Can Zytee (Benzocaine) Gel Be Applied in Children?
Zytee gel containing benzocaine can be safely applied in children 2 years of age and older for oral pain relief, but is contraindicated in children under 2 years of age due to the risk of methemoglobinemia. 1
Age-Specific Recommendations
Children 2 Years and Older
- Benzocaine topical products are FDA-approved for use in children 2 years of age and older for relief of oral pain, including mouth ulcers and dental discomfort 1
- Application should be limited to the affected area using the applicator tip, up to 4 times daily or as directed by a dentist or doctor 1
- Children under 12 years of age must be supervised during use to ensure proper application and prevent excessive dosing 1
Children Under 2 Years
- Benzocaine is contraindicated in children under 2 years of age 1
- Parents must consult a dentist or doctor before any use in this age group 1
- The contraindication is based on the increased risk of methemoglobinemia in young children due to their higher body-surface-to-mass ratio, similar to concerns with other topical agents like salicylic acid 2
Critical Safety Concerns
Methemoglobinemia Risk
- Benzocaine is a well-documented cause of acquired methemoglobinemia, a potentially life-threatening condition that requires rapid identification and treatment 3
- This complication can occur even with appropriate topical use and has been reported across multiple species including humans 3, 4
- Methemoglobinemia typically develops 10-20 minutes after application and can substantially alter cardiovascular and pulmonary function 4
- Treatment with methylene blue is required in most cases to reverse methemoglobinemia and achieve clinical recovery 3
Clinical Pitfalls to Avoid
- Never exceed the recommended frequency of 4 times daily, as repeated applications increase the risk of systemic toxicity 1
- Avoid applying to large surface areas, as this increases systemic absorption
- Watch for signs of methemoglobinemia including cyanosis, altered mental status, or respiratory distress, particularly within 20 minutes of application 3, 4
- Do not use in children with glucose-6-phosphate dehydrogenase (G6PD) deficiency, as they are at higher risk for methemoglobinemia
Efficacy in Pediatric Populations
- Benzocaine has demonstrated effectiveness for oral pain relief in children, with studies showing significant pain reduction for chemotherapy-induced oral ulcers lasting at least 3 hours 5
- In comparative studies of topical anesthetics for dental procedures in children aged 6-10 years, 20% benzocaine gel performed equivalently to other topical anesthetics like lidocaine gel and EMLA cream 6