Lidocaine Ointment USP 5%: Topical Uses, Application, and Side Effects

Lidocaine can be found in a multitude of topical medications and drugs that provide relief from muscle pain, various skin conditions, bug bites, sunburn, allergic reactions, rashes, and more. But what is it, and how does it help with these varying afflictions?


“Best Help Ever! This product is better than the prescription my doctor gave. I’m sticking with what works.”

Maryann S. Verified Reviewer

At Doctor Butler’s, we’re mainly focused on how Lidocaine is helpful in treating hemorrhoids as an ingredient in our hemorrhoid ointments, though we do make a pure Lidocaine cream called Numb-It-All for minor skin irritations. But Lidocaine is available in patches, shots, sprays and IVs, and is widely used in treating things from shingles to labor pains. This guide is mainly about 4% to 5% topical lidocaine ointments. 

We will take you through some of the general benefits of this common topical medication and get into greater detail about what lidocaine is. We’ll also outline how it’s used to treat skin and discuss potential side effects and precautions.

It’s a thoroughly tested drug and the side effects are minimal when following manufacturer instructions, but it’s always good to learn more about any drug you take and whether Lidocaine specifically is right for you and your condition. 

One last thing before we get started: The truth about any drug is that without speaking to your doctor first about its use, the generalized information you find online might not be the perfect fit for you. There are many references ahead telling you to speak with your doctor before use. Most people will react as expected to a drug as common as topical lidocaine, but it wouldn’t be responsible for us to advocate that use for everyone who might come across this.

Let’s look a little closer at the benefits, precautions, and side effects of lidocaine. 

What is Lidocaine?

Lidocaine is a common ingredient in topical medications that helps to reduce pain, itching, and burning. Lidocaine is a type of drug called an anesthetic and helps to numb the tissues it comes in contact with, masking the pain, itching or burning you may be experiencing.  

It does this by blocking the pain signals that are being sent to the brain. Lidocaine can be used as a local anesthetic before certain procedures and is commonly found in creams, ointments, skin patches, and sprays that are sold over the counter to treat hemorrhoids as well as cuts, burns, bites, and skin conditions. 

The highest concentration of topical Lidocaine available is 5% and it’s available over the counter. Hemorrhoid creams typically contain 4% to 5%. You will rarely find an OTC ointment with less than 4%, though some common prescriptions such as AnaMantle feature 3% Lidocaine mixed with hydrocortisone.

Most Common Uses of Lidocaine 

As an over-the-counter anesthetic, lidocaine is a versatile drug as this common ingredient has a number of effective uses as a topical ointment. At Doctor Butler’s we’ve found it to be an effective symptom reducer for hemorrhoids but it can be used for many abrasions, rashes, cuts, bites or inflammation affecting the skin.

It’s useful for hemorrhoids because:

  • Hemorrhoids cause itching, burning, and pain and can be disruptive to our day-to-day life. Lidocaine products for hemorrhoids include creams, wipes, and sprays and can significantly reduce the discomfort and inflammation while the condition heals. It won’t cure hemorrhoids, but will reduce symptoms.

Other uses of Lidocaine include:

  1. Tattoos – 5% topical lidocaine is used to numb the skin before a tattoo, and it can be used afterwards as well while the skin heals.
  2. Mouth sores – Lidocaine is often included in sprays and gels used to treat sores and ulcers inside the mouth. This ingredient dulls the pain and allows the ulcers to heal.
  3. Bug bites and stings – Topical lidocaine medications can reduce the pain and itching caused by bug bites and stings.
  4. Poison ivy, etc. – Poison ivy and poison oak can cause intense itching, and when patients scratch too much, they can cause bleeding, pain and scarring. Lidocaine medications can be applied to the itchy area to stop the patient from scratching, allowing the condition to heal.
  5. Sunburn – In cases of severe sunburn, the pain can disrupt our sleep and other aspects of our lives. Lidocaine numbs that pain allowing us to get the healing sleep we need.
  6. Premature ejaculation – A 5% lidocaine cream will numb the genitals preventing premature ejaculation. The cream should be applied half an hour to an hour ahead of time to give the cream time to absorb into the skin.
  7. Cuts – topical application of lidocaine products can numb the pain caused by abrasions and cuts, though ask a doctor before use on an open wound.

Lidocaine Ointment Precautions

Before you begin using any medication, it’s always best to speak with your general practitioner to ensure lidocaine ointment is safe for you to use. This is especially true if you suffer from certain conditions outlined below, as lidocaine can interact poorly with them, though adverse reactions are not common with topical treatment.

