Guest Blog: Cheating with Lidocaine
05:56 PM
johnmack14_leftinnerthigh.jpgThe use of numbing creams and sprays has been a hot tattoo topic (recently discussed here in our Robert Atkinson profile and my new tattoo post). In this guest blog, John Mack is back to share his experience using anesthetic while getting tattooed by Horiyoshi III

** This post has been updated with further information since its publication **

During my first appointment with Horiyoshi III, I asked what he thought of trying Lidocaine.  He replied, "Sure, it's better if it doesn't hurt." Well, all right then. I'll give it a try.

I already had Lidocaine 5% cream (from another procedure) but the taboo against
topical anesthetic for tattooing dissuaded me from trying it, that is, until I spoke with Horiyoshi. Before I went to Japan for my tattoo sessions (combined with a business trip) I researched Japanese law as transporting drugs across borders is a dicey business.  According to the Koseirodosho-iyakushokuhinkyoku, bringing your own duly prescribed medical drugs into Japan is permitted.
For my next session, an hour before my appointment, I applied the cream and covered it with Saran Wrap.  Even though I washed my hands immediately, my fingertips became a little numb. This stuff really works. And then I went to get tattooed.  The project was koi fish on the insides of my thighs, a very painful place to be tattooed.  But with local anesthetic, it was completely tolerable.  Horiyoshi's son Kazu was observing the session, and commented to me, "Wow, you're really strong."  I sheepishly told him the real reason I was taking it so well.

I missed some places with the cream, and I tell you, that was some serious pain.  An even more distressing problem with this area was the nerve reflexes that made me move involuntarily.  The anesthetic reduced this effect at its source.

When I asked Horiyoshi III for his opinion, he said that Japanese law prevents him from making a recommendation without a license to practice medicine.  He did say that personally, he would prefer to not cause suffering, and if the client had a way to avoid it, then there was no reason not to.  If the client seeks the therapeutic effect of becoming stronger through the painful ordeal, then that too is fine.  He added that there was no particular unfairness in how some people endure the pain of tattooing while others can choose to escape it.

But wait.  Isn't pain an integral part of tattooing?  Is it really okay to remove just this part of the experience?  It certainly removes the macho "I can take anything" element of being tattooed.  I'm cheating, and cheaters like me will never make yakuza boss.

Next, I would like to share the technical details of my experience with this controversial approach to tattooing.  It is important to note that I have no training in tattooing nor medicine.  I can only offer anecdotal evidence to help those who do have qualifications make their decisions.

The anesthetic reduced but did not completely eliminate the nerve reflexes that made my thigh twitch involuntarily as it was being tattooed.  Getting tattooed on the floor helped -- Horiyoshi could further arrest my movement by sitting on my calf as he worked (thankfully, he's not very heavy). He also had a sand bag close at hand that he plopped onto my leg to hold it down.

The next area to tattoo was my arms. The result I want for this public area demands that I be an absolutely still canvas.  I used the Lidocaine for the outline, and was able to completely relax.  During the tattooing of both arms, I did not even come close to tensing my muscles or twitching.

A particularly delightful part of my tattoo experience is my conversations with Horiyoshi.  Discussing wide ranging topics in a foreign language over the din of a tattoo machine while not facing the speaker is hard enough.  The anesthetic allows me to better concentrate on the conversation.

Nonetheless, a few sessions after the critical outlining was done, I eventually stopped using the Lidocaine on my arms.  Being tattooed there is not particularly painful, and not using anesthetic is undeniably more authentic.  But I will definitely use it again for my underarms.

If there is a problem with using Lidocaine cream for tattooing, I think it is the physical form of the cream.  A potentially inexperienced client must properly apply it before coming under the supervision of the tattooist.  It is a bit messy, and is best applied in private where soap and water are available.  It must be applied according to schedule, potentially when you are in an inconvenient location.  I once had to apply it in the restroom at the Dai Ichi Hotel Tokyo while wearing a business suit.  After application, the cream must be covered with Saran Wrap for maximum effectiveness.  Why would anyone bring Saran Wrap to a business meeting?

