PRE-TREATMENT INSTRUCTIONS

• Avoid the sun 4-6 weeks before and after treatment until your physician allows it. RECENTLY TANNED SKIN CANNOT BE TREATED
• Your technician may ask you to stop any oral or topical medications or other skin care 
products 3-5 days prior to treatment
• Tanned or darker skin types should not be treated. If treated within 2 weeks of active 
(natural sunlight or tanning booth) tan, you may develop hypo-pigmentation (white spots) 
and this may not clear for 2-3 months, or may be permanent
• The use of self-tanning skin care products must be discontinued 1-2 weeks prior to 
treatment. Any residual self-tanner must be removed prior to treatment
• Your provider may apply a topical anesthetic for treatment discomfort. This should be
removed just prior to treatment.
• If you have had a history of perioral or genital herpes simplex virus, antiviral therapy is recommended in order to prevent a breakout.  Follow the directions for your particular antiviral medication
• The treatment area should be clean of any perfume, deodorant, makeup, lotions, sun block, or any other chemical or skincare products

 

INTRA-TREATMENT CARE

• At the beginning of every treatment session, we will review your medical status, and ask if there have been any changes. Please remember to inform us of any changes such as health, medications, and sun exposure. Changes may alter the effectiveness of treatment and may cause side effects and/or complications
• The skin is thoroughly cleaned prior to treatment. 

• The technician may line the area with a white pencil in order to effectively treat you. This will wash off
• If treating the upper lip, the teeth may be protected with a moist, wet gauze. The gauze 
also serves to support the lip during treatment, allowing a surface to push against. 

• Safety considerations are important during the laser procedure. The patient and all 
personnel in the treatment room MUST wear protective eyewear during the procedure to reduce the risk of eye injury. Your provider will take all necessary precautions to ensure your safety and comfort. 

• Multiple treatments may be necessary 


 

POST-TREATMENT INSTRUCTIONS

• Immediately after treatment, there should be a “slight frosting” on the area that is treated. Erythema (redness) and edema (swelling) at the treatment site can occur and may last up to 2 hours or longer. Pinpoint bleeding may also occur. 

• It is normal for the treated area to feel like sunburn for a few hours after treatment.
• After the treatment, the skin may scab over. It is very important not to pick, scratch or aggressively wash the area to prevent possible scarring. This crust should flake off in 7-10 days. 

• Avoid sun exposure to reduce the chance of hyper-pigmentation (darker pigmentation) 

• Use sun block (SPF 40+) at all times throughout the course of your treatments. 

• There are no restrictions on bathing except to treat the area gently, as with any other 
wound. 
Avoid hot/scalding water and baths
• Avoid physical exercise (aerobics, lawn mowing, sport activities) for 3 days to reduce the risk of infection.  If blistering occurs, avoid the activity until the blisters heal
• Please do not participate in any rough, physical, contact activities (playing football or ice hockey, etc.) for 10 days after treatment and also avoid excessive perspiration to the area as it may cause tissue disruption. 

• Please keep the area covered for the first three days with Telfa or a non adhesive bandage and medical tape, opening twice/day to clean with a mild soap (Dove or Aveeno – no antibacterial, antimicrobial, or scented/perfumes body wash), apply Laser Balm (available for purchase in our salon), and redress
• Do not use band aids, plastic wrap, or any other dressing
• Redress the treatment area twice a day after cleaning with a mild soap (no perfumed soaps or body wash)
• If blistering occurs, do not pop or pick at them. Keep the wound dressed (cleaning twice daily) until the blisters pop on their own (longer than 3 days if necessary)
• At no point in time should the treatment area dry out. Please keep it well moisturized with the Laser Balm (available for purchase in our salon) to prevent potential scarring
• Please do not hesitate to call or text us at (702) 823-0852 if you have any questions or concerns

We are committed to serving you with compassion, care, skill, and respect. As one of our clients, you have choices, rights, and responsibilities.

I hereby authorize Simply Skin Las Vegas, its employees/agents/clinicians to perform tattoo removal treatments on me.
 
