Dermatology of Seattle · Burien & Bellevue, WA
Nitronox: Comfort Care During Dermatology Procedures
Worried about pain or anxiety during your procedure? Nitronox — a 50/50 blend of nitrous oxide and oxygen — takes the edge off without needles, fasting, or a designated driver. You're back to normal in minutes.
Schedule an AppointmentWhat Is Nitronox?
Nitronox is a patented, on-demand analgesic and anxiolytic system that delivers a precisely blended 50% nitrous oxide / 50% oxygen mixture through a handheld mouthpiece or mask. Unlike traditional dental "laughing gas," Nitronox is entirely patient-controlled — you hold the mouthpiece yourself and inhale only when and as much as you choose.
Nitrous oxide has been used safely in medicine and dentistry for over 150 years. At the 50/50 concentration used in Nitronox, it produces a mild, pleasant state of relaxation and reduced pain perception without loss of consciousness or significant impairment. The continuous oxygen ensures safe delivery throughout the procedure.
Dermatology of Seattle offers Nitronox as an optional comfort enhancement for patients who experience procedural anxiety, have a low pain threshold, or simply want a more relaxed experience during their visit.
How Nitronox Works
The mechanism is straightforward and well understood:
- Before and during your procedure, you breathe the nitrous oxide/oxygen blend through a handheld mouthpiece — inhaling slowly and deeply when you want relief
- Onset is rapid: you will typically feel the effects within 30 to 60 seconds of your first few breaths
- Nitrous oxide acts on opioid and GABA receptors in the brain, producing mild sedation, a sense of euphoria or warmth, and reduced perception of pain and anxiety
- You remain fully awake, responsive, and in control throughout — the mouthpiece is in your hand, and you stop inhaling simply by removing it
- When the procedure is complete and you stop inhaling, the nitrous oxide is eliminated through your breathing within approximately 5 minutes
- Our staff monitors you throughout and will walk you through the process before beginning
The self-administration design is an important safety feature: if you ever become too relaxed to hold the mouthpiece, you will naturally release it and stop inhaling — a built-in ceiling on the dose you can receive.
Procedures Where Nitronox Can Help
Nitronox is available as an option for most in-office dermatologic procedures, including:
- Skin biopsies — including shave, punch, and excisional biopsies
- Excisions of cysts, lipomas, and other benign growths
- Mohs micrographic surgery and reconstructive closures
- Intralesional corticosteroid injections (acne cysts, keloids, alopecia areata)
- Laser procedures — fractional resurfacing, IPL, laser hair removal
- Chemical peels — especially medium-depth peels
- Microneedling and other device-based aesthetic procedures
- Cryotherapy for multiple lesions or sensitive areas
- Any procedure where procedural anxiety or discomfort is a concern
Practical Advantages
Nitronox offers a unique combination of effective comfort and real-world practicality that sets it apart from other forms of procedural sedation:
No IV required
Unlike conscious sedation, Nitronox requires no intravenous line — ideal for needle-averse patients.
No fasting needed
You can eat and drink normally before your appointment. No dietary restrictions.
Drive yourself home
Effects clear in minutes. You do not need a driver or escort for your appointment.
Rapid onset
Relief begins within 30-60 seconds — you feel it working almost immediately.
Patient-controlled dose
You decide how much you inhale. There is no external push of sedative agents.
No lingering effects
Nitrous oxide leaves the body through breathing alone, with no metabolic processing needed.
Safety & Monitoring
Your safety during any procedure at Dermatology of Seattle is our top priority. When Nitronox is used:
- A trained staff member monitors you throughout the procedure
- The 50% oxygen blend ensures you always breathe more oxygen than in normal room air
- The patient-controlled mouthpiece is a built-in safety mechanism
- Vital signs can be monitored as appropriate for the procedure
Who Should Not Use Nitronox
Nitronox is not appropriate for everyone. Please inform your provider if any of the following apply:
- First trimester of pregnancy
- Vitamin B12 deficiency or conditions affecting B12 metabolism
- Severe chronic obstructive pulmonary disease (COPD) or other significant respiratory conditions
- History of pneumothorax (collapsed lung)
- Recent middle ear or sinus surgery
- Certain psychiatric conditions — discuss with your provider
Schedule Today
Ask about Nitronox when you schedule your next procedure. Our team will make sure you're comfortable every step of the way.
Schedule an AppointmentQuick Facts
- Patient-controlled — you set your own comfort level
- Onset in 30–60 seconds
- Effects wear off in approximately 5 minutes
- No IV needle or fasting required
- Drive yourself home after the procedure
- Continuous oxygen delivery throughout
Frequently Asked Questions
Is Nitronox safe?
Yes. Nitronox has an extensive safety record across medicine and dentistry. The 50/50 blend of nitrous oxide and oxygen ensures you are always breathing at least 50% oxygen — more than the ambient air around you — so hypoxia is not a concern. Because the system is patient-controlled, you naturally reduce or stop inhaling if you feel overly sedated. Our staff monitors you throughout the procedure and the effects reverse completely within minutes of stopping.
Will I be knocked out or unable to communicate?
No. Nitronox produces light sedation and a calm, relaxed feeling — not general anesthesia. You remain awake, fully conscious, and able to speak with your provider throughout the procedure. Most patients describe a pleasant floating or warm sensation. You are always in control of the mouthpiece and can stop inhaling at any point.
Can I drive myself home after using Nitronox?
Yes — this is one of the most practical advantages of Nitronox. Because nitrous oxide is eliminated from the body almost entirely through the lungs, the effects wear off within approximately 5 minutes of removing the mouthpiece. No lingering sedation, no grogginess. Unlike IV sedation, you are safe to drive yourself home and return to your normal activities immediately after your procedure.
Is it the same as the laughing gas used in dentistry?
Yes and no. The active agent is the same — nitrous oxide — but the Nitronox delivery system is specifically designed for medical use and gives the patient direct control over how much they inhale. Patients hold the mouthpiece themselves and breathe on demand, which provides a built-in safety mechanism: if you become too relaxed to hold it, you stop inhaling.
Does insurance cover Nitronox?
Nitronox is typically considered an add-on comfort service and is not routinely covered by insurance. There is usually a separate fee for its use. Our team will let you know the current cost when you schedule a procedure where Nitronox may be appropriate, so you can decide whether to include it.
Who should not use Nitronox?
Nitronox is not recommended for patients in the first trimester of pregnancy, those with a known vitamin B12 deficiency or conditions affecting B12 metabolism (such as MTHFR mutations at high risk), patients with severe respiratory conditions (such as emphysema or a pneumothorax), or those with a history of certain ear surgeries. Your provider will review your medical history before the procedure to confirm that Nitronox is appropriate for you.
Comfortable Procedures Start Here
Don't let procedural anxiety keep you from the care you need. Ask about Nitronox at your next appointment — no needles, no fasting, no worries.