BLT CREAM — 20 / 10 / 10
The triple-agent compound used by dermatologists, dentists, aesthetic injectors, and med spas. Benzocaine 20% + Lidocaine 10% + Tetracaine 10%. 15-minute onset. 2 to 4 hour duration. Compounded fresh per order in the USA. For licensed providers.
THREE ANESTHETIC AGENTS. ONE COMPOUND.
BLT cream is the shorthand name for a compounded topical anesthetic that combines three local anesthetic agents — Benzocaine, Lidocaine, and Tetracaine — into a single multi-agent formulation. The classic concentration is written as 20/10/10: Benzocaine 20%, Lidocaine 10%, and Tetracaine 10%. Total active anesthetic load is approximately 40%, about eight times the concentration of consumer-grade single-agent products.
The three agents work in series rather than parallel. Benzocaine penetrates the outer epidermis fast — it is responsible for the early numbing sensation patients feel within 5 to 10 minutes. Lidocaine reaches the deeper dermal layer and provides the main bulk of the anesthesia. Tetracaine is the most potent of the three and the slowest to onset; it penetrates deepest, lasts longest, and maintains anesthesia after the cream is removed. Together they cover the full pain pathway from surface to deep dermis.
Many BLT formulations — including MediCaine Pro — add Phenylephrine 0.5% as a vasoconstrictor. Phenylephrine narrows the cutaneous blood vessels at the application site, which slows systemic absorption of the anesthetic and keeps it concentrated in the treatment area. The net effect is faster perceived onset, longer duration, and reduced bleeding at the procedure site.
WHAT PROVIDERS CALL IT
Search for this compound and you will find it written half a dozen ways. They describe the same preparation.
BLT / BLT CREAM
The initials of the three actives: Benzocaine, Lidocaine, Tetracaine. The shorthand most providers use out loud.
20 / 10 / 10
The concentrations in order: Benzocaine 20%, Lidocaine 10%, Tetracaine 10%. Writing "BLT 20/10/10" specifies the strength, not just the family.
BENZOCAINE LIDOCAINE TETRACAINE
The actives spelled out, in any order. Lidocaine-tetracaine-benzocaine and benzocaine-tetracaine-lidocaine all point at the same compound.
TRIPLE ANESTHETIC CREAM
Named for the count of agents. "Triple numbing cream" and "triple anesthetic" mean a three-agent compound, which in practice is almost always BLT.
BLT+ / QUAD-AGENT
A fourth anesthetic added to the BLT base. In MediCaine Ultra that is Prilocaine 8%, for a longer window.
COMPOUNDED TOPICAL ANESTHETIC
The formal description. It is compounded because no manufacturer mass-produces this combination; a 503A pharmacy mixes it per order.
CREAM OR OINTMENT, PUMP OR JAR
The actives are identical across formats. What changes is how the compound sits on the skin and how your team doses it.
CREAM BASE
A modern transdermal base. Absorbs faster, spreads smoothly and distributes the actives evenly across the treatment area. The default for most aesthetic work.
OINTMENT BASE
Mineral oil and polyethylene. Stays where it is placed, supports high concentrations and releases gradually over a longer contact time. Often chosen for extended procedures.
AIRLESS PUMP
Consistent dosing with no fingers in the product, which keeps the compound clean across a busy day. Available from 30 g upward.
PROFESSIONAL JAR
Wide-open access for high-volume rooms. The 454 g professional size is a jar. See pricing by size.
Single-use packets are a common request for travel kits and per-client dosing. Ask a pharmacist on (310) 889-0733 what is available for your order.
LICENSED PROVIDERS, VERIFIED FIRST
NOT SOLD RETAIL
At roughly 40% total anesthetic concentration, BLT is not a shelf product. You will not find this compound on a marketplace, and anything sold there at these percentages deserves scrutiny.
NPI VERIFICATION
Every order is checked against the CMS National Provider Identifier registry. Name, NPI, licence number and licence state must match active records before anything is compounded.
HOW TO ORDER
Build the order on this site or call a pharmacist. We confirm your details, send a secure payment link, compound it fresh and ship within 2–3 business days.
BLT CREAM PRICE BY SIZE
Standard BLT and quad-agent BLT+ share the same size ladder. Prices are per unit, compounded fresh per order.
| SIZE | PRO · BLT 20/10/10 | ULTRA · BLT+ |
|---|---|---|
| 30 g | $80 | $80 |
| 50 g | $100 | $100 |
| 100 g | $130 | $130 |
| 150 g | $180 | $180 |
| 200 g | $220 | $220 |
| 454 g jar | $275 | $290 |
Full detail on the Pro and Ultra pages. Sold to licensed providers only.
HOW BLT CREAM ACTUALLY WORKS
Three local anesthetics, three different speeds, three different depths — engineered to overlap.
BENZOCAINE
Ester-class anesthetic. Penetrates the outer epidermal layer fastest. Responsible for the early "tingling" sensation patients describe within 5 to 10 minutes of application. Provides surface-level pain blockade.
LIDOCAINE
Amide-class anesthetic. The most widely used local anesthetic in clinical medicine, with decades of safety and efficacy data. Penetrates deeper than Benzocaine into the papillary and reticular dermis. Provides the bulk of clinical anesthesia.
TETRACAINE
Ester-class anesthetic. The most potent and longest-lasting of the three. Slow to onset but penetrates deepest and maintains anesthesia after the cream is removed. Responsible for the 2 to 4 hour duration tail.
