In some arrangements, a dermal lance apparatus is adapted to pierce a person's skin to obtain bodily fluids for medical testing. The lance can stimulate nerves in the person's skin to reduce or eliminate pain during the lancing procedure. After the nerves are stimulated, the lance can form the opening at a lance point. The lance can use mechanical motion to stimulate the person's skin. Alternatively, the lance can affect the temperature of the person's skin for effective stimulation.