Will it Hurt - Assessing Pain Management Options

It’s often the first question we get asked when a client walks through the door, “How much is it going to hurt?”

 

 

It’s completely normal to be concerned about the mysterious, unknown pain we’re choosing to inflict on ourselves, however problems can arise when we let fear make our decisions. Fear can convince us to get a tattoo that’s smaller than we really wanted, or in a different part of the body than we hoped.

 

As they become more readily available, more artists and clients are turning to pain management products, and today we’re gonna discuss the pros and cons, review different options, and share my personal experiments.

 

Lidocaine is an anesthetic and the most common numbing compound. It works to prevent pain by blocking the nerve signals in your skin. The highest lidocaine concentration available to the public by the FDA or Health Canada is 5%. Any product promising a higher percentage could pose a more significant health risk and should be avoided. 

 

Epinephrine is a common vasoconstrictor, which constrict the blood vessels and slows down the absorption of other anesthetics. (So it makes your lidocaine/etc. products last longer) You can see them working by noticing the white halo that surrounds the area as blood flow is reduced. (This is particularly noticeable when used during a tattoo, where you can see the halo around all of the inked areas) 

 

 

WHY SOME ARTIST'S DON'T LIKE NUMBING PRODUCTS 

 

Possibly issues include:

• Tattoo can heal poorly and end up patchy, needing more touch ups
• The skin is more difficult to work with  
• It can make the tattoo take longer
• When it wears off, the client is often in more pain then before they started, and taps out right away
• Possibly reactions to your body or the ink
• Health issues with overuse    

Legitimate medical concerns:

 

Toxicity can be fatal.

In the most extreme cases, if too much of these anaesthetics seep into your bloodstream, you can experience systemic toxicity, resulting in; dizziness, cardiovascular or respiratory distress, and even death. (In the early 2000’s there were famously 2 recorded cases of women dying after applying large amounts of numbing products to their legs for a laser treatment.)

 

 

You're not likely to actually die, but these are serious medical risks that some artists are not willing to carry. 

 

 

 

PART 1 - BEFORE THE APPOINTMENT (PRE-DEADENERS)

 

Pre-deadeners are ointments or creams that can permeate your skin and disrupt the signals that your nerves send, reducing or eliminating pain. They are highly contested, as they can be very effective, but can also cause a lot of problems, and you won’t know scenario you’re in until you start tattooing.

 

Because they have to absorb through your skin, pre-deadeners can cause a change to the texture of your skin; making it spongy, reducing elasticity, and even less able to accept ink.

 

As time goes on, more companies are perfecting products that affect the skin less, and we’ll look at a few brands in a moment. But even if the skin is unaffected, there are other concerns:

 

The pre-deadening affect does not last. Some products require an hour or more of prep time before the tattoo (which means that you’re applying it at home yourself) and if applied improperly, you may be in for a big surprise when the actual tattooing starts.

 

Even when applied perfectly, most products can only numb your skin for a half hour or an hour. And the clock starts ticking as soon as your artist washes your skin and starts to prep a stencil, a process that could take 15-30 minutes or longer depending on your artist.

 

And here’s the real kicker. When your nerves are back online, many people report that the pain is even more unbearable then had they not used any numbing at all.

 

 

Emla Cream

Emla Cream is a mixture of lidocaine and prilocaine. It’s commonly available at the pharmacy, and oft pharmacist recommended, but it affects the texture of the skin terribly.

 

Verdict: No.

 

Zensa

Zensa is my personal favourite right now. It contains 5% lidocaine and no vasoconstrictors. The website suggests applying it 30-45 minutes before the appointment and that it can last for 2-3 hours, but I’ve not been able to produce those results with clients.  (see my personal experiment below)  

 

Verdict: Yes, but only with artist consent.

 

 

PART 2 - DURING THE APPOINTMENT (NUMBING SPRAY/CREAM)

 

Numbing sprays/foams/creams can only be applied to open skin (skin that has already been tattooed and perforated with many little holes) where the product can get into the body.

 

These are most effective use of these is as a ‘finisher’. The artist may time the use of the product to alleviate the client’s intensifying pain so that they can finish the appointment. Then, even if they lose effectiveness after a half hour, it doesn’t matter because the appointment is already over.

