
ADVANCED SKIN CONSULTATION FORM
Please read through all of the contraindications and suitability information below before proceeding with any treatment
Contraindications to Microneedling & Chemical Peels :​
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Pregnant / Nursing
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Active acne
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Herpes simplex or any other infection such as flat warts
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Moderate to severe chronic skin disease such as eczema and psoriasis
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If received any medical grade chemical peel in the last 4 weeks
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Blood dyscrasias, patients on anticoagulant therapy.
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Extreme keloidal tendency.
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Patient on chemo/radiotherapy
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Haemophilia
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Blood thinner medications
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Recent use of glycolic acids, alpha-hydroxy acids
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Rosacea
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Skin cancer
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Sunburn
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New tattoos in the area
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Telangiectasia/erythema may be worsened or brought out by exfoliation
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Uncontrolled Diabetes
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Vascular Lesions
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Have open cuts or lesions on the skin
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Allergies / anaphlaxis
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Frequent sunbed user - Pigmentation treatment only
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Allergic to AHA's
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Laser Treatments
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Keloid Scars
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Ro-accutane user
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contraindication to dermaplaning
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Current inflamed acne lesions;
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Skin cancer;
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Active cold sores;
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Uncontrolled diabetes;
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Dermatitis;
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Open skin lesions;
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Use of Accutane currently or in the past six months; and/or.
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The use of prescription retinol within a week of treatment.