I hereby authorize Apollo Aesthetics LLC, and the professional staff to perform micorneedling, and all future microneedling treatments through the duration of my sessions. 

 

Microneedling / Collagen Induction Therapy                                

I understand microneedling is a treatment where fine needles will be introduced through the skin. This will combine active ingredients to go deeply into the skin / dermis. I understand 3-6 treatments can be required to see a result, and there is no guarantee that can be given to me as to the condition of my skin or degree of improvement expected in the following treatment, that multiple treatments and the use of the recommended home skin care maintenance are required to achieve optimal results. I am not pregnant or lactating and I have told the medical staff about any allergies.

You are eligible for micro-needling if the following applies to you: 

- Lack of skin radiance, loss of elasticity and epidermal thickness, rough and uneven skin texture, large pore size

- Wrinkles, Fine Lines, Crow’s feet 

- Hyperpigmentation, Scars, specifically indented acne or chicken pox, and post surgical scars   

 You are NOT eligible for micro-needling if the following applies to you: 

- You suffer with active pustular acne, active bacterial, viral or fungal infections, autoimmune disease 

- Eczema, Psoriasis, Rosacea, Actinic (solar) keratosis or Diabetes

- Keloid or raised scars or scars less than 6 months old

- Presently using isotretinoin (Accutane)

- Raised moles or warts, had facial surgery in the past 6 months 

- Patients taking blood pressure, blood thinning or heart medications or Immunosuppression

-Recent radioactive or chemotherapy treatments

-Sunburn, windburn, or broken skin

-Recently waxed or used a depilatory (such as Nair) on the area to be treated.

Side Effects and Post Care Instructions

After the procedure, the skin will be red, flushed, blotchy, and possible pin point bleeding in appearance, similar way to moderate sunburn. You may also experience skin tightness, swelling, and mild sensitivity to touch on the area being treated. This will diminish greatly after a few hours following treatments and within the next 24-48 hours the skin will look mostly healed.       

I understand that results will vary among individuals. I understand that although I may see a change after my first treatment, I will likely require a series of sessions to obtain my desired outcome. I am advised that though good results are expected, the possibility and nature of complications cannot be accurately anticipated and that, therefore, there can be no guarantee as expressed or implied either as to the success or other result of the treatment. I am aware that micro-needling treatment is not permanent on its own, prevention products and maintence sessions will be needed, as natural degradation will occur over time.

Avoid saunas, hot tubs, intense exercise, swimming pools, and hot showers for 24 hours post treatment. 

Along with pinpoint bleeding on the surface of the skin, it is also possible to get pinpoint bleeding trapped under the skin, looking like small brusies, but will subside after a few days. 

Cleanse with a gentle cleanser 6+ hours after treatment, you can then apply a hyaluronic acid serum and moisturizer, or post procedure products approved by the professioal. 

For 5-7 days discontinue the use of retinoids, exfoliating scrubs and acids, and benzoyl peroxide. You will want to use gentle, hydrating products, then continue a regular routine when any redness and/or sensitivity has subsided. Cleanse, moisturize, and sunscreen daily.

It is advised to avoid wearing makeup and sunscreen for 12 hours post treatment. A sunblock of 30 SPF or greater is required after the 12 hour period and you must avoid sun exposure for 2 weeks post treatment. 

 I understand I will be topically numbed for this treatment, allergic reaction is possible to numbing cream.

Preparatory Care Procedures

Prior to undergoing treatment, one must avoid over-exposure to sunlight or using tanning treatments. Prepare this at least 2 weeks prior to the treatment date.

It will be required to have appropriate and approved skincare products to use with your microneedling treatment to prepare and protect the skin through the healing phase. It may also be mandatory for certain fitzpatrick types to pre-treat with or be actively using a pigment inhibitor. 

Avoid the use of retinoids and exfoliating acids 3-5 days before treatment, and you must wait 6 months after the last dose of Accutane to have microneedling done. 

Although rare with microneedling, if you have a history of cold sores, you may want to pre treat with antiviral medication from your doctor before doing the treatment. 

Please inform your provider if there are any known medical conditions prior to the treatment, like infection or wound healing issues. Blood thinning agents, along with over the counter ibuprofen and aspirin, are recommended to stop a week before treatment. Risk of bruising increases if not.

• I understand it is the provider's discretion to choose not to perform any of these treatments even if I request, due to skin conditions, health reasons, etc. I also recognize certain areas of the face can not be treated with these treatments.
• I understand that It is my responsibility to let my provider know if I am pregnant, have any allergies, and are taking any medications.
• I understand every precaution will be taken to ensure a safe treatment by my provider, but risks, unknown risks, and allergic reactions to any of the treatments and products are possible.
• I understand that results vary and multiple treatments over an extended period of time is expected for significant results. Results also depend on age, skin type, skin condition, sun and environmental damage, acne degrees, pigmentation degree, etc., and noticeable results are not promised.
• I understand it is my responsibility to follow the instructions and recommendations my professional gives me via document or word of mouth to eliminate any possible negative side effects and ensure proper healing. 

 I have read the above information and was given the needed information to consent to the treatments above and had the opportunity to ask the necessary questions, which were answered by your provider, for you to make that decision. By signing this form, I acknowledge that I have fully read and understood its contents. I understand that I can call or return to the office at any time with questions or concerns from these treatments. The treatments I receive are voluntary and I release Apollo Aesthetics, LLC and/or the skin care professional from liability associated with these procedures. I certify that I am a competent adult of at least 18 years of age.