 

Bactine

Bactine is a mixture of lidocaine (2-5% depending on the product) and benzalkonium chloride (an anesthetic/cleaning product commonly used on painful and itchy injuries like contact with poison ivy). It can be great to ‘take the edge off’ during an appointment, and reduce swelling during the appointment.  

 

Verdict: Okay to use, but minimally effective.  

 

Vasocaine/The Solution

Vasocaine/The Solution and other products containing a mixture of lidocaine and epinephrine are fast acting and can be applied during the tattoo for a highly effective dose of pain reduction. As with all vasoconstrictors though, they affect the texture if the skin more and can make it harder to tattoo. 

 

Verdict: Sometimes the benefits will outweigh the issues.  

 

Zensa

Zensa was listed with the pre-deadeners, but can also be used during the appointment. Since it has no vasoconstrictors, it does not affect the texture of the skin, and I quite prefer using it in this way, then before the appointment.  

 

Verdict: Yes, a great way to get to the finish line, but will not work for everyone. (See experiment notes below)  

 

 

Spoiler alert! This section is pretty much just a big steaming pile of nope. Read on to learn why, or skip to the next section "My Experiments"   

 

Alcohol

Let’s get this out of the way first. Never, never, NEVER (did I say never?) consume alcohol before you get a tattoo. Alcohol thins the blood, which will make you bleed and swell more during your appointment, sometimes to the point where it impedes the artists ability to see what they are doing. The ink can also settle incorrectly or ‘fall out’ in areas, resulting in a sloppy or faded tattoo.

 

A responsible artist will not be willing to work on you if they suspect that you’re under the influence of alcohol or drugs, which could result in the loss of your deposit, and a lot of disappointment.

 

Verdict: No, never, not even a little.

 

 

Over the Counter Painkillers

 

Aspirin/acetylsalicylic acid are blood thinners, bringing with them many of the same concerns as alcohol consumption.

 

Advil/Motrin/ibuprofen are designed for pain relief, and also have anti-inflammatory properties. Common side effects include prolonged bleeding, which make them a non-ideal drug to take before you pay someone to poke thousands of holes in you.

 

Tylenol/acetaminophen are designed for pain relief, and have no anti-inflammatory properties, however there is no evidence that they can reduce the pain of getting a tattoo. So if you happen to have a headache before your tattoo, it is generally acceptable to take before your appointment (as directed on the bottle, and with your pharmacist’s blessings), as long as your artist is comfortable with that.

 

Verdict: None will really help with your tattoo pain. 

 

Prescription Drugs 

For the love of your chosen Diety, do not down some random pills you found in your bathroom, or have left over from that surgery you had last year. Even if the drugs were prescribed to you, within their expiry date, and don’t have any hindering side effects that you know of, tattoo appointments are not what they were designed for, and your artist does not want to be responsible for an medical side effects or reactions that may occur. 

 

If you happen to be on some kind of pain management medication at the time when you want to get a tattoo, you should probably wait until you’re done with those drugs before getting tattooed. At the very least, check with your pharmacist and your artist in advance.

 

Verdict: Big ol’ nope.

 

Cannabis 

Cannabis is legal is many places now, and a common and effective way to reduce stress and pain. It does however have blood thinning properties which can cause problems with the tattoo process (see the notes on alcohol above). Cannabis can also have positive or negative consequences with your mood and anxiety levels, depending on many factors including dose and strain.

 

Verdict: Probably better to save for after your appointment.  

 

 

A science nerd at heart, I love to do experiments and see how things work on myself and my clients whenever possible. I ran an experiment with the product Zensa, and here’s how it all went: 

 

I had two clients who were similarly having a hard time during their respective appointments. We found that 1-2 hours was the longest appointment possible, and they were both struggling greatly during that time. For each client, we did two things:

• Using Zensa during the appointment to try and alleviate the pain in real time
• Using Zensa before the appointment as a pre-deadener

 

Participant #1 - responded well both times. During the appointment, they were very relieved to be able to finish the end of the session with much less pain. For our pre-deadening appointment, things started well and the product lasted long enough for us to finish the session with only the end being very painful again. We didn’t get a longer session out of the experiment, but we alleviated a lot of the struggle and made the pain bearable.       

