That soothing cream you're using to numb the pain of your latest tattoo or cosmetic procedure could be putting your heart at serious risk, warns the FDA. High concentrations of lidocaine, a common numbing agent, are lurking in many over-the-counter products - and the consequences could be deadly.

Lidocaine, a common local anesthetic, has been a staple in medicine cabinets for decades, providing welcome numbness to everything from dental work to cosmetic procedures. But a recent FDA warning has revealed a darker side to this ubiquitous drug: in high concentrations, as found in many over-the-counter creams and sprays, lidocaine can pose serious risks to the heart and nervous system.¹

The Danger Dose

According to the FDA, products containing more than 4% lidocaine can contribute to irregular heartbeats, seizures, and difficulty breathing, especially when applied over large areas of skin or for prolonged periods.¹ This risk is heightened if the skin is broken or irritated, as is often the case after cosmetic treatments like microdermabrasion, laser hair removal, tattooing or piercing - the very procedures these numbing products are marketed for. Lidocaine can also interact dangerously with other medications.¹

"These products pose unacceptable risks to consumers and should not be on the market," stated Jill Furman, director of the FDA's Office of Compliance.¹ The agency has issued warnings to six companies selling high-dose lidocaine products, with some creams containing a whopping 40% of the drug.¹

The Quest for Alternatives

The FDA warning highlights the need for safer pain relief options, especially in the realm of cosmetic procedures and dentistry where topical anesthetics are routinely used. Enter clove oil, a natural substance that has been used for centuries in traditional medicine and is now being investigated as a potential lidocaine alternative.

A recent study published in the Journal of Dental Anesthesia and Pain Medicine compared the effectiveness of various topical agents, including lignocaine (a lidocaine variant), clove oil, ice, and a novel gel made from betel leaf extract, in reducing needle insertion pain during dental injections in children.²

The trial included 60 children aged 6-10 years, divided into four groups. Each group received a different topical agent applied for one minute prior to injection: 2% lignocaine, 4.7% clove gel, ice, or 10% betel leaf extract gel.² Pain during needle insertion was assessed using both subjective (Wong Bakers FACES pain rating scale) and objective (Sound, Eye, Motor scale) measures.

Clove Power

The results were intriguing: clove oil performed just as well as lignocaine in reducing injection pain based on the objective scale, and was actually superior according to the children's self-reported pain scores.² The betel leaf extract, while not as effective as lignocaine, also showed promise as a natural anesthetic. Ice provided comparable pain relief to clove and betel.²

This is not the first study to demonstrate clove oil's anesthetic potential. The active ingredient eugenol has been shown to have analgesic properties, likely due to its ability to block nerve conduction.³ Clove has long been used in dentistry for toothache and is generally recognized as safe by the FDA in concentrations under 1500ppm.²

The Path Forward

While more research is certainly needed to establish the safety and efficacy of herbal anesthetics like clove oil, these initial findings offer a glimmer of hope in the quest for non-pharmacological pain management. With concerns mounting over the risks of conventional drugs like lidocaine, natural alternatives merit further investigation.

Of course, even "natural" does not always mean risk-free. Herbal preparations, while generally considered to be much safer than pharmaceutical sometimes have side effects and interactions of their own, and consistent standardization of dosing and formulation remains a challenge. However, the long history of traditional use and generally favorable safety profile of options like clove suggest they may have a role to play, especially in lower-risk applications like dental anesthesia.

The takeaway for consumers is to exercise caution with any over-the-counter numbing product, and to be especially wary of those marketed for cosmetic use which may contain dangerously high lidocaine levels. If pain control is needed for a procedure, discuss safer options with your healthcare provider - and don't be afraid to ask about natural alternatives. While lidocaine has its place in medicine, for many common discomforts, a dab of clove oil may prove to be a sweeter solution.

To learn more about the health benefits of clove, visit our database on the subject here.

To learn more about natural approaches to pain management, visit our database on the subject here.

References

1. Commissioner, Office of the. "FDA Warns Companies Illegally Selling Over-the-Counter Topical Anesthetics Containing High Levels of Lidocaine." U.S. Food and Drug Administration, 1 July 2023, www.fda.gov/news-events/press-announcements/fda-warns-companies-illegally-selling-over-counter-topical-anesthetics-containing-high-levels.

2. Havale, Raghavendra, Dhanu G Rao, Shrutha S P, Kanchan M Tuppadmath, Namratha Tharay, Irin Mathew, and Kausar E Taj. "Comparative Evaluation of Pain Perception Following Topical Application of Clove Oil, Betel Leaf Extract, Lignocaine Gel, and Ice Prior to Intraoral Injection in Children Aged 6-10 Years: A Randomized Control Study." Journal of Dental Anesthesia and Pain Medicine 21, no. 4 (2021): 329-36. https://doi.org/10.17245/jdapm.2021.21.4.329.

3. Gunjan M, Rajkumar P, Shilpa N, Pallavi SK. Analgesic Efficacy of Clove (Syzygium Aromaticum) Essential Oil on Dental Pain: A Randomized Control Trial. Quintessence Int. 2022;53(7):606-614. doi: 10.3290/j.qi.b3147457.