More caution should be reserved for localized injections of Lidocaine, and in that case you will likely be under the supervision of a medical professional who can speak to you about Lidocaine and its effects and interactions. But if you suffer from any of the following conditions, speak with your doctor before using lidocaine.  


Allergies to Lidocaine are rare, but possible. Check to make sure you are not allergic to other ingredients in the ointment you are using as well. If you are allergic to lidocaine, you may experience several symptoms after using this topical medication. 

These side effects include anaphylaxis, hives, swelling, wheezing, coughing, difficulty breathing, unconsciousness, hyperventilation, nausea, vomiting and changes in your heart rate or blood pressure.

Despite the fact that allergies to lidocaine are not common, they can happen, so make sure you clear your use of this topical medication with your family doctor. 

Heart Problems

Some patients with heart problems will need to speak with their general practitioner before they begin using lidocaine products. If you’re suffering from a slow or irregular heartbeat or heart block, lidocaine might not be the best choice for you. Speak with your doctor first if you have any history of heart conditions or problems. 

Cuts and Sores

It’s important to let your family doctor know if you have any open sores, cuts, or abrasions in the area that a lidocaine product will be applied to. Do not apply it in these situations unless a doctor tells you to, as the Mayo Clinic advises here. Your doctor will advise you whether or not the use of this type of medicine is safe while you are healing. 

Pregnancy and Breastfeeding

Lidocaine is classified as a category B drug, meaning it is considered to have almost no negative effect on the fetus or mother, with no proven risks in humans. Studies of Lidocaine use in cesarean sections have confirmed that it is safe for the fetus.

No special precautions are required if using Lidocaine during breastfeeding either, which has been confirmed through extensive medical testing of intravenous infusion and high doses of topical anesthetics specifically for labor pains.

Still, you should speak with your doctor before using lidocaine if you are pregnant or breastfeeding, as the medicine can pass on to breast milk in small amounts. It is not considered harmful to the infant, but it’s always best to discuss it with your doctor anyway. 

Lidocaine Ointment Common Side Effects

Here is a list to reiterate possible side effects we’ve mentioned and a few more. As with any medicine, lidocaine does come with potential side effects, but they are incredibly rare. However, it’s always good to be careful and know what to look for before beginning any new medicine. The potential side effects of lidocaine include: 

  1. Allergic reactions – allergic reactions are rare with lidocaine but still possible. You may experience hives, tightness in the chest, difficulty breathing, swelling, and nausea. If any of these symptoms present themselves after you’ve used lidocaine, consult your doctor immediately. 
  2. Breathing problems – If you feel like you’re having difficulty breathing after your use of a lidocaine product, you may have used too much. Breathing problems that signal potential overdose include slow or shallow breathing, hyperventilation or wheezing, and chest tightness. If any of these symptoms occur after using lidocaine, please see your practitioner right away. 
  3. Drowsiness – Using too much lidocaine can also cause drowsiness in some patients. Additionally, this symptom can present itself in patients who are abnormally sensitive to this type of numbing medicine. If you experience drowsiness after using lidocaine, see a doctor immediately. 
  4. Seizures – Another symptom of lidocaine overdose can be seizures. This is a particularly scary side effect which is why it’s crucial to use the product precisely as directed. Seizures require immediate medical attention.
  5. Tremors – You will need to seek medical attention right away if you experience shakiness and tremors, as well. This is also a sign that you have either used too much lidocaine topical ointment or you are particularly sensitive to this type of medicine. 
  6. Arrhythmia – arrhythmia is an abnormal heart rate, and if it occurs after your use of lidocaine products, it can be a sign of allergy, sensitivity, or overdose. If you experience this side effect, seek medical assistance immediately. 
  7. Changes in vision – if problems with your vision present themselves after you have used a lidocaine ointment or other product, you should see your doctor right away. Blurred vision or double vision can be a sign of overdose or allergy.

How Does Lidocaine Interact with Other Medicine

Lidocaine has no known interactions with other drugs and medicine. However, you should always discuss with your doctor any other medications you might be taking before you begin using lidocaine. This is especially true if you are using other products that contain lidocaine so you can avoid the risk of overusing the drug and experiencing the symptoms of overdose.  If you drink alcohol or use marijuana, mixing these with the use of lidocaine products may produce excessive drowsiness. 

Lidocaine Dosage

The dosage of lidocaine cream you will need is going to depend on several different variables. First, the product you’re using and the concentration of lidocaine it contains will help to determine how much you should use. Following the instructions on the package is crucial because every product varies.

