Lidocane for ATN, cream or patch?

Hello, I am 27 ATN fighter, looking for advice.

Yesterday I bought Lidocane patches and cream, I tried the cream and it was wonderful, first of several topicals I have tried to actually work, I was becoming quite skeptical. I plan to try the patches next time I have bad break through, most likely this afternoon/tonight if my pattern of the last few days holds.

I was wondering peoples thoughts on which one works better, or lasts longer?

Is there a single spot further back on your head or neck that eliminates pain further forward?

Is there a way to get it to help with teeth since you can’t put it on your teeth? (maybe like the further “up stream” on the nerve idea mentioned above)

I plan to do my own experiments, but I thought I would pick your collective mind to try and speed the process, and maybe share with others.

I am all about the patch!

What I do is cut it into inch wide strips across the short side of the patch and apply the patch all the way along the nerve branch (typically along my jaw to the base of my ear).

In consult with my neuro and several pharmacist I work with it was determined it was such a small piece of patch I could wear it round the clock if I wanted, as long as there were no issues with the adhesive.

it’s been a miracle for me. The medication in the patch releases over time so it should, in theory, last much longer than a cream.

Thanks for the info! I was only able to find large patches designed for back pain, so I was wondering how well cutting them would work, good to know about the time allotment too!

The cream lasted about 3 hours, which was nice on it’s own, I was assuming the patch should be longer.

I’m not sure where you are experiencing the pain, but if it is “near” the skin, the patches should work well for you.

Mine is completely dental. so I use a mixture of 3/4 lidocaine gel (4%) and 1/4 capsaicin cream (.1%). If the pain seems more spread out on the gums, I use a q-tip to apply to the gums. If it seems more tooth-centric (as it has lately), I apply it with a green rubber GUM pick between the teeth.

I wish there was some kind of patch or other slow-release method to attach to the gums! I suppose I could try a lidocaine patch, but not sure where I would put it.

I cut the strips into very thin (maybe 1/8) inch strips and put them all along the nerve.Works well.And does not look as silly as the big patch-and is very cost effective.

Thanks all! My pain is pretty much everywhere on the left. Skin, bone, teeth, inside and outside of my mouth, Recently it’s spread up around my eye and behind my eyebrow, the deep ear ache like pain is one of the worst.
I tested the patches a bit today. I ended up cutting off 1/2x2 inch strips and placing them in front of my ear and along the back edge of my jaw. The relief was not as strong as the cream last night but I figure the slower release time is to blame, it is a tradeoff, time or power. I was hoping the patch in front of my ear might short-circuit some of the pain further out in my cheek, but it didn’t, so I added a strip over my cheekbone, which worked pretty well.
I work in a medical office and both docs in today learned about my ATN because they noticed the patches. Thay had no clue I had this, and one was a nurologist, he was quite taken aback that I had not shown any noticable symptoms of pain before this.
Overall, I was not disappointed. Even if it does little to nothing for my teeth, knocking back 60% of the pain area is better than nothing!
I’m gonna do one of those shaved side undercuts on my hair, on the left side, in the next week so I can get better placement of patches and electrode pads from my TENZ, around my ear. I’ve been thinking about doing it for months and this just gave me a good reason to move forward.

My fingers are crossed for you. I did find that the longer I have the patch on the better it works. Right now all I can picture is you with a giant back patch slapped on the left side of your face with an eye hole cut out so you can see snicker

One thing that I did find workable is to run a strip of patch the full length of the engaged nerve branch. That seemed to do more than to put a smaller section directly over the smaller part that really hurt. I’ve done both and I’m personally sold on covering the entire nerve branch.

The other option is to have a sit down with your local compounding pharmacist and have a talk. If she is any good at all she will come up with a Lidocaine - NSAID _DMSO compound either in patch or cream (or some other mixture) and call your doc for authorization if it requires prescription compound.


I am experimenting with an 8% lidocaine nasal spray for horrible eye pain that none of my other meds can get rid of, as well as low dose naltrexone. the spray has been wonderful.
the patches are great but they start to burn don’t they? and they look ridiculous.
or they fall off my eyebrow ridges because it’s rounded and covered with eyebrow hair.
but they do last the longest because you can keep them on for 12 hours.
I have 4% lidocaine aspercreme that I put on in a pinch.
oddly enough, if my gums have been making me cry like this week, I take another 300mg of gabapentin until my morning dose of all my meds kick in. that seems to help.
and call me crazy, but I spray chloraseptic onto my gums just to get out the door. benzodent just feels grody lol

I never thought of chloraseptic! What a great idea! I will definitely be trying that next time my gum/teeth hurt (hopefully not for years and years, tho!).

