect once the skin has been broken.
The most common anesthetic agent in tattoo numbing cream is lidocaine, which has been proven to work best.
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