For Lidocaine ointment or cream for pain and irritation caused by hemorrhoids or other mild skin conditions:

  • Adults: Apply a maximum five grams (about 6 inches of 5% ointment) to clean skin 3 to 6 times per day as instructed by the package
  • Children: Ask your family doctor

 For Lidocaine patches for shingles:

  • Adults: Use one to three patches a day not more than 12 hours per day, following package instructions

Additionally, the severity of the condition you are treating is also a determining factor in how much of a lidocaine product you should be using. Any medical conditions you might have or drugs you’re taking can also affect your dosage, as well as your overall response to lidocaine. It’s best to find a suitable dosage with the feedback of your doctor if there are any questions.


Lidocaine overdose is possible when patients are either sensitive to the drugs or are using more than the recommended dosage. Overdose on lidocaine can cause a number of alarming side effects, including blurred or double vision, trouble hearing, excessive dizziness or drowsiness, difficulty breathing, fainting or passing out, seizures, tremors and irregular heartbeat. If you experience any of these symptoms while using lidocaine products, please seek immediate medical attention. 

Missed Dose

Missed doses on lidocaine are not a significant problem like they may be with other drugs but if you remember close to your next dose, just wait for that next scheduled dose. If you still have a good amount of time between remembering and your next dose, you can take it as soon as you recall. 

Who Should Use Lidocaine Ointments?

Patients who suffer from various skin conditions or conditions that affect the tissues just below the skin will benefit the most from lidocaine products. Hemorrhoids are a perfect example. 

Because lidocaine helps to block pain and discomfort signals from reaching the brain, any topical condition that causes pain or discomfort can be treated by it. These conditions include bug bites, cuts, abrasions, rashes, minor burns, poison ivy or poison oak, cold sores, nerve pain, muscle pain, and more. Lidocaine can also commonly be found in use as a local anesthetic, preventing pain from needles and other procedures that can cause localized pain or discomfort. 

Patients who suffer from hemorrhoids will benefit greatly from the effects of lidocaine as this medication significantly reduces the discomfort associated with this condition. Hemorrhoids cause pain, burning, and itching and can be incredibly disruptive to our lives. 

Hemorrhoid creams like Doctor Butler’s Advanced Hemorrhoid Cream with Lidocaine can provide the relief you need to get back to your day-to-day life.   


Lidocaine is a common medication, often found in topical treatments for pain, itching, and general discomfort. It is a safe medication to use with no known interactions with other drugs. However, it’s important to follow the directions on the package for the specific product you’re using to avoid overdose.


“Best Help Ever! This product is better than the prescription my doctor gave. I’m sticking with what works.”

Maryann S. Verified Reviewer

Some patients may experience side effects if they are particularly sensitive to the medication or if they have an allergy to it, though both of these scenarios are incredibly rare. Lidocaine can help relieve the pain of many different skin conditions and other types of conditions that affect the outer tissues of the body. 

These include rashes, bug bites, burns, allergic reactions, poison oak or poison ivy, cuts, scratches, cold sores, muscle pain, nerve pain, and of course, lidocaine is tremendously effective in reducing the discomfort of hemorrhoids. 

If you’re suffering from hemorrhoids and are struggling with the pain, itching, and burning the condition can cause, reach for Doctor Butler’s Advanced Hemorrhoid Cream with Lidocaine. Not only will you experience rapid relief from the disruptive symptoms of hemorrhoids, but you’ll also reap the benefits of ingredients like lanolin and glycerin included in the formula to protect the sensitive skin in the affected area and promote healing. Doctor Butler’s Advanced Hemorrhoid Cream with Lidocaine also includes zinc oxide to provide additional pain relief.

Don’t wait for the relief you’re looking for. Grab Doctor Butler’s hemorrhoid treatments, including soothing hemorrhoid spray, wipes, hemorrhoid ointment, and Advanced Hemorrhoid Cream with Lidocaine, today!

About Robert Cutler, D.O.

Dr. Robert Cutler has performed duties as a specialist in the field of Proctology over 30 years as a practicing physician. Over this time, he has had great success integrating patient care from both an efficiency standpoint and as a practical approach to holistic and preventative medicine.

Dr. Cutler also performs FDA approved Clinical Trials and has had formal research training in Human Subject Assurance Training, OHRP/NIH and Good Clinical Practice for Investigators, Quintiles. Dr. Cutler continues to work on creating more affordable solutions to help people who are affected by ano-rectal problems as well as various chronic or acute skin issues.

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