Lidocaine patch itself won’t burn, especially with using a strip. The issue is whether or not you have an allergic reaction to the adhesive (which should be rare, but then again, this entire site is about rare things). And, the 12 hour rule of wearing one is based on wearing 3 patches for 12 hours, which is the max dose. When wearing one patch or just a strip off a patch you can wear it much longer, just watch your skin at first and make sure you’re not reacting to the adhesive. And, since you’re also using a lidocaine spray you may want to check in with a pharm for max use between the two forms.

Well dang, I had an idea but my dentist nixed it. I was thinking perhaps there was some kind of adhesive patch I could use on my gums, to be able to utilize a lidocaine patch there. He said that he did not know of such a product, and if he did, he did not think it was a good idea, as it would be hard on the mucosal tissue (would burn the gums).

Really no good options for longer-lasting topical pain relief in dental areas.

Okay, this is WAY outside the box… you know those teeth whitening strips? Those overlap gums. Is there maybe a way to clean off the whitening stuff and smear lidocaine cream or something on one of those strips and apply it that way for a period of time? It probably won’t “stick” extremely well but it may work for a good bit, at least long enough for some relief I would think. Dunno.

How about some serious regression to your babyhood: Teething gel?

I’ve actually used mouth sprays and teething gels designed for infants. They don’t do anything for the “ice cream” teeth feeling (feeling like you bit ice cream and can’t stop) but my gums often feel like they were burnt by hot soup, and it numbs that.

I had no reaction to the patches, but if I am active, perspiration does make them fall off, which is annoying. I am all about making my disease more visible, I paint my face with bright colors and fancy patterns where it hurts when I don’t have “look professional” for work. So, I love having the excuse of needing patches at work. I like being able to let people know I am in pain, and why, without bringing it up myself and seeming like a complainer. If they see the “evidence” and ask about it I have found people are way more compassionate about it than if I make claims about how much pain I am in with no visual evidence. Basically, people are judgemental and stupid so I work the system.

Today I had almost no breakthrough pain so I didn’t use anything beyond my daily meds, but the last several days I fell into a pattern of patches in the day (still experimenting with size and placement best for me) and then a 1-2 hour break and a slather of cream right before bed. I’ve found if I need to sleep with breakthrough pain, the best way to fall into a good sleep is the Lidocaine cream.

Thanks all for your input! And wishing you all blessed numb nerves!

I don’t recall the name of it but your local pharmacy should have medical tape on a roll you can put over the patch to help hold it in place when you’re active.

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The teething gels, Anbesol, etc…all utilize benzocaine. Supposedly it is lipid soluble and goes into the gums faster and better, but I don’t like the way it feels–“zingy?”. Lidocaine seems much smoother and longer-lasting to me.

Hello all, so glad you are having this discussion and getting results. I just started putting on otc aspercreme 4% lidocaine and I think it might help my tn2/ dental/ migraine facial pain. But I have a question…it does not numb my skin at all so how is it getting to and numbing the deeper trigeminal nerves? And, does it work better after you have used it a while? Thanks!

I’ve never noticed any skin numbing with the lidocaine patch but it definitely works on the nerve and it definitely works better the longer I have it on.

I didn’t notice numbness in my skin. I have no clue how it works I just know it did and I was amazed. The cream I use seems to reach full efectiveness within like 1 minute of putting it on. The patches seem to take a little longer to give me what relief they can, more like 10 or 20 minutes. I’ve only been trying them for about a week. So I am unsure if longer daily use would increase/decrease efectiveness. Also, I plan to only use them on bad pain, or high activity days, because I worry about building a tollerance.

General info about lidocaine patch – it’s typically used with shingles break outs, up to three patches a day for 12 hours a day based on daily use, and that pain lasts upwards of a month – with that info in mind I bet your odds of developing a tolerance are low, especially since you’re only using strips on your face.

Now, that being said, I totally understand the tolerance concern! I seem to spend half my life being careful to not build a tolerance to something that’s working!