Dermalplaning consent 2020

Dermaplaning (skin blading or leveling) is a safe and highly effective, clinically proven technique for precise, manual exfoliation of the skin. Exfoliation promotes the reduction of fine lines, wrinkles, micro scars, stretch marks, and sun damage. It also regenerates epidermal cell structure resulting in improves skin elasticity and a more youthful, pliable, smooth skin texture. Dermaplaning removes the outer most layers of dead skin cells and the vellous hairs leaving the skin immediately smooth, supple, and vibrant. Dermaplaning is a non-traumatic method of skin rejuvenation and vellous hair removal.

I understand that a sterile surgical blade is used for this procedure. The blade is held at a 45 degree and stroked along the face, very similar to shaving.*

Initial

I acknowledge that there is the possibility of nicking or cutting the skin, as a blade is used in this procedure. However, the incidence of cutting into the skin is slim. Our aestheticians have been thoroughly trained in the procedure (a mandatory requirement) and have previous experience performing the procedure.*

Initial

I understand that blading of the skin is performed primarily on the face excluding the nose, eye neck, or chest, and may be performed every 3 4 weeks. Blading removes 2 3 weeks' worth of dead cells*

Initial

I acknowledge that I have been informed that blading the skin on the face DOES NOT cause the grow back thicker or darker. The structure of the vellous hair (thin, translucent blond hair) is not during blading and grows back the same. However, because the hair is cut, it grows back with edge but the hair has not been physiologically altered.*

Initial

I understand that there is the possibility of the skin to peel after dermaplaning, although this is not and if peeling does occur, there is no damage to the skin.*

Initial

I understand that all skin types can benefit from derma planing or blading. However, the procedure recommended for those suffering from severe acne and/or over production of the sebaceous The oils from the sebaceous glands need to travel up and connect with the vellous hair. If the is removed, then the oils tend to stay below where they are prone to mix with bacterial colonies, ultimately stimulating more acne.*

Initial

Patient First Name*

Email*

example@example.com

Patient Name

Patient Signature*

Date*

Date

Provider Name

Provider Signature

Date

DERMAPLANING CONSENT FORM