 

Participant #2 – was not benefited from the product. In both scenarios, the product did not change the way they were experiencing their pain in a significant way. Though this is not terribly uncommon, and over the years, I’ve seen many people for whom the lidocaine has no impact. So despite our best efforts, this is a possible outcome.

 

(Lidocaine is the same product used by dentists - ask around and see how many of your friends have ever had a dental procedure where they needed more lidocaine, or where the lidocaine just stopped working. It’s happened to me and it suuucks.)   

   

 

HOW IT WORKED FOR ME: 

 

For my own personal experiment, I used Zensa as a pre-deadener. It worked perfectly at first, I felt absolutely nothing, it was like magic. But, it didn’t last long. I started regaining sensation after about 15 minutes, back to full feeling at 25 minutes, and the last few minutes of the appointment were very, very painful.

 

This was the timeframe:

• Applied cream/wrapped it up 12:50
• Unwrapped/washed/tattoo stencil applied 1:50
• Tattooing starts 2:15
• Started to feel some sensation 2:30
• Basically feels normal 2:40
• Frikkin ouch for the rest of the short session

Verdict: I'll experiment further, but for myself, I felt that the pre-deadener was not a great choice. Though it was neat to feel nothing for a while, I could have sat through the tattoo without it, and would personally prefer the start of the appointment hurting and using numbing at the end if I needed it. The end of the appointment is the worst, that's when I would prefer a little help. 

 

 

FOR MY CLIENTS: 

 

I don't allow my clients to use pre-deadeners for initial appointments. In the rare cases where it's truly necessary, I'll recommend it. 

  

I do however, always have numbing options on hand for my clients. I like to have a combination of basic sprays (Bactine), numbing creams (Zensa), and numbing sprays with epinephrine on hand. There are lots of reasons why we might need them, and I like to be prepared. 

 

For me, using products during the appointment allows me to familiarize myself with the client's skin and pain threshold/tolerance (learn the difference here), BEFORE complicating things with any products. 95% of the time, nothing is needed at all, and we can avoid the risks and complications all together.  

 

 

 

 

This is the million-dollar question!

 

It’s no surprise that everyone handles pain differently. What may feel like mild irritation to one person can be excruciating to someone else. (I discuss this at length in my post “Pain Tolerance and Threshold”)

 

In five+ years, I’ve only seen a handful of people who really and truly could not be tattooed without numbing products. For the majority of people, and across much of your body, you can probably handle more then you think.

 

But there’s nothing wrong with wanting to be comfortable. Whether this is your first tattoo, and you’re afraid of the unknown pain, or you know through experience that you need the numbing; talk to your artist before your appointment. Ask them what their plan for you is and what products they might have available if you need them.

 

Your artist may not allow these products, or they may be very open to them, and you won’t know unless you ask.

 

Just note that no one should EVER shame you or make you feel badly for wanting these products. Ideas like having to ‘earn your tattoo’ through suffering are dated and silly. Sitting through your session is ‘earning it’ enough, and there’s no prizes in going pain free!  

 

 

HOW TO HAVE THE BEST TATTOO EXPERIENCE:  

 

Take care of your body, and it will take care of you;

• Rest up! You would be surprised how much a good night’s sleep can do for you.
• Eat! Having a large meal, and bringing a snack to your appointment will keep your blood sugars level.
• Hydrate! Drink plenty of water before, during and after your appointment.
• Get comfy! Bring a pillow, or anything else that will help you remain comfortable for long sittings.
• Relax! That might mean a dab of lavender oil, or an iPod full of relaxing music and podcasts. (We’ve even had people set up a laptop and watch a movie during appointments)

For people who menstruate, you may also find that some parts of your cycle are more painful then others. For most, two weeks into your cycle (or closest to ovulation) is their best window for tattoos. 

 

Pro Tip! 

Larger pieces can be divided into multiple sessions. Instead of sitting through a 4 hour appointment, start with 2 hours, then come back for the other 2 hours another day. 

 

And remember, even though getting tattooed can suck, it’s always worth it. 

 

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