Some women find relief from vestibulodynia (VVS) with topical anesthetics. All topical anesthetics may cause initial burning and stinging on application; the discomfort lasts for a few minutes until the area is numb. The longer the ointment is on the area, the deeper the anesthesia. Examples of topical anesthetics include: lidocaine (Xylocaine) ointment 5%; EMLA (a mixture of 2 local anesthetics; lidocaine and prilocaine); LMX 4, and LMX 5 (previously called ELA-Max) (lidocaine 4% and 5%). Benzocaine, which is the anesthetic in Vagicaine and Vagisil can cause an allergic contact dermatitis and SHOULD NOT BE USED. Diphenhydramine found in topical Benadryl cream can also cause an allergic contact dermatitis and SHOULD NOT BE USED. For women who cannot tolerate oral medication for vulvodynia (see below), both amitriptyline (Elavil) and gabapentin (Neurontin) can be specially compounded into hypoallergenic preservative free creams. Other topical medications that patients have used include capsaicin, atropine, nitroglycerin, and Traumeel but there is very limited experience with these medications and they should be considered experimental. Certain topical therapies are known NOT TO HAVE SIGNIFICANT BENEFIT for vulvodynia and have potential side effects and could make things worse so they SHOULD NOT BE USED. These include: steroid creams; antifungal (anti yeast) creams and testosterone cream.