I understand that the PicoWay is a device used for removal of tattoos, of which I am consenting to be a client.  I understand that clinical results may vary depending on individual factors, including but not limited to medical history, skin type, patient compliance with pre- and post-treatment instructions, and individual response to treatment.
 
I certify that I have been fully informed of the nature and purpose of the procedure, expected outcomes and possible complications, and I understand that no guarantee can be given as to the final result obtained. I am fully aware that my condition is of cosmetic concern and that the decision to proceed is based solely on my expressed desire to do so.
 
I confirm that I have informed the staff regarding any current or past medical condition, disease or medication taken.

I certify that I have been given the opportunity to ask questions and that I have read and fully understand the contents of this consent form.

I understand that the treatment is purely elective, and I hereby consent to be a patient receiving treatment.
 
Other potential risks include itching, blistering, burns, infection, scabbing, and failure to achieve desired result.
 

The procedure may result in the following side effects or adverse experiences, and may carry some risks:

• DISCOMFORT – Some discomfort may be experienced during treatment
• REDNESS/SWELLING/BRUISING – Short-Term/temporary redness (erythema), swelling (edema), and/or mild sunburn-like effects of the treated area is common and may occur. There also may be slight bruising.
• SKIN COLOR CHANGES – There is a possibility that the treated area may become either darker (hyper-pigmentation) or lighter (hypo pigmentation). These conditions usually resolve within 3-6 months, but permanent color change is a rare risk. Compliance with the aftercare guidelines and avoiding sun exposure before and after the treatment reduces the risk of color change.
• WOUNDS – Treatment can result in burning, blistering, or pinpoint bleeding of the treated areas. If any of these occur, please contact our office immediately.
• INFECTION/BREAKOUTS – Infection is a possibility whenever the skin surface is disrupted, although proper wound care should prevent this. If signs of infection such as pain, heat, or surrounding redness develop, please call our office immediately. If you have had a history of perioral or genital herpes simplex virus, antiviral therapy is recommended in order to prevent a breakout. Follow the directions for your particular antiviral medication.
• SCARRING – 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 provided by your healthcare staff. Compliance with the aftercare guidelines and avoiding sun exposure before and after the treatment reduces the risk of scarring.
• ALLERGIC REACTIONS – In rare cases, local allergies have been reported.
• EYE EXPOSURE – Protective eyewear (shields) will be provided. Exposure of the laser to the eyes could harm vision. It is important to keep these shields on at all times during the treatment in order to protect your eyes from accidental laser exposure.

 

When removing permanent makeup, in addition to the above, additional risks may include:

• OXIDIZATION – Depending on the type of ink used by artist, a darkening of pigment may occur
• HAIR LOSS – Hair loss may occur in the treated area 

I HAVE THE RIGHT TO:

• Be treated with dignity and respect
• Know the name(s) and professional status of the person(s) serving you
• Privacy
• Confidentiality of your records
• Receive accurate information about your health-related concerns
• Know the effectiveness, possible side effects and problems of all forms of treatments
• Participate in choosing a form of treatment
• Receive education and counseling
• Consent to, or refuse any care or treatment
• Review your medical record with your clinician
• Amend your medical records
• Receive any information about services

I ALSO HAVE THE RESPONSIBILITY TO:

• Seek medical attention promptly
• Be honest about your medical history
• Ask about anything you do not understand
• Follow health advice and instructions
• Report any changes in health or medication
• Respect our policies
• Seek care during normal business hours and to provide useful feedback regarding our services and policies

Some clients experience mild to moderate discomfort during the laser treatments. For this reason, we offer the use of a topical anesthetic cream. In some instances, the cream may cause a temporary local irritation in individuals who are sensitive to the active ingredients. Although very rare, other more serious side effects can occur. People with a known sensitivity to local anesthetics (Benzocaine, Lidocaine, Tetracaine) should not use this product. If you have been diagnosed with cardiac or liver condition, take cardiac medications, or are currently pregnant, you should not use this product. This product will not be applied to large surface areas or multiple body sections during a single procedure.