What are numbing creams and how do they work?
“Numbing creams” (topical anaesthetics) are medicated creams, gels or sprays whose active ingredients — most commonly lidocaine alone or a lidocaine/prilocaine combination (for example EMLA) — temporarily block nerve signals in the skin. They are designed to reduce surface pain by numbing the top layers of the skin (the epidermis and upper dermis).
Important, practical point: tattoo needles reach the dermis. Topical creams mainly act on the surface, so while they can reduce stinging and the sharp “surface” pain, they rarely make tattooing completely pain-free. Artists and clients should expect a noticeable reduction in surface pain in many cases, not a complete absence of sensation.
Legal status in the UK — plain version
Topical anaesthetics are classed as medicinal products under UK rules. That classification affects how they can be sold, supplied and given to another person. In practical terms it means there are legal limits on who may supply or apply them, and under what circumstances — the law expects medicines to be handled in ways that reduce risk to the public.
Because of that legal status, many local authorities and public-health guidance documents caution about tattooists supplying or applying anaesthetic creams in the studio. This is the main reason many reputable studios take a conservative approach.
Can tattoo artists legally give or apply numbing cream?
Short answer: generally no as a routine practice. Local environmental health teams and council guidance commonly advise that tattooists should not be the ones supplying or applying topical anaesthetic medicines to clients. Instead, studios typically follow one of these approaches:
- Refuse to supply or apply anaesthetics at all (studio policy).
- Allow the client to bring a pharmacy-supplied, licensed product in original packaging and to apply it themselves (sometimes with the artist present to verify correct product and application time).
- Allow a clinician (pharmacist or nurse/prescriber) to supply or apply the product under their own professional responsibility.
Which approach you choose should be written into your studio policy and communicated clearly to clients at booking and in pre-appointment notes.
Safety risks & clinical notes (what you must know)
- Allergic and local skin reactions: creams can produce itching, redness, swelling or blisters. An allergic reaction can make the site unsuitable for tattooing and may worsen healing.
- Systemic toxicity: applying too much cream, applying over too large an area, or applying to damaged skin can allow enough active ingredient into the body to cause systemic symptoms (dizziness, tremor, headache, cardiac symptoms in severe cases). Licensed products include maximum dose guidance for a reason.
- Methemoglobinemia: certain ingredients (notably prilocaine, used in combination creams) carry a small risk of methemoglobinemia — a condition affecting oxygen delivery in the blood — in susceptible groups. While rare in healthy adults, it is a serious condition and worth mentioning in risk briefings.
- Masking of feedback: when the skin is numb, the client can’t feel pressure or overworking. That can lead to the artist applying excessive pressure or going over the same area too much, increasing the risk of scarring, poor pigment retention or prolonged healing.
- Unlicensed or imported products: many products sold online and marketed specifically for tattooing (sometimes under brand names like “TKTX” or similar) are not licensed in the UK. Their composition and sterility can be unreliable. Using unlicensed imports carries both safety and legal risk.
Practical implication: insist on patch testing (see below) and be conservative about allowing unknown or unlabelled products in your studio.
Practical guidance for artists (policy, consent, patch tests, record-keeping)
(This section is the studio-facing checklist you can use directly.)
Quick recommended studio policy (copy and paste)
“Topical anaesthetics are medicines. For legal and safety reasons our studio does not supply or routinely apply topical numbing products. Clients may bring a pharmacy-supplied, MHRA-licensed topical anaesthetic in its original packaging and may apply it themselves prior to the appointment following the manufacturer’s instructions. If a client wishes to have a clinician apply a topical anaesthetic we will request evidence of the clinician’s credentials and written instructions. We will refuse unlabelled or unlicensed products.”
Step-by-step procedures to implement
- Choose and publish a clear studio policy: add the policy to your website, booking pages and your pre-appointment emails so clients know in advance.
- Require a patch test: ask clients to do a patch test 24–48 hours before a session if a topical anaesthetic will be used. Patch tests should be documented: site, date/time and reaction (if any). If there is any adverse reaction, do not proceed with the tattoo until cleared by a clinician.
- Update consent forms: add a clause that records whether a topical anaesthetic was used or will be used, the product name, who applied it, the time applied and confirmation of patch-test results (template included below).
- Record-keeping: keep the product name, batch/expiry (if shown), where it was bought (pharmacy), the time it was applied, the amount/area treated, and the patch-test outcome in the client file.
- Refuse unlicensed/unknown products: if a client brings a product without clear labelling or from an untrusted online seller, politely refuse and explain the reasons — safety and studio liability.
- Do not apply to broken or inflamed skin: creams should not be used on open wounds, active eczema or heavily scarred tissue. If in doubt, reschedule or seek clinical advice.
