Biggest news from last week: had laser hair removal on genitals for the first time. I have been told I have a high pain threshold, but I was a nervous wreck leading up to my appointment because my experience with laser on my face was excruciating (comparable maybe to a hot clothes iron being pressed on your face fifty times). My only hope was that I was trying out a new lidocaine this time, but I had little faith in it.

Previously I had used the typical 5% lidocaine cream you can commonly get over the counter, and the pain on my face was not discernibly different.

Then I found a 10% lidocaine cream from South Korea called Anesten, which likewise wasn’t that helpful. The pain on the face was still pretty bad, especially around the upper lip and chin areas. Each time I applied the cream thickly and “occluded” the area with plastic wrap (basically kept the plastic wrap over the cream) until the appointment (more on this in a minute). I think the first time I applied the 5% cream around 1 hour before the appointment, the next time I applied 10% 2 hours before.

There was one time I used the 10% cream and it seemed to help my face, but I think I just didn’t have that much hair growth since the last session, so I suspect it was the lack of hair rather than the cream that made the experience less painful.

Anyway, I was so nervous before my Brazilian appointment that I talked to my primary care physician about it, and was hoping I could get a stronger lidocaine or maybe a one-time pill to help me not care about the pain (maybe an anti-anxiety, or a dissociative, I wouldn’t care what).

My doctor was able to get me a prescription for a lidocaine made at a compounding pharmacy with 23% lidocaine and 7% tetracaine (it’s technically a “BLT” preparation, but there is 0% benzocaine, so just the “LT” part).

Well, it worked perfectly - I applied the 23% lidocaine to the genitals 90 minutes before my appointment, and I loosely occluded the area with plastic wrap mostly to protect my clothes (because you aren’t supposed to occlude 23% lidocaine).

I felt no pain at all on my genitals, anus, perineum, etc.

You are explicitly not supposed to occlude such a strong lidocaine cream because it can be toxic and cause death (in fact there have been lidocaine deaths due to using too much and occluding before laser hair removal). However, I suspect your mileage may vary - I am a large person and maybe I could withstand a larger dose than other people. I also was only getting the Brazilian area done, so I wasn’t covering even larger parts of my body with the cream (I think the legs for example are a place where people can get into trouble). But genitals are more likely to absorb the lidocaine, so it is an area where you would want to exercise more caution and overdose is more likely. I say this because I don’t want anyone else to go and try this without talking to their doctor first to ensure they don’t hurt themselves.

The risks aside, the relief for me was massive and hard to overstate. I was really struggling with obsessive rumination and anxiety about the pain, and during the session I felt that weight lift from me as I realized I could definitely get through this.

It’s a good week. :-)