harspa

Chemical Peel Consent Form

What is a Chemical Peel?

A chemical peel involves applying a specially formulated solution to exfoliate and remove damaged outer skin layers. This process stimulates skin regeneration, boosts collagen production, and improves texture, resulting in smoother, firmer, and more youthful skin. The depth and type of peel will be tailored to your specific skin condition, sensitivity, and desired outcomes.

 

Important Information

  • You cannot receive a chemical peel if you are pregnant or breastfeeding.
  • You must not receive a chemical peel if you have active herpes (cold sores) on the lips.
  • Avoid sun exposure or tanning beds for at least 2 weeks before and after treatment.

 

Preparing for Treatment

  • Begin a full skincare regimen prior to your appointment to optimize results.
  • Discontinue any skincare products containing retinol, glycolic acid, salicylic acid, benzoyl peroxide, or hydroquinone at least 1 week prior.
  • Stop Accutane use at least 6 months prior to treatment.
  • Inform us of any history of cold sores; medication may be prescribed to prevent a flare-up.
  • Avoid waxing, electrolysis, laser treatments, or microdermabrasion in the treatment area for at least 1 week before your peel.

 

Post-Treatment Instructions

  • Use only gentle products on your skin for the first 36 hours—avoid any active or anti-aging ingredients.
  • You may resume your regular skincare routine after 3 days or once flaking and peeling have subsided.
  • Avoid sun exposure and use SPF 30+ mineral sunscreen with zinc oxide daily.
  • Do not pick at or peel flaking skin to avoid scarring.
  • Mild side effects such as redness, tightness, swelling, or peeling are normal and may last a few days up to 1 week.

 

Client Acknowledgments

Please check each to confirm your understanding: