Anesthesia, Topicals, and Complication Management
This domain tests topical anesthetic safety, patient monitoring, and recognition of complications. PMU artists are not managing general anesthesia; they are using approved topical products within scope and label limits.
Core rules
Use only approved topical anesthetics and follow maximum dose and application limits. Common agents include lidocaine, tetracaine, benzocaine, and prilocaine. Benzocaine and prilocaine carry methemoglobinemia risk, especially with excessive or occlusive use. Epinephrine prolongs effect and reduces bleeding but requires caution. Patch test when indicated, avoid expired products, and never inject anesthetics. Monitor for dizziness, swelling, rash, or breathing difficulty. Complications include allergic contact dermatitis, infection, granuloma, pigment migration, scarring, hyperpigmentation, hypopigmentation, vasovagal syncope, and anaphylaxis.
Worked example
A client becomes pale and dizzy after topical application. Reasoning: stop the procedure, remove product, lay the client flat, assess airway and breathing, and activate emergency help if symptoms do not resolve. Document the event and do not continue.
Traps
Mixing anesthetics without tracking total dose; overapplying under occlusion; ignoring a benzocaine allergy; using expired topical; continuing through a vasovagal episode; promising that complications cannot happen.