What are the best topical analgesic options for painful open wounds in pediatric patients, specifically toddlers?

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Last updated: April 17, 2025View editorial policy

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From the Guidelines

For open painful wounds in toddlers, I recommend using petroleum jelly (Vaseline) or Aquaphor as the first-line topical calming option, as they create a protective barrier that keeps the wound moist, reduces pain, and promotes faster healing without the risks of medicated products. When considering pain management for open wounds in toddlers, it's essential to prioritize interventions that minimize discomfort while promoting healing. The use of topical lidocaine, as discussed in 1, may be beneficial for procedural pain but is not the first-line recommendation for ongoing wound care due to potential side effects and the need for careful application to avoid mucous membrane contact or ingestion. For mild pain relief, children's acetaminophen (Tylenol) can be used at the appropriate dose for the child's weight, typically 10-15 mg/kg every 4-6 hours, as mentioned in 1. It's crucial to avoid using antibiotic ointments like Neosporin unless specifically directed by a healthcare provider, as they can cause allergic reactions and aren't usually necessary for minor wounds. Keeping the wound clean by gently washing with mild soap and water before each application, and covering with a non-stick bandage if needed to prevent clothing friction or further injury, are also important aspects of wound care. These simple interventions are supported by the principle of moist wound healing, which is scientifically proven to reduce pain and speed recovery while minimizing scarring, as indirectly related to wound care principles in 1. Contact a doctor if the wound shows signs of infection (increasing redness, warmth, swelling, pus) or isn't improving within a few days.

From the FDA Drug Label

◆ Apply to affected area not more than 3 to 4 times daily ◆ AFTER APPLYING, WASH HANDS WITH SOAP AND WATER children under 12 years or younger: ask a doctor

The best topical calming option for open painful wounds in toddlers is not explicitly stated in the provided drug label. Lidocaine (TOP) is not recommended for children under 12 years without consulting a doctor.

  • For toddlers, it is advised to ask a doctor before applying any topical calming options, including lidocaine (TOP) 2.

From the Research

Topical Calming Options for Open Painful Wounds in Toddlers

  • The use of topical lidocaine has been studied for wound pain relief in various patient populations, including adults with traumatic wounds, venous ulcers, and post-surgical wounds 3.
  • A study on the administration of lidocaine in wounds provides guidance on how to safely and effectively use lidocaine for wound pain relief, although it does not specifically address its use in toddlers 4.
  • Topical antibiotics such as bacitracin have been used to prevent infections in uncomplicated soft-tissue wounds, but their use as a calming agent is not well-established 5, 6.
  • Topical lidocaine has been shown to be effective in reducing pain intensity and is considered a safe and tolerable treatment option for various pain conditions, including chronic pain 3, 7.
  • However, there is limited research on the use of topical calming options specifically for open painful wounds in toddlers, and more studies are needed to determine the safest and most effective treatment options for this population.

Key Considerations

  • The safety and efficacy of topical lidocaine in toddlers have not been extensively studied, and its use in this population should be approached with caution 3, 7.
  • The use of topical antibiotics such as bacitracin may be associated with an increased risk of allergic reactions, and their use should be carefully considered 5, 6.
  • Further research is needed to determine the best topical calming options for open painful wounds in toddlers, taking into account their unique needs and potential risks.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

5% Lidocaine Hydrochloride Cream for Wound Pain Relief: A Multicentre Observational Study.

Journal of investigative surgery : the official journal of the Academy of Surgical Research, 2022

Research

How to administer lidocaine in wounds.

Nursing standard (Royal College of Nursing (Great Britain) : 1987), 2017

Research

Bacitracin.

Cutis, 2005

Research

Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED.

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 1995

Research

Topical Lidocaine for Chronic Pain Treatment.

Drug design, development and therapy, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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