current definition of pain is “An unpleasant sensory and emotional experience
associated with actual or potential tissue damage”. In laymen’s terms pain is
subjective. It is whatever the person experiencing pain says it is. Pain can
range widely in intensity, quality, and duration and has diverse
pathophysiologic mechanisms and meanings. Pain is distressing, unpleasant and
perceived as a negative experience.
we will discuss five pain management options we offer here at SkinSavvy
Aesthetics. Which each route we will cover the time it takes to reach maximum
effect, the amount of time it lasts, any contraindications and any possible
medical spas, any oral pain medication recommended is usually over the counter.
It is unlikely that you will be prescribed any opioids or prescription strength
NSAIDS for the type of treatments you will be undergoing at SkinSavvy.
also known as Tylenol, works on the central nervous system. This accounts for
its pain relief properties. The benefit to Tylenol is that unlike NSAIDs, there
is no bleeding complication. One recent literature review determined that a
single dose of Tylenol after a surgical procedure achieves a 50% reduction in
pain over 4-6 hours. Tylenol reaches its peak effect in a little as half an
hour. The maximum dose of Tylenol in a healthy adult is 4,000mg in a 24 hour
period or 3,000mg in someone who’s taking the medication for a period of
greater than 7 days. Contraindications include those with liver disease,
malnutrition, low body weight, geriatric age or febrile illness. These
circumstances would require a decrease in dosing.
are similar to Tylenol in the sense that they can be purchased over the counter
to be used for moderate pain relief. However drugs in this category, such as
Ibuprofen and Aleve, increase your risk for bleeding and bruising after
undergoing minimally invasive aesthetic procedures. Onset for their pain relief
effects can be as quickly as 30 minutes and can last up to 7 hours after
administration. Headache, dizziness, rash, edema, alterations in blood
pressure, abdominal pain, cardio vascular risks, peptic ulcer, GI bleeding are
all concerns with use of NSAIDs.
The most common use of pain
management at SkinSavvy is the use of topical numbing cream. We prefer a
compounded mixture of Lidocaine and Tetracaine. This combination allows a quick
onset and a duration that is adequate for our most uncomfortable treatments.
With Lidocaine you can expect an onset of as quickly as 5-10 minutes and a
duration of roughly 3 hours or more. In a recent double blinded study
evaluating the effectiveness of Lidocaine/Tetracaine cream, it was found that pain
scores were significantly lower in treatment sites compared to placebo. It was
noted that 95% of subjects using the cream had adequate anesthesia. Any history
of allergic reaction to numbing medications would be a definite contraindication
and amount we use is also closely monitored to ensure we do not reach toxic
Aside from using Lidocaine on the
skin, we can also inject lidocaine into the skin and fatty tissue to achieve
adequate pain relief for procedures. The effect of this administration is rapid
and can last even longer than the topical route, depending on the dose used. An
absolute contraindication, apart from an allergy, would be any tissue
inflammation in the treatment area. Tumescent anesthesia is a common technique
and involves the use of diluted lidocaine in large volumes and allows for
higher maximum safe dosage of lidocaine. This is a method your provider may
discuss with you for the use with Morpheus8.
is a 100% self-administered N2O and O2 gas delivery system, producing effects
which most practitioners and patients describe as “similar to laughing gas.”
Unlike anesthesia (which halts the brain and body’s nerve signals), analgesia
temporarily blocks the body’s pain signals from reaching the brain, and
disassociates the brain’s ability to even process pain signals. Pro-Nox is FDA
approved and can minimize the need for oral pain medications and numbing cream.
Effects wear off in 5-10 minutes. The short-lasting effects of Pro-Nox allow
the patient to reap the benefits of an pain medication, while still being able
to drive before and after an procedure. Some possible short term side effects
of nitrous oxide are dizziness, nausea, light-headedness, and unsteadiness.
Anemia and/or a vitamin B12 deficiency is a major contraindication of Pro-Nox.
Someone who suffers from extreme chronic fatigue, a typical symptom of anemia
and B12 deficiency, should not use Pro-Nox. Pro-Nox is contraindicated for
patients, providers and assistants in the first trimester of pregnancy. Other
relative contraindications include nasal obstruction, chronic obstructive
pulmonary disease, active cystic ?brosis, recent tympanic membrane surgery,
claustrophobia, intoxication, and others.