I am aware of the following possible experiences/risks that can result:

  • DISCOMFORT: Some discomfort may be experienced during laser treatment.
  • BRUISING/SWELLING/INFECTION: Occasionally, bruising of the treated area may occur. Additionally there may be some swelling, or rarely an infection of the skin at the site of the treated area may occur.
  • SKIN PIGMENT CHANGES: During the healing process, there is a slight possibility that the treated area can become either lighter or darker in color compared to the surrounding skin. This is usually temporary but rarely may be permanent. Patients with darker skin types have an increased risk of complications and are not recommended for this treatment..
  • WOUND HEALING: The Photofacial treatment(s) can result in swelling, blistering, crusting or flaking of the treated areas, which may require 1-3 weeks to heal. Once the surface has healed, it may be pink or sensitive to the sun for several months or longer in some patients. This is more likely to happen in patients taking medications causing photosensitivity or in patients with dark skin.
  • SCARRING: Scarring is a rare occurrence, but it is a possibility when the skin’s surface is disrupted. To minimize the risk of scarring, it is important to follow all post-treatment instructions carefully.
  • EYE EXPOSURE: Protective eyewear (colored shields) will be provided for wear during the laser treatment. It is MANDATORY that the shields be worn at all times during the treatment. Failure to do so could result in accidental laser exposure to the eye that could cause vision damage.
  • LACK OF RESULTS: Individual results vary and NO guarantee can be made that a client will benefit from treatment or achieve any level of improvement. Several treatments may be necessary to achieve maximum benefit.
  • ACKNOWLEDGEMENT I understand and acknowledge that payments for the above named procedure(s) are nonrefundable.
  • Hair follicles, tattoos, and permanent make-up in the treatment area may be altered unintentionally.
  • Patients with the following conditions may not receive the Photofacial laser treatment(s): history of keloid formation, pregnancy or lactation,history of seizures, tanned skin, or active sun exposure 4 weeks prior to treatment.
  • I hereby authorize Blush and Grey to perform the Photofacial treatment on me. I understand that this procedure targets and reduces pigmented lesions including sun spots and mottled pigmentation while leaving the surrounding skin unaffected. The following points have been discussed with me and I have had the opportunity to ask questions: The potential benefits of the proposed procedure, The possible alternative to this procedure, The probability of success, The most likely possible complications/risks involved with the proposed procedure and subsequent healing period, and pre and post treatment instructions

My signature below certifies that I have fully read this consent form and understand the information provided to me regarding the treatment.