It is essential to remove the cream before beginning to tattoo.  I wash it off with soap and water immediately before starting. [The tattooist can also wipe it off.] If you leave the cream on, paper stencils stick to it and disintegrate upon removal.  During tattooing, it is difficult to wipe away excess ink.  Injecting the cream into the skin during tattooing causes inflammation, pain afterward, and retards healing, but there was no permanent damage the one time this happened to me.

The half life of Lidocaine is 1.5 to 2 hours.  This is more than enough for my one hour sessions with Horiyoshi, but probably insufficient for a session of even two hours.  A continuous process might work whereby the client applies anesthetic to a new area as the artist tattoos toward it.  Kind of like a steel mill.

The spray form of Lidocaine, and the new product, Vasocaine are presumably easier to apply, less sticky, and more foolproof. Lidocaine 5% cream often requires a prescription.  This is inconvenient, but I am more comfortable knowing that we are all within Japanese law.  If I try Vasocaine, I will just declare it to Japanese customs, and if it is illegal they can confiscate it.

On the trunk of my body, I never really noticed any inflammation after getting tattooed, but on my forearms the swelling is quite pronounced.  The vascular constrictor in Vasocaine looks useful for preventing swelling.

If you're not getting tattooed for the pain, the ultimate objective of all this is a quality finished tattoo. On my skin, Lidocaine 5% cream gives the benefits of pain relief and motion arrest without adverse effect on the finished tattoo.  In fact I think improves the result by keeping me still and allowing me to extend my bodysuit into areas that would otherwise be intolerably painful.

that is great to know. i find as i get older, my skin has changed (thinner, dryer) and tattooing hurts more. i'm not in it for the pain/badge of honor-schmonor.


My tattooist says that numbing cream "sends the skin to sleep" and that stops your capillaries from pushing back against the needle/ink, meaning the ink disperses into your cells more sloppily and the end result is not as vibrant and tends to fade quicker. Or it was something like that. I'd like to see some scientific investigation of that.

I'm still down to try it. The next time i can afford to get tattooed I'll give it a whirl.

I still stand by the notion that if using the Lidocaine 2.5% in Bactine, which many tattooers and collectors do (myself included), then it can't be much worse to use 5%.

I also still believe that most of the resistance to this approach lies with the "you didn't earn it if it didn't hurt" bravado. I like tattoos because of the art and the personal meaning, not because I enjoy pain.


I actually feel somewhat embarrassed that I pursue something so painful with such maniacal intensity. It makes me feel like I'm crazy, not tough.

As humans we characteristically sacrifice in pursuit of goals. Part of the attraction of tattooing involves enduring pain to attain a new tattoo. However, the transient pain is nothing to being permanently marked. That's the real sacrifice.

And what of that transient time when you are getting tattooed? For me the most thrilling part is that moment when my blank skin changes to being indelibly colored, never to return to its natural state. Anesthetic removes the pain that interferes with my ability to savor this. Anesthetic makes getting tattooed even more exhilarating. Imagine that.

When I was younger, I'd say "you gotta earn 'em" blah, blah, blah. Now, many tattoos and years later, with some squiggled lines here and there due to my own twitching, I would use it for the more sensitive areas and not be embarrassed to say so. Thanks for the information. I'll try the spray version if I ever get up the courage to cover my ribs.

I've tried a bit of everything...after the last 10 years of getting tattooed consistently. I've tried Tequila...hmm..helpful, but not always smart. and Spray on Lidocaine. Lidocaine was the most useful. It went on easily and then wrapped with plastic to maximize efficiency. It numbs the skin. However, when it wears off, about 2 hours later and you're sitting in a 3-4 hours session... the skin is already inflamed and the pain... INCREDIBLY INSANE. It's almost worth NOT using it if you're gonna sit longer than it's efficiency. My personal tattoos took longer to heal and with more scabbing than normal. I'm now content with Bactine and a beer. :)

i think the acceptance and normalization of this behavior will have profound effect on the industry
mostly it becoming even more mainstreamed.
Also, increased attention from law-enforcement, etc. it could easily become a new way to come after the Body Art/Mod industry and its communities.

but i also think this kind of thing has been going on forever, it just had a kind of stigma that kept it hush-hush.
i say we all get to do as we wish with ourselves. just be honest with your artist(s).

coming from Horiyoshi-San, says volumes to me!

