Dr. Matt Zirwas, MD, FAAD

Physician (MD, DO)


Dermatologic Surgery,
General Dermatology

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Bexley Dermatology
2359 E. Main St.
Bexley, Ohio 43209 [MAP]
For an appointment , call (614) 947-1716
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Caine Anesthetics Allergy

“Caine” anesthetics are used in creams, sprays, gels, etc that are supposed to relieve pain or itching. They are NOT in “regular” products. They are also used as injections before dental work or skin surgeries to numb the area.

There are two types of “caine”. One type has at least two of the letter “i” in the name (the amide group) and the other type has only one letter “i” in the name (the ester group).

Almost everyone who is allergic to a caine is only allegic to one group and is ok to use the other group.

Where might they be found?

  • itch relief creams        
  • vaginal anti-itch cream           
  • sore throat or cough lozenge
  • sore throat spray
  • toothache treatment
  • canker sore treatment
  • insect bite treatments
  • poison ivy treatments
  • hemorrhoid creams and suppositories
  • first aid antiseptic       
  • sunburn treatments
  • canker sore treatment 
  • Cold sore treatments
  • boil treatments
  • pain relief creams and ointments
  • teething cream or gel
  • sexual lubricants                      
  • pre-waxing treatment


Review this sheet with your doctor and all other medical professionals you work with. They probably won’t be familiar with this kind of allergy, so show them the list of safe choices below. Also, this type of allergy is not life threatening, so if it is an emergency

How to avoid this allergen:

If you are allergic to the ester group, avoid all caines that only have one i in the name, if you are allergic to amides, avoid all caines that have two i’s in the name.  

 What is okay to use?

If you are allergic to esters, you can use:

  • Bupivicaine
  • Dibucaine
  • Etidocaine
  • Lidocaine
  • Mepivicaine
  • Prilocaine
  • Pyrrocaine

If you are allergic to amides, you can use:

  • Benzocaine
  • Butacaine
  • Monocaine
  • Chloroprocaine
  • Isobucaine
  • Meprylcaine
  • Orthocaine
  • Piperocaine
  • Procaine
  • Proparacaine
  • Propoxycaine
  • Tetracaine