[Local anesthetic procedures in dermatology. Part 2: Practical aspects]

The vast majority of dermatologic surgery is performed with local anesthesia. The different methods provide safe and effective analgesia in circumscribed areas of skin and subcutaneous tissue and allow patients to tolerate otherwise painful diagnostic or therapeutic procedures while remaining conscious. Some forms of local anesthesia are unique, such as topical anesthesia with EMLA® or cryoanesthesia; others offer options to general anesthesia. Tumescent local anesthesia has gained widespread acceptance in the past decade for many indications other than cosmetic liposuction and is used for excising benign and malignant tumors, for extensive skin and soft tissue procedures (such as excision of acne inversa or sweat gland curettage) and in phlebologic surgery.