IPL Skin Rejuvination
IPL is a broadband pulsed light source that can be used effectively to lighten, fade or remove photo-damaged skin, veins, and/or hair removal in a non-ablative manner.
Risks- Although it is impossible to list every potential risk and complication, these are some known risks. Furthermore, it is your responsibility to fully and accurately disclose all medical history prior to initial treatment, as well as provide any necessary updates at all future treatment sessions. I do understand that any hormone imbalance present within my anatomical system can alter the treatment. Please review the following carefully. It is important that you answer all questions honestly and to the best of your ability and knowledge. Failure to do so can result in unsatisfactory results and/or injury.
Allergic Reaction- A variety of products may be used on the face in conjunction with the procedure such as Jelly/Soothing/Restorative hydrogel/ calming mask, chemical peels and other chemical exfoliants and products your esthetician deems is best for your skin to which an allergy can occur. Additionally, since this procedure increases the penetration of topical substances, it can cause you to be hypersensitive to products used on the face. I do understand allergic reactions can occur. You must contact our office immediately or notify your esthetician of any abnormal feeling during the treatment. In rare cases you may be advised to contact your physician.
Infection- Viral, bacterial, and fungal infections can occur anytime the integrity of the skin is compromised. In rare cases you may be advised to contact your doctor.
Lack of results- I understand it may take multiple treatments to obtain optimal results for hair reduction and IPL. Although these devices are effective in most cases, no guarantees can be made. I understand I may not experience complete clearance, and that it usually takes multiple treatments. Some conditions may not respond at all and, in rare cases, may become worse. The treatment may not completely or permanently improve skin texture, tone, elasticity, hyperpigmentation, scars, or minimize fine lines and wrinkles. It is important that your expectations be realistic and understand the procedure has its limitations. Additional procedures may be necessary to achieve desired effect. No Refunds or Returns Due to the nature of the services and products provided, Foreverbyashh LLC and Ashley Holdings LLC, including their employees, independent contractors, subsidiaries, and affiliates (collectively, “Foreverbyash”) does not issue refunds for used or unused services and does not accept any product returns.
Pain- Discomfort may be experienced during the treatment. There may be a hot, and irritated sensation to the skin. This is usually temporary and is gone within a few hours after treatment. If you have persistent redness or swelling please reach out to the office. In rare cases you may be advised to contact your physician.
Pigment and Color Change- During the healing process, there is a possibility that the treated area can become either lighter (hypopigmentation) or darker (hyperpigmentation) in color compared to the surrounding skin. This is usually temporary, but on a rare occasion, it may be permanent. Failure to follow post treatment instructions can put you at risk for hypo/hyper pigmentation. You MUST avoid direct sun exposure for two weeks after the treatment. You should also wear a daily SPF facial moisturizer, which your esthetician can recommend.
Redness/swelling/bruising/scabbing -Short term redness or swelling of the treated area is common but could be prolonged. Adverse reactions may include hyper and hypopigmentation, burning, scarring, blistering, redness, swelling, itching and other similar side-effects and reactions. Please contact the office if any persistent redness or discomfort occurs. In rare cases you may be advised to contact your physician.
Scarring- Is a rare occurrence, but it is a possibility if the skin surface is disrupted. To minimize the chances of scarring, it is important that you follow all post-treatment instructions carefully and apply sunscreen to treated areas.
Contraindications- Although it is impossible to list every potential risk and complication, the following are recognized as known contraindications. Furthermore, it is your responsibility to fully and accurately disclose all medical history prior to initial treatment, as well as provide any necessary updates at all future treatment sessions. If you have any of the conditions listed below, you should bring it to the attention of your esthetician PRIOR to signing this consent form.
Accutane within (1 year)
Active infection of any type (bacterial, viral, or fungal)
Autoimmune disease
Blood thinner medications (2 weeks prior discontinue)
Blood Pressure medications
Botox (Discontinue 2 Weeks Prior)
Breast Feeding
Cardiac disease/abnormalities
Chemotherapy or radiation (1 Year)
Cold Sores
Compromised skin
Dermatitis
Diabetes
Eczema
Nickel allergy
Open lesions
Psoriasis
Pregnancy
Raised body temperature 2 hours prior
Removing hair by the root (waxing / tweezing 4 weeks prior to treatment (hair removal only)
Retin A discontinue (Discontinue 3 days Prior)
Recent Skincare treatment (Discontinue 2 Weeks Prior)
Self Tanner, spray tans, and tanning beds (Discontinue 2 Weeks Prior)
Sunburn/ sun exposure (Discontinue 2 Weeks Prior)
Waxing (Discontinue 2 Weeks Prior)
If you have any of the listed conditions below we will need a doctor’s note prior to receiving any services.
Any Autoimmune disease
Blood pressure medication
Cancer
Chemotherapy / radiation
Psoriasis
Serious Medical Condition
Cannot perform any services if you’ve been on accutane in the past 1 year.
Post Care-
Avoid harsh sun exposure (14 days)
Avoid scrubs/exfoliants/ harsh ingredients for (3 days)
Avoid raising body temperature (72 hours hot tub, saunas, sun)
Makeup (24 hours)
Retinol (3 days)
Use sunscreen daily
Vitamin C (3 days)