PROCEDURES THAT USE BLT CREAM
DERMATOLOGY
Skin biopsies, cryotherapy, laser resurfacing, Mohs surgery, mole removal, electrosurgery, ablative laser, fractional laser.
DENTISTRY
Pre-injection numbing, scaling and root planing, crown preparation, mucogingival surgery, periodontal procedures.
AESTHETIC MEDICINE
Dermal fillers, Botox, lip augmentation, microneedling, RF microneedling, chemical peels, PDO threads.
LASER TREATMENTS
Laser hair removal, laser tattoo removal, IPL photofacial, fractional laser, vascular laser, picosecond laser.
MICRONEEDLING
Traditional microneedling, RF microneedling (Morpheus8, Vivace, Genius), exosome therapy, PRP/PRF combination treatments.
LIP & FACIAL FILLERS
Lip augmentation, cheek and jawline filler, under-eye treatment, nasolabial fold correction, chin contouring.
HOW TO APPLY BLT CREAM
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1
CLEAN AND DRY THE TREATMENT AREA
Wash the skin with mild soap and water. Pat completely dry. Do not apply BLT to broken, inflamed, or recently waxed skin without provider judgment.
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2
APPLY A GENEROUS EVEN LAYER
Apply approximately 1 to 2 grams per 10 by 10 cm of skin. Rub in gently — do not occlude unless specifically called for by the procedure. Maximum single-use dose: 30 g of 20/10/10 BLT on intact skin without occlusion.
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3
WAIT 15 TO 25 MINUTES
15 minutes for superficial procedures (Botox, IV access, light biopsies). 20 to 25 minutes for deeper procedures (fillers, microneedling, laser). Add 5 to 10 minutes if not using occlusion for deep procedures.
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4
REMOVE COMPLETELY BEFORE PROCEDURE
Wipe the area thoroughly with gauze, then cleanse with alcohol or saline. This is especially critical before microneedling, laser, and any procedure that breaches the skin barrier — residual anesthetic can otherwise be driven into the dermis and increase systemic absorption.
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5
PROCEED WITH PROCEDURE
Clinical anesthesia is at peak 30 to 45 minutes after application and persists 2 to 4 hours for standard BLT, 3 to 5 hours for quad-agent BLT+. For procedures longer than 2 hours, plan accordingly.
BLT SAFETY GUIDANCE
BLT cream is a high-concentration compound restricted to licensed providers because it requires clinical judgment.
MAXIMUM SAFE DOSE
For a healthy adult, approximately 30 g of 20/10/10 BLT on intact skin without occlusion. Larger body-surface treatments — such as full back or thigh laser hair removal — require divided dosing or step-down to a single-agent formulation. Pediatric, elderly, hepatic-impaired, and cardiac patients require provider judgment and lower dosing.
DO NOT APPLY TO
Broken or inflamed skin, mucous membranes (unless specifically indicated), eyes, large body surface areas under occlusion. Avoid in patients with known allergies to ester-class anesthetics (Benzocaine, Tetracaine) or amide-class anesthetics (Lidocaine). Caution in patients with methemoglobinemia risk.
OCCLUSION INCREASES ABSORPTION
Plastic film occlusion approximately doubles the rate of transdermal absorption. Use occlusion intentionally — for deep procedures requiring rapid onset — and reduce total dose accordingly. Never occlude broken skin. Always document occlusion in the procedure note.
REMOVE BEFORE BREACHING SKIN
Always remove BLT completely before microneedling, laser, biopsy, or any procedure that breaches the epidermis. Residual anesthetic driven into the dermis bypasses the normal absorption barrier and can produce systemic levels disproportionate to the topical dose.
BLT VS EMLA, LMX, AND OTC
| FORMULATION | ACTIVES | TOTAL | ONSET | DURATION | ACCESS |
|---|---|---|---|---|---|
| MediCaine Pro (BLT 20/10/10) | Benz / Lid / Tet / Phen | 40.5% | 15 min | 2–4 hr | Licensed providers |
| MediCaine Ultra (BLT+ quad) | Benz / Lid / Tet / Pri / Phen | 48.5% | 15 min | 3–5 hr | Licensed providers |
| EMLA | Lid 2.5% / Pri 2.5% | 5% | 30–60 min | 1–2 hr | Rx (some OTC) |
| LMX 4 / LMX 5 | Lidocaine only | 4–5% | 30–45 min | 1–2 hr | OTC |
| OTC Lidocaine | Lidocaine only | ≤ 4% | 30–45 min | 1–2 hr | OTC |
BLT CREAM QUESTIONS
What is BLT cream?+
How much does BLT cream cost?+
How long does BLT cream last?+
How long before treatment should BLT cream be applied?+
How much BLT cream should be used?+
What procedures use BLT cream?+
Is BLT cream FDA approved?+
What is the difference between BLT and EMLA?+
Can BLT cream be used before microneedling?+
Can BLT cream be used before tattoo or PMU procedures?+
What does BLT 20/10/10 mean?+
Is BLT the same as triple anesthetic cream?+
Where can I buy BLT cream?+
Can I order BLT cream online?+
Do I need a prescription to order it?+
Does BLT come as an ointment or in packets?+
What is the difference between BLT and BLT+?+
GET PRICING FOR YOUR PRACTICE
Tell us where you practice and a pharmacist will send current pricing and answer formulation questions. No license details needed yet — we only ask for those once you decide to order.
ORDER BLT CREAM
Compounded fresh per order in a USP 795 compliant facility. Sold to licensed providers — we verify your license before the first shipment, not before you inquire. See also: what numbing cream professionals use.