CHEMICAL PEEL TREATMENT PURPOSE: A chemical peel is a mid-deep level designed to improve the texture and appearance of your skin.
CLIENTS WHO SHOULD NOT BE TREATED: A chemical peel SHOULD NOT be used on clients with active cold sores or warts, skin with open wounds, sunburns, excessively sensitive skin, dermatitis or inflammatory rosacea in the area to be treated. Inform your esthetician if you have any history of herpes simplex. You should also not have a Chemical Peel if you have a history of allergies, rashes, or other skin reactions, or may be sensitive to any of the components of this treatment. A Chemical Peel should not be performed on clients with an allergy to salicylates (i.e., aspirin). A peel is also not recommended if you have taken Accutane® within the past year, or received chemotherapy or radiation therapy. Chemical Peel should not be administrated to pregnant or breast feeding (lactating) women.
ONE WEEK BEFORE YOUR CHEMICAL PEEL: Avoid these products and /or procedures in area(s) treated: • Electrolysis • Waxing • Depilatory Creams • Laser Hair Removal • Clients who have had medical cosmetic facial treatments or procedures (e.g. laser therapy, surgical procedures, cosmetic filler, microdermabrasion, etc.) should wait until skin sensitivity completely resolves before having a Chemical Peel • Clients who have had BOTOX® injections should wait until full effect of their treatment is seen before receiving a Chemical Peel.
THREE DAYS BEFORE YOUR CHEMICAL PEEL: Avoid these products and /or procedures: • Retin-A®, Renova®, Differin®, Tazorac® • Any products containing retinol, AHA or BHA, or benzyol peroxide • Any exfoliating products that may be drying or irritating
Note: the use of these products/treatments prior to your peel may increase skin sensitivity and cause stronger reactions.
AFTER YOUR CHEMICAL PEEL: It is crucial to the health of your skin and the success of your peel that these guidelines be followed:
1. It is imperative that you use a sunscreen with an SPF of at least 20 and avoid direct sunlight for at least 1 week.
2. Clients with hypersensitivity to the sun should take extra precautions to guard against exposure immediately following the procedure as they may be more sensitive following the peel.
3. Because of the superficial nature of a chemical peel, clients should expect to see visible peeling. Occasionally, some clients may have very minor flaking 3-4 days after the procedure.
4. Skin may appear red for about one hour after treatment. If neck and décolletage area are treated, the redness might last slightly longer.
5. Skin should look normal the next day.
6. Apply a light moisturizer as often as needed to relieve dryness and tightness.
7. You may resume the regular use of Retin-A®, alpha-hydroxy acid (AHA) products or bleaching creams ONLY after the peeling process is complete or after 4-5 days.
ADVERSE EXPERIENCES THAT MAY OCCUR AFTER YOUR CHEMICAL PEEL: It is common and expected that your skin will be red and possibly itchy and/or irritated. It is also possible that other adverse experiences (side effects) may occur. Although rare, the following adverse experiences have been reported by clients after having a chemical peel: edema, stinging and burning, dryness and erythema.
I understand that the Chemical Peel treatment is not an exact science and the degree of improvement is variable.
I understand that occasionally there is no visible improvement and another form of treatment may be required.
I do not have any of the conditions described in the “Clients Who Should Not Be Treated” section.
By my signature below, I acknowledge that I have read this Chemical Peel informed Consent form and understand it. I have been given the opportunity to ask questions and may question have been answered to my satisfaction. I have been adequately informed of the risks and benefits of this treatment and wish to proceed.
January 15, 2019