The S-Caine peel: A novel topical anesthetic for cutaneous laser surgery

BACKGROUND. The S-Caine peel (Zars, Inc., Salt Lake City, UT) is a novel eutectic lidocaine/tetracaine mixture that is applied as a cream, drying upon exposure to air to form a flexible film that can be peeled off easily. The patented formulation can be used to anesthetize the skin prior to a variety of cutaneous procedures. OBJECTIVE. To examine the clinical efficacy of the S-Caine peel as a topical anesthetic for pulsed dye laser (PDL) treatment and to determine the optimal application time for adequate cutaneous anesthesia. METHODS. Sixty patients were enrolled in one of three separate double-blind, placebo-controlled protocols in which the active product or a placebo was applied to the skin and left intact for 20, 30, or 60 minutes prior to laser treatment. A 585 nm or 595 nm PDL was used to treat facial telangiectases or port-wine stains in each protocol. Patients rated the level of pain experienced during laser treatment on a visual analog scale (VAS). Independent assessments of observed discomfort and side effects were recorded. RESULTS. All patients experienced significant pain reduction with the S-Caine peel as their sole topical anesthetic. An application time of 20 or 30 minutes was as effective as 60 minutes in achieving anesthesia. Side effects of the peel application were limited to transient mild erythema. CONCLUSION. The S-Caine peel is a rapid, safe, and effective method of topical anesthesia for cutaneous PDL treatment.