Micro-Needling Consent for Treatment Form

MICRO-NEEDLING CONSENT FOR TREATMENT FORM

Please read all terms and condition before filling the form

I hereby give my consent to undergo Collagen Induction Therapy (Micro-needling) treatments provided by (Kittaya Royal Beauty)

I understand this technique involves the introduction of fine needles through the skin. The purpose is to create micro-channels in the skin allowing the infusion of active ingredients (such as vitamin C, hyaluronic acid and others) to penetrate deeply and effectively into the dermis, nourishing the skin and stimulating the regrowth of collagen. A series of 4 to 6 treatments are recommended and the frequency will depend on the intensity and depth of the needle.

I understand that the treatments require many small injections on the area(s) to be treated.

I understand that the administration of numbing creams may be used if deemed needed.

Micro-needling is not suitable in these circumstances:

- Have used Accutane (isotretinoin) within the last year.
- Have open wounds, cuts or abrasions on the skin.
- Have had radiation treatment to the skin within the last year.
- Have any kind of current skin infection, condition, herpes simplex in the area to be treated.
- Are pregnant or breast feeding.
- Have any history of keloid or hypertrophic scars or poor wound healing.

I understand that there are some risks with any procedure. The following are possible reactions with Micro-needling: temporary bruising, skin discomfort during injections, redness or swelling, lightening or darkening of the skin, itching and burning. Skin infection is a possibility any time an injection or surgical procedure is done. Side effects are most of the time temporary and typically resolve within 3 days. Total healing time depends on the depth of the treatment, skin type, and skin condition, and some patients may heal completely in 24 hours.

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Benefits and Results

Treatment results include skin hydration, increased skin tone and smoothness causing existing wrinkles to be jess visible and skin younger looking. Results become visible 24 hours after the procedure and shall last for a few months. The procedure is repeated up to three times ten to fourteen days apart.

After the procedure, the skin will be red and flushed in a similar way to moderate sunburn. You may also experience skin tightness 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 hours the skin will be completely healed. After 3 days most visible erythema will be absolved.

By filling form, I certify that I have thoroughly read and understand the contents of this form and the disclosures listed above were made to me. I acknowledge that no promises or guarantees have been made to me as a result of the treatment.

I am aware that the results achieved by this treatment may vary from person to person. Some patients typically notice an immediate glow, but visible improvement will take about 2-4 weeks and can continue for up to 6 months.

I have read potential risks have been explained to me and I accept them.

I hereby give my voluntarily consent to have this treatment perform on me.

I accept all the Terms and Conditions

Collagen Induction Therapy / Micro-needling Post-Treatment Instructions What to be expected :

Despite some initial redness and possible swelling, immediately after your treatment your skin should already look and feel tighter and refreshed. You might even see a slight plumping effect on your skin as soon as the swelling goes away.

Assuming your treatment involved needles of the appropriate length, your skin should start to increase its collagen production some 48 to 72 hours after your procedure.

Despite this increase, most patients don't see real, noticeable results for at least 1 to 4 weeks after their first treatment. Full results from the first treatment can take as long as 2 months to appear.

While several treatments are usually required, you'll likely see scar tissue shrink and a reduction of UV damaged skin, dark spots, and stretch marks after only one treatment. You may also see improvements in the texture of your skin as it grows thicker, firmer and healthier overall.

The new collagen that is produced will remain for a few years, making micro needling a treatment with excellent longevity, especially considering how simple it is. Of course, the effects of aging and sun exposure will still eventually take their toll, and at some point, you’ll likely seek future treatments as part of your regular skin maintenance plan.

Day 1: Skin will be erythematous and flushed after treatment, depending on the intense of the treatment. Pinpoint bleeding may occur. Do not apply makeup for at least 12 hours.

Day 2: A red or pink hue persists like moderate sunburn. Swelling and slight bruising may be more noticeable on the second day. Minor scratches may be visible. Apply moisturizer as needed.

Day 3: Skin can be pink or normal color. Swelling subsides. The skin can feel dry or feel tight. A slight outbreak of acne or milia (tiny white bumps) is possible. Light peeling usually occurs in about three days and will be replaced with brand new skin.

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Home Care :

1. Wash with a gentle cleanser using your fingers only. Gently massage the face with lukewarm water. Remove serum and other debris such as dried blood. Do not scrub, use a wash cloth or a Clarisonic brush. Cleanse areas treated twice a day. Do not use exfoliating products for 72 hours.

2. Cold compresses may be applied following treatment for comfort. If neck or décolletage are treated, the redness might last slightly longer.

3. Apply 1% Hydrocortisone cream or Benadryl spray or gel on treated areas to reduce itching or redness.

4. Continue taking Skin Candy up to 5 days after each treatment to decrease bruising and help with healing process.

5. Do not exercise for 24 hours after treatment.

6. Avoid saunas, steam rooms, hot baths or showers until redness is gone.

7. Continue to avoid sun exposure to the treatment areas and apply a broad- spectrum sunblock with SPF minimum of 30. Apply it at least 30 minutes prior to sun exposure and repeat after every two hours of sun exposure.

8. After 2-3 days patients can return to regular skin care products or as soon as it is comfortable to do so. Mineral makeup may be applied the following day.

9. Avoid strenuous exercise for two to three days after treatment.

10. Avoid waxing, facials, Botox, injectable fillers or any other skin care treatment two weeks after treatment.

11. New cell regeneration requires at least 6-8 8 oz. glasses of water a day (if you already drink that- increase by 2 glasses)

12. Try eating fresh pineapple to speed up your recovery. Pineapple has many body-positive chemicals and nutrients that help skin to heal quickly and efficiently. One of the most important of these nutrients is bromelain, which helps bruises to heal quickly and sometimes even preventing them from forming in the first place.

13. For the very best results, book repeat treatments 4 weeks after your initial session, and a series of 3 to 5 treatments in total. You'll likely see some amazing improvements after just one session, but only by completing a full treatment cycle will you achieve your full goals.

14. If skin becomes painful, swollen, red or inflamed, please message me immediately as this may represent an infection or allergic reaction that may require treatment.

I accept all the Terms and Conditions