Journal of Cutaneous and Aesthetic Surgery
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   Table of Contents     
Year : 2021  |  Volume : 14  |  Issue : 4  |  Page : 416-417
Innovative use of a comedone extractor as an anesthetic tool for intradermal injections on scalp

1 Mehektagul Dermaclinic, New Delhi, India
2 Department of Dermatology, North Delhi Municipal Corporation Medical College & Hindu Rao Hospital, New Delhi, India
3 MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India

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Date of Web Publication13-Feb-2022

Keywords: Anesthesia, comedone extractor, intradermal injections

How to cite this article:
Arora G, Jakhar D, Gupta S. Innovative use of a comedone extractor as an anesthetic tool for intradermal injections on scalp. J Cutan Aesthet Surg 2021;14:416-7

How to cite this URL:
Arora G, Jakhar D, Gupta S. Innovative use of a comedone extractor as an anesthetic tool for intradermal injections on scalp. J Cutan Aesthet Surg [serial online] 2021 [cited 2022 Aug 13];14:416-7. Available from:

   Problem Faced Top

Intradermal injections in the scalp are often painful, and it is a challenge to obliviate the pain factor. Various methods of anesthesia for the scalp have been used, such as regional nerve blocks, infiltration anesthesia, and topical anesthetic creams. Each of these methods has its inherent drawbacks. Regional blocks and infiltration anesthesia need a certain level of skill to perform and topical anesthetic creams are messy, take a long time to act on the scalp, and are often ineffective.[1] Cooling and vibration are other methods, which have a limited efficacy and need additional devices.

   Solution Proposed Top

We used a sterile comedone extractor [Figure 1]A, which is a simple and readily available instrument in dermatology clinics, as a device to alleviate pain during scalp injections. The instrument was pressed on the scalp, and injections with an insulin syringe with a 30-32G needle were administered through the head (loop) of the extractor [Figure 1]B, Video 1]. This provided a dual benefit of significant anesthesia via the pain gate theory,[2] as well as hemostasis. According to the pain gate theory, pain perception is reduced by the perception of pressure by the instrument. The rim of the loop provides hemostasis, pressure anesthesia, and a window for injections. The familiarity with the instrument and ease of use are added advantages. This technique provides a neat and effective method of inducing anesthesia for scalp injections.
Figure 1: (A) A commonly available comedone extractor with loops at both the ends. The wider loop provides a better opportunity for injection. (B) A comedone extractor pressed against the scalp surface provides pressure anesthesia and hemostasis. Platelet-rich plasma (PRP) is injected through the loop with an insulin syringe (32G needle) while maintaining the pressure at comedone extractor

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/ have given his/ her/ their consent for his/ her/ their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Safran T, Zammit D, Kanevsky J, Khanna M Efficacy of local anesthesia in the face and scalp. Plast Reconstr Surg Glob Open 2019;7:e2243.  Back to cited text no. 1
Mendell LM Constructing and deconstructing the gate theory of pain. Pain 2014;155:210-6.  Back to cited text no. 2

Correspondence Address:
Dr. Gulhima Arora
Mehektagul Dermaclinic, K105, Ground Floor, Hauz Khas Enclave New Delhi 110016.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JCAS.JCAS_239_20

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