Lidocaine Patch Application to the Neck
Yes, you can safely apply a lidocaine patch to your neck—the lidocaine 5% patch has been studied and used effectively on the head and neck region with minimal systemic absorption and a favorable safety profile. 1, 2
Evidence for Neck Application
The lidocaine 5% patch is FDA-approved for postherpetic neuralgia and has been extensively studied for application to various body regions, including the head and neck. 1, 3 A specific analysis of 332 patients applying lidocaine patches to different anatomic locations (head/neck, trunk, and extremities) demonstrated that the patch was effective for pain relief across all sites, though head/neck application was associated with slightly more local adverse events compared to other body regions. 2
Safety Profile
Systemic absorption from lidocaine patches remains minimal even with application to highly vascular areas like the face and neck. 1, 3 Key safety data includes:
- Pharmacokinetic studies show systemic lidocaine levels remain within safe range with up to four patches applied for 24 hours daily 1, 4
- When 5g of topical lidocaine was applied to the face and neck with occlusion, peak serum levels occurred at 90 minutes but remained well below toxic thresholds 5, 6
- Adverse reactions are rare, mild, and mostly limited to local skin reactions such as rash 1
Proper Application Guidelines
Apply up to 3 patches maximum to intact skin over the painful area for 12 hours on, followed by a mandatory 12-hour patch-free interval. 4, 7 This dosing schedule maintains safe pharmacokinetics and prevents cumulative toxicity. 4
Critical application rules:
- Only apply to intact, non-irritated skin 7, 8
- Never use occlusive dressings over the patch, as this triples systemic absorption 6
- Avoid applying heat to the patch area, which increases systemic absorption 7, 8
- Do not use within 4 hours of any other local anesthetic intervention to prevent cumulative toxicity 4, 7
Contraindications and Precautions
Absolute contraindications include advanced liver failure (due to 60% reduction in lidocaine clearance) and known allergy to amide-type anesthetics. 1, 4, 7
Use with caution in:
- Patients weighing less than 40 kg 4
- Cardiac disease, seizure disorders, or neurological conditions 4
- Age over 70 years (increased toxicity risk) 4
Monitoring for Toxicity
While toxicity is extremely rare with proper topical use, recognize early warning signs that appear at plasma concentrations of 5-10 μg/mL: 4
- Circumoral numbness or facial tingling
- Slurred speech or metallic taste
- Tinnitus or auditory changes
- Lightheadedness or dizziness
If any signs of toxicity appear, remove all patches immediately and seek emergency medical attention. 4
Anatomic Considerations for Neck Application
The neck region showed comparable effectiveness to other body sites in clinical trials, though patients applying patches to the head/neck region reported more frequent (but still mild) local adverse events compared to trunk or extremity application. 2 This likely reflects the thinner, more sensitive skin in this area rather than increased systemic toxicity risk.