• Chemical Peel Consent Form

  • Information: 


    Chemical Peel is a superficial peeling treatment used to rapidly exfoliate the skin. This active solution assists in drying acne lesions, reducing acne scarring, clearing the skin of blackheads, smoothes superficial lines and wrinkles, and lightens pigmented skin disorders.

    The skin is thoroughly cleansed and a pre-treatment is used to remove dead skin cells and oil ensuring an even penetration of the  Chemical Peel Solution.

    The Chemical Peeling Solution is applied with cotton swabs or pads in one even coat and is left on the skin. As the peel solution penetrates, a white frost may appear and usually fades within an hour.

    The skin’s tolerance will depend on individual sensitivities. It is normal to experience a mild to moderate feeling of activity. To minimize any discomfort, a small fan may be used until the feeling subsides.

    Most individuals experience mild visible peeling or flaking, however the exact degree of exfoliation (peeling) cannot be predicted. For a few hours after the peel you will feel a tightening of the skin. Your face will appear red and may become a deeper tan or brown color. Your skin will become very dry and tight.

    You should NOT wash your face the first day after your peel. You can rinse your face with cool water and pat dry as often as you like after the first six hours following the peel. On the second day you may cleanse with the Surface Lotion Cleanser and rinse your face with cool water and apply the prescribed moisturizer. Sun Protective Cream SPF 15 or higher must be applied 30 minutes before sun exposure.

    Success of the Chemical Peel will depend on faithfully following all instructions from your Skin Care Specialist. If you are not prepared to see visible signs of peeling, then a lighter Glycolic, Lactic, Enzyme, or Microdermabrasion Treatment may be a better choice for you.

     

     

  • NO GUARANTEE IS MADE OR IMPLIED AS TO THE PRECISE RESULTS OF THE PEEL. TEMPORARY SIDE EFFECTS CANNOT BE PREDICTED AND CAN VARY GREATLY DEPENDING ON SKIN THICKNESS, AGE, SENSITIVITY AND ADHERENCE TO THE PRESCRIBED PRE AND POST PEEL SKIN CARE INSTRUCTIONS.

  • Cautions:


    Individuals with a dark complexion run the risk of a temporary post inflammatory hyperpigmentation of the skin. To help prevent this condition pre-treat with the prescribed Lightening Treatment product.
    Plan to avoid direct sun for at least one week post-peel and use the Sun Protective Cream daily to minimize discoloration and ensure optimal results.

     

  • Clinical Skincare


    YOUR COMPLIANCE PRE-PEEL
    1. Discontinue Accutane six months prior to the peel.
    2. Discontinue use of Retinoic Acid products three days prior to the peel.
    3. Report all skin diseases, viruses, infections, cold sores, eczema or allergies.
    4. Persons with allergies to aspirin, salicylates, cigarette smokers, pregnant or     lactating women should not have this peel.
    5. Pre-treat skin 2 weeks prior to the peel using prescribed Products.
    6. Do not exfoliate, use Glycolic Acid, Benzoyl Peroxide, or any other skin     irritants 24 hours before.
    7. Do not shave, use depilatories, wax or have electrolysis the day of the peel.
    8. If the skin is red, irritated or sunburned the peel must be rescheduled.
    9. Report all medication taken the day of the peel.
    10. Optional: take a couple of Tylenol or Advil the day of the peel to calm

  • Physical Sensitivity


    YOUR COMPLIANCE POST-PEEL
    1. Avoid direct sun exposure and apply Sun Protective Cream 30 minutes prior to sun exposure.
    2. Avoid strenuous exercise 48 hours post-peel.
    3. Avoid touching, rubbing, peeling or picking of the skin.
    4. For at least one week post-peel do not use exfoliators, glycolic acid, Benzoyl     peroxide or any other skin irritants.
    5. Do not shave, tweeze or wax.
    6. Resume home care products as directed by your Skin Care Specialist.
    7. On day 7 schedule an appointment for an Enzyme Peel.

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  • I hereby release Caribbean Day Spa from any claims implied or stated that I have or may have in the future in connection with this treatment regardless of the result.

    I understand the pre and post-peel compliance instructions.
    By signing below, I hereby consent to the Chemical Peel.

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