Conscious sedation for skin procedures
Consultant anaesthetist-led sedation and pain relief to help you feel relaxed and comfortable during selected procedures
At Midland Skin, selected procedures can be carried out under conscious sedation, sometimes called twilight sedation. Whether sedation is right for you is decided as part of planning your procedure.
Quick Facts about conscious sedation
Best for
Anxiety, longer procedures
Treatment
IV conscious sedation
Anaesthetic
Sedation + local anaesthetic
Recovery
Escort home, rest 24 hours
Consultant
Consultant anaesthetist
Price
See below
What is conscious sedation?
Conscious sedation helps you relax and eases anxiety during your procedure. At Midland Skin we use light to moderate sedation. You stay awake enough to talk with your team throughout, but you will usually remember little, if anything, afterwards.
A combination of a sedative and a short-acting painkiller is given through a small cannula in your hand or arm by a consultant anaesthetist. Sedation is not a general anaesthetic and does not replace local anaesthetic. The treatment area is still numbed in the usual way, and the sedation adds further pain relief and comfort on top of this.
Who is conscious sedation suitable for?
Sedation may be worth discussing if:
- Procedure anxiety – you feel anxious or apprehensive about having treatment while fully alert
- Longer procedures – your treatment is expected to take some time and lying still would be difficult
- More extensive treatment – such as treatment covering a larger area of the face
- Previous difficult experience – a past procedure under local anaesthetic alone was hard to tolerate
- Generally good health – sedation in a clinic setting is best suited to people without significant heart, lung or other major medical problems
Sedation is available for selected procedures, including laser treatments, eyelid surgery (blepharoplasty), skin cancer surgery and surgery to remove benign skin lesions.
Before you book: you will need a responsible adult. Someone aged 18 or over must collect you from the clinic, travel home with you and stay with you overnight. Sedation cannot go ahead without this.
If sedation isn’t appropriate for you, your procedure may still be possible under local anaesthetic alone. Otherwise we will discuss other options with you.
Treatment pathway
Initial assessment
You meet the consultant who will carry out your procedure. They assess your skin, agree a treatment plan with you and discuss whether sedation is required.
Suitability and sedation plan
Your medical history and medicines are checked against our sedation safety criteria. Sedation is only offered where it is considered safe in a clinic setting, and you are given eating, drinking and medication instructions to follow before your appointment.
Procedure under sedation
On the day, your consultant anaesthetist goes through your health, the sedation plan and consent with you before treatment. They stay with you and monitor you throughout.
Recovery and going home
You recover in the clinic until for a period. You can only be discharged into the care of your escort. Any follow-up for the procedure itself is arranged as usual.
Is conscious sedation safe?
With modern sedation, serious problems are uncommon. Risk can never be removed completely, but modern drugs, monitoring and training have made sedation much safer. Your sedation is given by a consultant anaesthetist whose sole role during your procedure is your sedation and safety, separate from the clinician carrying out your treatment. Your breathing, oxygen levels, heart rate and blood pressure are monitored throughout, and you are given extra oxygen through a soft sponge tube in the nose.
During sedation
- Slowed breathing can occur whenever sedation is used. Your anaesthetist monitors this closely and can support your breathing if needed.
- A small drop in blood pressure is very common, and your anaesthetist can treat it.
- A small bruise where the cannula was placed is very common.
- Feeling sick or vomiting is uncommon.
- Stomach contents entering the lungs is rare. Following the eating and drinking instructions keeps this risk very low.
- An allergic reaction to the sedation medicines is very rare.
- Serious complications, including death, are very rare, particularly in healthy people having light to moderate sedation with a dedicated anaesthetist.
After sedation
- Drowsiness and unsteadiness are common, and you may be at higher risk of falling, particularly if you are older.
- Effects on judgement and memory are common and can last for up to 24 hours.
On the day: what to expect FAQs
Who will give my sedation?
Your sedation is given by a consultant anaesthetist, a doctor with extensive specialist training in anaesthesia and sedation. They stay with you throughout your procedure, and you can discuss the sedation with them before treatment starts.
Do I need to stop eating and drinking beforehand?
Yes. You must avoid eating solid food and milky drinks for 6 hours prior to your appointment for sedation. Water, squash and black tea or coffee can be consumed up to 2 hours before your sedation.
Should I take my usual medicines?
You must take your routine medicines at the usual time, unless advised otherwise, and bring them with you (including inhalers). You must phone and inform the clinic if there is any change to your health or medication.
What should I wear and bring?
You must not wear false nails as a monitor will be placed on your finger.
Bring your medicines with you. Your escort will need to be contactable and ready to collect you.
What happens when I arrive?
