A child with epidermolysis bullosa required dental extraction under general anaesthesia. Severe facial and oral bullae, and superficial sloughing, had followed a previous anaesthetic. Trauma was therefore reduced to a minimum by inducing anaesthesia with the facepiece clear of the skin, achieving surgical anaesthesia with the face protected by hydrocortisone-soaked muslin, and maintaining anaesthesia by insufflation through a short delivery tube at one side of the mouth. The right lateral head-down position was used. There were no postoperative complications.