Lidocaine spray and benzocaine: uses and safety explained

Lidocaine spray and benzocaine are both local anaesthetics: medicines that block nerve signals where they're applied, so the area feels less pain for a while. In the UK you'll find lidocaine in sprays used for dental work and medical procedures, in sprays used to delay ejaculation, and in creams and plasters. Benzocaine is in sore throat sprays, a mouth gel and a skin cream sold without a prescription.

What is lidocaine?

Lidocaine is an amide-type local anaesthetic. It stops nerve fibres passing on signals where it's applied or injected, which is why it's used to prevent pain during dental work and minor procedures. Injected into a vein, it's also used to treat some abnormal heart rhythms, including during resuscitation, according to the BNF.

Lidocaine comes as injections, sprays, creams, ointments and medicated plasters. It's also combined with prilocaine, another amide-type local anaesthetic, in a cream and a spray.

What is lidocaine spray used for?

The BNF lists two lidocaine sprays. Sprayed on the lining of the mouth and throat, the Xylocaine spray is used for dental work and for procedures such as a bronchoscopy or having a breathing tube put in. The other, a 9.6% lidocaine spray, is licensed to reduce the sensitivity of the penis before sex, to delay ejaculation.

The BNF lists both as pharmacy medicines. It also lists the Xylocaine spray for some other procedures, such as during childbirth, and says dentists can prescribe it as lidocaine spray 10%.

For delaying ejaculation, there's also a spray that combines lidocaine with prilocaine, licensed for lifelong premature ejaculation. Both delay sprays, the evidence behind them and their effects on partners are covered in delay sprays, creams and gels for men explained.

Some lidocaine and benzocaine medicines in the UK

	What it's licensed for.	How you get it.
Lidocaine spray (Xylocaine)	Applied to mucous membranes, such as the lining of the mouth and throat, for dental work and procedures such as a bronchoscopy or a breathing tube being put in	Pharmacy medicine
Lidocaine 9.6% spray	Reducing the sensitivity of the penis before sex, to delay ejaculation	Pharmacy medicine
Lidocaine and prilocaine spray	Lifelong premature ejaculation	Pharmacy medicine
Lidocaine 4% cream	Before a cannula or a blood test	Pharmacy medicine
Lidocaine and prilocaine cream	Before minor skin procedures, such as a blood test	Pharmacy medicine
Lidocaine plasters	Nerve pain after shingles	Prescription only
Benzocaine throat spray	Sore throat pain	Without a prescription
Benzocaine mouth gel	Mouth ulcers and soreness from dentures	Without a prescription
Benzocaine skin cream	Itching and irritation from insect bites and stings, nettle stings, cuts and scrapes, chafing, and external vaginal or anal itching	Without a prescription

Sources: the BNF and the MHRA's patient leaflets. Pharmacy medicines are sold only from a pharmacy, with a pharmacist present. Read the leaflet that comes with any medicine.

What is benzocaine?

Benzocaine is a local anaesthetic from a different chemical family to lidocaine. The product information for the lidocaine and prilocaine spray groups benzocaine with procaine and tetracaine as para-aminobenzoic acid derivatives, and says people allergic to those haven't shown cross-sensitivity to lidocaine or prilocaine.

The BNF notes that allergic reactions happen mainly with ester-type local anaesthetics, such as tetracaine, and less often with amide types such as lidocaine and prilocaine. Benzocaine is also one of the ingredients of the "caine mix" in a licensed patch test kit used to find out what a person's skin is allergic to.

What is benzocaine used for?

In UK medicines, benzocaine is used for sore throats, mouth ulcers and itchy skin. The MHRA's leaflets describe a benzocaine throat spray to relieve sore throat pain, a mouth gel to reduce the pain of mouth ulcers and soreness from dentures, and a skin cream for itching and irritation from bites, stings, cuts and scrapes and chafing.

• The throat spray is sprayed at the back of the throat. Its leaflet says not to use it if you have difficulty breathing, noisy breathing or severe difficulty swallowing.
• The mouth gel is for short-term use until you can get to a dentist, its leaflet says, and you should avoid hot drinks while using it.
• The skin cream also covers external vaginal and anal itching, but not large areas of skin, a rash, sunburn, infected or broken skin, or the mouth or eyes.

The NHS says you can ask a pharmacist about medicated lozenges containing a local anaesthetic for a sore throat, and about anaesthetic sprays, though there's little proof the sprays help when used on their own. BAUS (the British Association of Urological Surgeons) says condoms containing benzocaine have proved useful in some men with premature ejaculation; see delay condoms and wipes explained.

Is lidocaine safe?