The anaesthetist will ask about your medical history and any previous anaesthetics, explain the procedure and sedation, and answer your questions. In the procedure room, monitoring is attached, oxygen is given through your nose, and a small cannula is placed in your hand or arm to start the sedation.
Will I be asleep?
No. You will feel relaxed and drowsy but awake enough to talk with your team. Most people remember little, if anything, afterwards.
Will I feel any pain?
The treatment area is numbed with local anaesthetic, and your sedation includes a painkilling medicine. You will also be given paracetamol when you arrive. You may still feel pressure, movement or warmth, but most people find the procedure, including the numbing injections, comfortable, and they remember little of it afterwards.
Can my sedation be postponed on the day?
Yes. If you are unwell, have not followed the eating and drinking instructions, or do not have an escort, sedation may be postponed for your safety. You must phone and inform the clinic if you develop a cold or chest problems or if there is any change to your health or medication.
After sedation: going home and recovery FAQs
When can I go home?
After your procedure you rest in the procedure chair for a few minutes before moving to a recovery area. You can go home once the team is happy you are ready. Recovery times vary, so we can’t always give your escort a precise collection time.
What does my escort need to do?
Your escort must be a responsible adult aged 18 or over. They must collect you from the clinic, travel home with you, and stay with you overnight, able to help you and call for help if needed. Please send them the link to our information for escorts before your appointment. This can also be found at: https://www.midlandskin.co.uk/sedation/#escort
What should I avoid for 24 hours?
Sedation can affect your judgement and coordination even when you feel normal. For 24 hours you must not:
- drive, or travel home by bus or taxi without your escort
- travel as a passenger on a motorcycle or bicycle
- operate machinery, including cooking and making hot drinks
- make important decisions or sign business or legal documents
- do strenuous activity
- drink alcohol
- be responsible for children
Take care when sending messages or posting online, and rest once you get home.
When can I return to work?
You should not work for the rest of the day. Returning to work after that depends mainly on the procedure you had, and your consultant will advise you.
What pain relief can I take?
The team will tell you which pain relief medicines are suitable before you leave.
Who do I contact if I am worried?
During office hours, call the clinic. Outside office hours, call NHS 111 for urgent advice, or 999 in an emergency.
Information for your escort
If you have been asked to collect someone after a procedure under conscious sedation at Midland Skin, this section is for you. Sedation can leave people drowsy, unsteady and forgetful for the rest of the day, so they need a responsible adult with them until the following morning.
Collecting them from the clinic
- You must be aged 18 or over.
- The patient can only be discharged into your care, and you must be with them as they leave. Please stay contactable by phone from the time of their appointment.
- Recovery times vary, so we cannot always give a precise collection time. Either the patient or a member of the team will call you when they are nearly ready.
- Travel home with them. They must not drive, and they should not travel by bus or taxi on their own.
Looking after them at home
- Stay with them overnight, where you can help them and call for help if needed.
- Encourage them to rest. They may be unsteady on their feet, so take care on stairs and in the bathroom.
- For 24 hours they should not drive, operate machinery, cook, use hot appliances, drink alcohol, make important decisions, sign business or legal documents or be responsible for children.
- They may not remember what they were told at the clinic. Please keep their written aftercare instructions somewhere you can both find them.
- They should take their usual medicines unless the clinic has told them otherwise. The clinic will have told them which pain relief medicines they may take.
If you are concerned
During office hours, call the clinic on 0121 285 4540. Outside office hours, call NHS 111 for urgent advice, or 999 in an emergency.
Fees
For some procedures the cost of sedation is included in the procedure fee; for others it is an additional fee. Your care plan will tell you which applies to you before you decide to go ahead. Sedation is not available through private medical insurance.
References used for this article
- Academy of Medical Royal Colleges. Safe Sedation Practice for Healthcare Procedures: Standards and Guidance. London: AoMRC; 2013.
- Academy of Medical Royal Colleges. Safe Sedation Practice for Healthcare Procedures: An Update. London: AoMRC; 2021.
- Royal College of Anaesthetists. Sedation explained (patient information). rcoa.ac.uk/patients/patient-information-resources/information-sedation
About the Author
This page has been written and/or medically reviewed by Dr Faisal Baig, Consultant Anaesthetist at Midland Skin, Birmingham.
Dr Baig is on the GMC Specialist Register in Anaesthesia. He has extensive experience of sedating patients for a wide range of procedures across different surgical specialties, including plastic and oculoplastic surgery. Dr Baig provides clinical oversight to ensure the information on this page is accurate, balanced and consistent with current practice.
Dr Faisal Baig
Date last updated: 2nd Nov 2026
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Expert, consultant led care in dermatology, skin surgery, eyelid surgery, lasers and aesthetics.
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