Use of EMLA cream as an analgesic in the management of painful otitis externa. A new application of EMLA cream is described. Relief of pain in otitis externa is difficult and systemic analgesics for this localized condition are often ineffective. Meticulous cleaning of the external auditory meatus is an essential step in the treatment. EMLA cream is an effective analgesic which can be used to relieve pain and anaesthetize the external auditory meatus to allow cleaning in patients with intact tympanic membranes. 