Laser Hair Removal/Reduction - Patient consent & Fitzpatrick Skin Type
The purpose laser hair reduction is to diminish or remove unwanted hair from most areas of the body. The procedure requires more than one treatment and may produce permanent hair reduction. The total number of treatments will vary between individuals. On occasion, there are those that do not respond to treatments. The treated hair should exfoliate or push out in approximately 2-3 weeks.
The following risks may occur with treatment. However slight, there is a risk of scarring, pain, bruising, swelling, redness, itching, skin inflammation or irritation (dermatitis), allergic reaction, blistering, hypopigmentation, hyperpigmentation, mottling of skin vascularity and pigmentation, and other unforeseen complications. These conditions usually resolve in 3-6 months, but permanent color change is a risk. Avoiding sun exposure before and after the treatment reduces this risk. Infection following treatment is unusual; bacterial, fungal and viral infections can occur. Herpes simplex virus infections around the mouth can occur following a treatment. This applies to both individuals with a past history of herpes simplex virus infections, and individuals with no known history of herpes simplex virus infections in the mouth area. Should any type of skin infections occur, additional treatments or medical antibiotics may be necessary.
Other risks include the following: Pinpoint bleeding is rare but can occur following treatment procedures. In rare cases, local allergies to topical preparations have been reported. Systemic reactions, which are more serious, may result from prescription medicines. I understand that exposures of my eyes to light could harm my vision. I must keep the eye protection goggles on at all times during treatment.
Compliance with the aftercare guidelines is crucial for healing, prevention of scarring, and pigment changes. Occasionally, unforeseen mechanical problems may occur and your appointment will need to be rescheduled. We will make every effort to notify you prior to your arrival to the office.
I have read and understood the risks of treatment, the expected benefits, and alternative options, including no treatment at all. I understand that every effort will be made to provide a positive outcome, but there are no guarantees of results. I understand and accept the risks of the procedure, and request that it be performed on me. I hereby release the medical director, esthetician, and facility from liability associated with this procedure. I consent to this procedure today and for all subsequent treatments.
Fitzpatrick Skin Type Form
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Document Name: Laser Hair Removal/Reduction - Patient consent & Fitzpatrick Skin Type
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