Dr. Alan Greene answers the question, Can anti-itch creams be dangerous for my child?



I've heard that some children have been killed by the use of over-the-counter anti-itch creams. Is this true? Are they all unsafe? Which ones should I avoid for my daughter?


One would expect common first-aid creams to be fairly safe. However, there have been tragic, accidental deaths of young children caused by common over-the-counter remedies. Young children love to explore and experiment and put things in their mouths. These children had actually ingested a seemingly innocuous ointment or cream. They were dead minutes later.

The dangerous ingredient is called dibucaine. It's a powerful, topical anesthetic in the same class as Novocain or lidocaine. Of all the "caine" anesthetics, dibucaine is known to be the most lethal, if taken internally. Topical use is usually safe.

Dibucaine is an important ingredient in some ointments and creams commonly used to treat sunburn, insect bites, minor burns, cuts, scrapes, and scratches. It's sold as a pain-relief cream, an anti-itching cream, and as an ointment used to relieve discomfort from hemorrhoids. Somehow, first-aid creams seem safer than prescription drugs, and tubes of cream seem safer than bottles of pills. Appearances can be quite deceiving.

If taken internally, even small amounts of dibucaine can cause children to vomit, convulse, and turn blue -- followed by death from respiratory and cardiac arrest. This has happened to children within 10 to 20 minutes of putting a tube in their mouth.

Thankfully, the U.S. Consumer Product Safety Commission requires child-resistant tops for tubes containing more than 0.5 mg of dibucaine (or more than 5.0 mg of lidocaine).

Used as directed, these are safe, effective remedies. Young children, however, don't always follow directions. Make sure you keep all ointments and creams under the same lock-and-key as you keep prescription drugs and other medications.

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

Healthy Kid