An open comparative study was conducted with EMLA cream versus infiltration with prilocaine to determine if EMLA cream was an adequate topical local anaesthetic for the taking of skin biopsies by excision or punch. Of the 51 patients, 34 were allocated to the EMLA group and 17 to the infiltration group. Eight patients had a punch biopsy and 43 had an excision biopsy, 27 in the EMLA group and 16 in the infiltration group. There were no statistically significant differences between visual analogue scale (VAS) pain scores of all patients who received EMLA and those of all patients who received infiltration analgesia. For the EMLA group the mean VAS score was 25 mm on a 100 mm scale. Seven patients in the EMLA group required further infiltration analgesia. The infiltration group had a mean VAS score of 19.1 mm. This study shows that EMLA cream, at the dose and with the application time used, provides effective local analgesia for skin biopsies taken by punch or scalpel.