Applied to intact skin as directed, only low amounts of lidocaine reach the blood, but it isn't free of risk. The BNF notes the manufacturer's advice that local anaesthetics shouldn't be applied to damaged skin, because more gets into the blood and side effects become more likely. High blood levels can affect the nervous system and heart; allergic reactions are less common than with ester-type anaesthetics.

A few points from the BNF and the leaflets:

• Keep sprays away from your eyes, and don't use lidocaine on damaged skin.
• The BNF warns against anaesthetising the back of the throat (the pharynx) before meals, because of the risk of choking in adults.
• In pregnancy, the BNF says lidocaine crosses the placenta but isn't known to be harmful in animal studies, and should be used if the benefit outweighs the risk.
• In breastfeeding, it says lidocaine is present in breast milk but in amounts too small to be harmful.
• Very high blood levels of lidocaine have been linked to nervousness, dizziness, fits, loss of consciousness and effects on the heart and lungs, the leaflet for the lidocaine delay spray says.

Is benzocaine harmful?

The benzocaine medicines described here are sold without a prescription, and their leaflets warn about allergic reactions and about methaemoglobinaemia, a rare blood disorder that affects how red blood cells deliver oxygen. Signs of too much include shortness of breath, headache, tiredness, blue or grey skin or lips, dizziness and confusion, the skin cream's leaflet says.

The leaflets also say:

• Don't use benzocaine if you're allergic to it. The skin cream's leaflet adds other local anaesthetics, para-aminobenzoic acid, parabens, paraphenylenediamine and commercial hair dyes to the list.
• Don't use it if you've been told you have methaemoglobinaemia.
• Check before using it with other medicines: the mouth gel's leaflet says not to use it with sulphonamide antibiotics, such as co-trimoxazole.
• Check the age limit: the throat spray isn't for children under 6, and the mouth gel and skin cream aren't for under-12s.
• If you're pregnant or breastfeeding, the throat spray's leaflet says not to use it, and the cream's says to ask a doctor first.

Is benzocaine legal in the UK?

Yes. Benzocaine is the active ingredient in licensed UK medicines, including sore throat sprays, a mouth gel and a skin cream. It's also misused: in 2014 the Home Office said more than 7 tonnes of benzocaine, lidocaine and phenacetin had been seized in 2012 after being brought into the UK in suspicious circumstances, as cutting agents for illegal drugs.

The Home Office said at the time that most cocaine and crack sold on the street contains one or more cutting agents, which can pose unknown risks to health. It announced plans for a general power to seize substances suspected of being intended for cutting drugs.

Can you buy lidocaine spray over the counter in the UK?

Yes, from a pharmacy. The BNF lists the lidocaine sprays as pharmacy medicines, which the MHRA says you can buy only from a pharmacy, with a pharmacist present; pharmacy staff may ask questions to make sure the medicine suits you. Lidocaine plasters for nerve pain are prescription only.

If you buy online, the MHRA's advice is to avoid social media, messaging apps and unknown websites, and to use only UK-registered pharmacies, including online pharmacies showing the official green cross logo. You can check an online pharmacy based in Great Britain on the General Pharmaceutical Council's website.

Does lidocaine help with premature ejaculation?

Lidocaine sprays are licensed for it in the UK. The 2026 EAU guidelines from the European Association of Urology recommend the lidocaine and prilocaine spray as a first-line treatment for lifelong premature ejaculation, and say lidocaine-only sprays are effective too.

The NHS says local anaesthetics such as lidocaine or prilocaine can help, but may be absorbed by a partner's vagina and reduce their sensation. The other options, from techniques to tablets, are compared in how to stop premature ejaculation, and the bigger picture is in how to last longer in bed.

When should you get help?

Call 999 if you or someone else has signs of anaphylaxis, a severe allergic reaction, after using either medicine. For a rash or irritation, the leaflets say to stop using the medicine and see a doctor if it doesn't settle. The NHS lists these signs of anaphylaxis:

• lips, mouth, throat or tongue suddenly becoming swollen
• breathing very fast or struggling to breathe
• a tight throat or struggling to swallow
• skin, tongue or lips turning blue, grey or pale
• suddenly becoming very confused, drowsy or dizzy, or fainting and not waking up

If you get signs of too much benzocaine, such as shortness of breath, blue or grey skin or lips, dizziness or confusion, the skin cream's leaflet says to stop using it and see your doctor. If someone has swallowed a medicine and you're not sure if it's harmful, call NHS 111; call 999 or go to A&E if they've lost consciousness, have a fit or are struggling to breathe.

For a sore throat, the NHS says to see a GP if it doesn't improve after a week, and to call 999 or go to A&E if you can't swallow, have difficulty breathing or are drooling. See a GP or dentist about a mouth ulcer that lasts longer than 3 weeks.