I'll Have to agree with the refried Dreamer on this. Bactine And a cold beer will go a long way. Just Got my armpit Tattooed for 3.5 hrs a month ago. Bactine did the trick and I healed up like a champ!


I'm hearing more and more artists touting Bactine. Good to know that people are having positive experiences with it.

My parents' refusal to use Bactine was one of the great deprivations of my childhood. I was tortured by the siren call of TV commercials telling me that Bactine did not sting like iodine, the most feared liquid in the medicine cabinet.

And now you tell me that in Bactine also contains anesthetic? Oh, man. I really missed out.


Please allow me to make a gentle clarification.

Horiyoshi III did not indicate that he has experience with anesthetics, nor can he recommend their use. It is not appropriate to conclude that a legendary artist has endorsed anesthetics, so we should all go out and recklessly slather the stuff on.

Horiyoshi and I discussed at length how I should render his comments on this topic, and you will note that he sticks to the morality of using anesthetics. He did not comment on the medical effect that the anesthetic had on my skin.

This is the first time I've been tempted to comment on any post here, but as I recently had an experience with Lidocaine I thought I'd share it.

I was getting my chest tattooed and my artist said that as he didn't exactly enjoy inflicting pain on people, he recommended trying some Lidocaine on my sternum to see how well it worked. He'd only previously tried it on himself so was interested to see what someone else thought. It was marvellous while getting the work done, but around 2 hours afterwards I was hit by an incredible wall of pain that just wouldn't stop. I was actually bent double in my living room for about half an hour until some pain killers kicked in!

The area that had the Lidocaine applied scabbed much worse than the rest of it, took longer to heal and I wouldn't say that the final result is as crisp as the rest of the tattoo.

Based on my experience I wouldn't recommend it. Put up with the pain at the time (and at least it's a pain that you can stop if you have to). I don't see why you would want to risk impairing the quality of the tattoo for a bit of an easier ride.

If I could find a topical creme/spray containing Lido (or similar) plus epinephrine, that'd be perfect.
The epinephrine reduces swelling and bruising, and the product I've used that contains it (Sustaine blue gel) has had perfect, insanely fast healing on heavily coloured works, with dramatically reduced scabbing (compared to other numbing products without epinephrine, which always seem to heal worse).

Sustaine sadly only works on broken skin, so you have to run the machine over the whole area lightly beforehand with water to open it up, so it's really not ideal.


Readers should take your comments seriously. My experiences should never be taken as any sort of final word.

Did you remove the Lidocaine cream before starting your tattoo? I experienced symptoms similar to what you describe when I forgot to remove the cream.

Did you do anything else different? I just had a bad experience applying Aquaphor too early in the healing process--it made the tattoo leak lymph, and caused scabbing. I found that Aquaphor works well to alleviate itching very late in the healing process.

Thanks for the clarification John (Mack).
and to all the others for sharing their experiences.

Pleas be assured that i did not take Horiyoshi's comments as medical or scientific. I'm not sure the right words, but i guess i find the comments... liberating. Also it makes me smile that he continues to impress me as a wonderful person.

i doubt i will ever have the chance to meet him, but i think My fiancee and i will invite him to our wedding. He has already made an impact on our lives indirectly.

@ John Mack

Yes, it was removed before starting that section. As far as I'm aware my tattooist didn't do anything else different and my healing routine remained the same as usual.

I guess everyone's skin is diffent though. This approach may work well for others but I don't think I'll be trying it again.

i keep thinking about that scene in 'what about Bob?!'
on the bus, bob asking the person sitting next to him to punch him in the face and knock him out...

who needs chemicals?

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