Double-blind randomized trial comparing commercial and compounded topical anesthetics for diode laser hair removal

INTRODUCTION: The demand for laser procedures in dermatology is increasing, and topical anesthetics are widely used to reduce pain, enhance patient comfort, and improve treatment outcomes. Despite their frequent use, the evaluation of pain perception during diode laser hair removal using topical anesthetics has not been extensively studied.
OBJECTIVE: This study aimed to compare the analgesic effects of a commercial 4% lidocaine formulation (Dermomax ®, Aché Pharmaceutical Company, São Paulo, Brazil) with a compounded formulation containing 23% lidocaine and 7% tetracaine (Artpharma Pharmaceutical Company, São Paulo, Brazil) during LightSheer® diode laser hair removal procedures.
METHODS: A total of 74 women aged between 14 and 65 years underwent a total of 256 laser hair removal procedures. Sixty minutes before the procedure, the two anesthetic formulations were applied: the commercial 4% lidocaine on one half of the treatment area, and the compounded 23% lidocaine with 7% tetracaine on the other half. The treated areas included axillae, face, legs, and groin. The side of the body on which each formulation was applied, as well as the side to be treated first with the laser, were randomly assigned in a double-blind manner. Pain intensity was assessed using a Visual Analog Scale (VAS). Data were analyzed by comparing VAS scores across the different treatment areas.
RESULTS: Statistically significant differences in pain perception were found in all evaluated regions. The compounded formulation resulted in lower pain scores compared to the commercial formulation. No adverse effects were reported.
CONCLUSIONS: The compounded anesthetic formulation containing 23% lidocaine and 7% tetracaine was more effective in providing analgesia than the commercial 4% lidocaine product (Dermomax^®) for diode laser hair removal.

Keywords: Pain; Anesthetics; Laser Therapy.