Chemical Peel Consent Form

Thank you for choosing Skin Pretty! Before your facial, there are a few things I need to know about your skin.  Each treatment is customized, so it is important that you are as thorough as possible when completing this form. 

PLEASE READ!

Before completing this form, please email the peels you have received in the past and include how long ago the most recent peel was received. If you have received a peel by Shelby in the past, this does not apply unless it has been longer than 6 months since your last treatment. Please send to shelby@skinpretty.net. In the subject please include your first and last name + chemical peel consent. It does not have to be very thorough but I do need to have an idea of how you have been treated.

Pharmaceutical grade peels are used as in office treatments. If you are a first time client, you may NOT receive a chemical peel of any sort.  It is important that your practitioner understands how your skin works, and what it is able to tolerate to be treated effectively. Peels currently being offered are

*20% Salicylic 

*30% Glycolic

*15% TCA

*Cranberry Salicylic

*Oxygen Peel

* Pigment Peel (Coming Soon)

*Porcelain Peel (Coming Soon)

*GREEN PEEL (Coming Soon)

Depending on your previous treatments, the peel to be used will be determined by your practitioner at the time of your visit.  The form must be completed before the time of your appointment.

Please note, that following your peel, your skin will undergo changes.  These changes include sensitivity to the sun (it is critical to wear SPF every single day)

It is very important to stay hydrated by drinking a lot of water.  Some peels do penetrate the skin and enter the blood stream, so it is important to take simple measures to avoid dehydration.

Your skin will feel much drier than usual. This is due to the rapid turnover of your skin cells. This is all normal and expected.  Your old layer of skin is being removed, and making way for new, fresh and healthy skin.

Your skin may peel and flake following your peel.  Depending on the depth of your peel, you may peel for up to ten days.  It is NOT recommended to wear makeup of any sort for at least one week once the peel has been applied.  This negates the effects of the peel.

If you have any beach vacations approaching, it is recommended to schedule your peel four to six weeks beforehand.

Chemical peels are aggressive forms of exfoliation, that involves the use of acidic solutions to treat different concerns.

Depending on the peel chosen, there are guidelines that MUST be followed.  It is critical to be using products recommended by your practitioner in between your appointments for optimal results.

Peels may NOT be performed on individuals who

Are pregnant or breastfeeding

Have active viral infections

Are Diabetic, have high blood pressure, or those with cardiac concerns

Have an active facial rash

Have had a peel within the last two weeks

Have sunburned skin

Have rosacea

Have had facial waxing done within the last seventy two hours

Are using Retinol or derivatives (Use must be ceased seven days before peel)

Have permanent makeup (Peel should be performed at least ten days after procedure has been performed)

Have had facial fillers of any sort within the last two weeks

By signing your name below, you are accepting full responsibility and you are agreeing to the guidelines that have been stated.