In recent decades, dermatology and cosmetology are increasingly using laser procedures. Modern laser medicine can solve many dermatological and cosmetic problems with relatively minimally invasive interventions, which contributes to the popularization of the method. Different types of laser exposure to the skin — ablative and non-ablative — can be associated with painful sensations of varying severity, the elimination of which requires modern effective and safe methods of anesthesia. The review considers factors affecting the sensory and nociceptive sensitivity of the skin, the mechanisms of the occurrence of a pain impulse in the inner skin. Pharmacology, structure and properties of local anesthetics, conditions ensuring the transportation of active substances to the inner skin and subsequent anesthesia are described. Information is provided on the risks of using certain combinations of active ingredients. The United States Food and Drug Administration (FDA) issued an official warning about the potential dangers of drugs containing mixtures of amide and ether anesthetics. The features of the eutectic mixture of lidocaine 2.5% and prilocaine 2.5%, its therapeutic efficacy, clinical recommendations for the use of this combination as the main type of anesthesia for various laser procedures in dermatology and cosmetology are examined in detail. The review is of practical importance for dermatologists and cosmetologists, since the choice of an effective local anesthetic for minimally invasive dermatological and cosmetic procedures is a difficult task for practicing specialists.