- Train your team: ensure staff understand your policy and the reasons behind it so they can explain it clearly and consistently to clients.
Patch test procedure (sample)
- Ask the client to bring the product and the leaflet.
- Apply a small amount (as per leaflet) to a discreet area (e.g. inner forearm) and cover if required by instructions.
- Ask the client to check the site at 24 and 48 hours and report any reaction. Note any reaction in the client file.
- If there is redness, swelling, blistering or other reaction, do not use the product on the tattoo area and advise medical review if symptoms are significant.
Practical guidance for clients (what to bring, how to apply, expectations)
- Bring original packaging: always bring the original product box or tube and the instruction leaflet so the artist can check the product and expiry.
- Follow the leaflet: apply exactly as directed — timing before the appointment, amount and maximum area treated. Many products require application 60–90 minutes before the procedure.
- Patch test in plenty of time: carry out a patch test at least 24–48 hours before your appointment if your studio requests one.
- Realistic expectations: creams usually reduce surface pain but rarely eliminate the sensation entirely. Expect reduced stinging rather than total numbness.
- Avoid unlabelled imports: don’t use mystery online creams or unlabelled imports. When in doubt, purchase a pharmacy-supplied, licensed product or ask your GP/pharmacist for advice.
Studio policy, consent text & record checklist (copy/paste ready)
One-sentence consent addition (recommended)
“I confirm I have read the studio’s numbing-cream policy. I have brought a pharmacy-supplied, MHRA-licensed topical anaesthetic in its original packaging (product: ____________), I have performed or will perform a patch test on ______ (date/time), and I understand the potential risks including allergic reaction and masking of pain.”
Suggested fuller consent paragraph
“I understand that topical anaesthetics are medicinal products. I confirm the product I am using has been supplied by a pharmacy or clinician and was provided in its original packaging. I consent to the studio recording the product details and the patch-test result, and I understand the product may alter my sensation during tattooing and could affect healing. I accept the studio’s right to refuse use of any unlabelled or unlicensed product.”
Record-keeping checklist (for the client file)
- Client name / date of birth / ID (copy if required)
- Product name, strength, manufacturer
- Retailer (pharmacy/clinic), date purchased (if shown), batch/expiry (if shown)
- Who applied the cream (client/clinician) and time of application
- Patch test date, site and result
- Consent signature & date
- Notes of any immediate reaction or abnormal findings
FAQs
Q: Can an artist apply a pharmacy-supplied cream for a client?
A: Many studios avoid applying creams directly to reduce legal risk. A safe approach is to allow self-application by the client or arrange for a clinician to apply under their own professional responsibility. If an artist does apply, document the product, batch and time, and ensure the product is pharmacy-supplied and labelled.
Q: Are products sold online (TKTX-style) legal and safe?
A: Many such products are not authorised in the UK. Their contents, concentration and sterility may be uncertain. Using unlicensed imports carries safety and legal risk — best practice is to avoid them and use pharmacy-supplied, licensed products instead.
Q: Will numbing cream stop bleeding?
A: No. Topical anaesthetics reduce surface pain but do not significantly prevent bleeding from needles reaching the dermis. Normal infection-control and aftercare remain essential.
Q: Can a minor use numbing cream?
A: Tattooing minors for body tattoos is illegal in the UK. For any medication use, clinicians typically follow age-related safety rules. Studios should follow the law on tattooing age restrictions and not supply or permit medication use that conflicts with statutory age rules.
Q: What if a client has an allergic reaction during the appointment?
A: Stop the procedure immediately. Remove excess product, rinse the area with clean water, and seek medical assistance if the reaction is severe (swelling, breathing difficulty, dizziness). Record the event in the client file and advise the client to seek medical follow-up.
Conclusion — a sensible, professional middle way
Topical numbing creams can help many clients tolerate tattooing more comfortably, but they are also medicines and bring legal and clinical responsibilities. The practical, defensible approach used by many reputable studios is to not supply or routinely apply anaesthetics, to accept pharmacy-supplied licensed products only with strict documentation and patch-testing, and to update consent forms and client records accordingly. This reduces risk to clients, protects the studio’s reputation and makes inspections by local authorities straightforward.
References & further reading (examples to include in your blog)
- Human Medicines Regulations (summary guidance) — legislation and MHRA pages (link to official sources).
- NHS information pages on topical lidocaine and lidocaine/prilocaine — how to use and side effects.
- Local authority environmental health guidance and public-health toolkits for tattooing and piercing (useful for studio policy examples).
- Professional public-health toolkits (CIEH, local council toolkits) about safe practice in tattooing and record-keeping.
