MicroNeedling or MicroNeedling with PRP Consent Form

MicroNeedling or MicroNeedling with PRP Consent Form


I have received a consultation with a Skin Care Specialist and I consent to the treatment of MicroNeedling to be carried out upon myself.

The MicroNeedling treatment allows for controlled induction of growth factor serums, or hyaluronic acid, into the skin’s self-repair process by creating micro-injuries in the skin. These injuries stimulate new collagen production, while not posing the risk of permanent scarring. The result is smoother, firmer and younger looking skin. The skin needling treatments are performed in a safe and precise manner with a sterile needle head and are usually completed in 30-60 minutes.

Absolute Contraindications: Accutane within 6 months, Scleroderma, collagen vascular disease, or cardiac abnormalities, rosacea, blood clotting problems, platelet abnormalities, anticoagulation therapy (i.e.: Warfarin), facial cancer, past and present, chemotherapy, steroid therapy, dermatological diseases affecting the face (i.e. Porphyria), diabetes and other chronic conditions, active bacterial or fungal infections, immune-suppression, scars less than 6 months old and Botox/facial fillers in the past 2-4 weeks. Treatment is not recommended for patients who are pregnant or nursing. Precautions: keloid or raised scarring, eczema, psoriasis, actinic keratosois, and herpes simplex.

Side Effects Typically Include:
• Skin will be pink or red and may feel warm, like mild sunburn, tight and itchy, which usually subsides in 12 - 24hrs
• Minor flaking or dryness of the skin, with scab formation in rare cases.
• Crusting, discomfort, bruising and swelling may occur.
• Pinpoint bleeding.
• It is possible to have a cold sore flare if you have a history of outbreaks.
• Freckles may lighten temporarily or permanently disappear in treated areas.
• Infection is rare but if you see any signs of tender redness or pus notify our office immediately.
• Hyperpigmentation (darkening of the skin) rarely occurs and usually resolves itself after a month.
• Permanent scarring (less than 1%) is extremely rare.






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Document name: MicroNeedling or MicroNeedling with PRP Consent Form
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October 8, 2023 5:13 pm HSTMicroNeedling or MicroNeedling with PRP Consent Form Uploaded by Lucky Robinson - [email protected] IP