There are creams and ointments containing lidocaine available over the counter, but clinical strength lidocaine or lidocaine by itself is only available by prescription. Benzocaine is more prevalent over the counter and can be used as a substitute for lidocaine. They are both anesthetics.
Lidocaine is a local anesthetic used for minor surgeries and certain diagnostic procedures like endoscopy. In most states, a prescription is required. Lidocaine produces a numbing effect when applied or injected.