SkinPen Microneedling Consent Form

SkinPen Microneedling is an effective non-ablative procedure using devices to intentionally create very superficial micro-injuries to the outermost layer of the skin. These deep channels encourage collagen and elastin production without any damage to the epidermis at all. SkinPen Microneedling helps to improve the visibility of acne scars, fine lines and wrinkles, diminish hyperpigmentation, improve skin tone and texture, surgical scars and stretch marks, resulting in smoother, firmer, young-looking skin. Treatment is performed in a safe and precise manner with the sterile micro-needles that create channels deep into the dermis layer of the skin, these deep channels encourage collagen and elastin production without any damage to the epidermis at all. Treatment normally completed within 30-60 minutes, depending on the selected area. During the treatment period and for about 5 months following the treatments, treated skin experiences renewed growth, by a proliferation of fibroblast cells responsible for collagen and elastin. 

What to expect from the treatment:

• Your skin will be prepared with a topical anesthetic cream 

• There may be some degree of minor discomfort during the procedure 

• The process is entirely natural and safe to repeat 

• The treatment is not painful but has mild discomfort during the procedure 

• The procedure is not painful but has a mild level of discomfort 

• There is a short healing period, as little as 3-5 days 

• The treatment could be done on all areas to face and body 

• The is no permanent damage or sun sensitivity induced to the skin 

• Could be done on previously laser resurfaced skin and thin skin 

• Significant differences can be seen within 3-6 treatments 

• Pre-treatment exfoliation would excel the result

Common Side Effects: 

• Skin irritation (itching or redness) due to topical anesthetics cream 

• Lightheadedness, rapid heart rate, visual disturbances and tongue numbness 

• Allergic reaction 

• Minor bleeding 

• Persistent redness for the first 24 hours 

• Swelling, bruising, sensitivity to touch 

• Tight skin feeling, dryness or flaking 

• Pigment/colour change 

• Excessive pain 

• Acne outbreak or infection 

• Excessive skin peeling, scaring 

• Herpes, cold sore flareup 

Risks:

SkinPen microneedling risks include temporary redness, swelling, dryness, and sun sensitivity, but more serious concerns involve infection, scarring (especially with at-home use), hyperpigmentation, bleeding, and flare-ups of cold sores (herpes simplex), especially for those with certain skin conditions or taking certain medications like Accutane.

I consent and authorize a staff member of Oka Beauty Bar, who has been trained on the SkinPen, to perform a Microneedling Treatment on me. I understand that due to my unique skin composition, there are no guarantees, warranties, or assurances that I will be 100% satisfied with my results. Prior to receiving treatment, I have been candid in revealing any conditions or habits that may have a bearing on this procedure including, but not limited to, medical history, past or future tanning or sun exposure, medications, supplements, skin care regimen, etc. I understand that clinical results may vary depending on individual factors including, but not limited to, medical history, skin type, at home regimen, patient compliance with pre/post care instructions and individual response to treatment as well as strict sun avoidance. All my questions have been answered to my satisfaction, before and after. The treatment protocols have been discussed with me and that adhere to protocols is necessary for optimal treatment results and to avoid undesirable effects after treatment. I agree to have my photographs (when necessary) taken to document my conditions and to track my progress. I was explained the nature of my condition, the nature of the procedure, its risks and complications, alternative treatments, and the benefits to be reasonably expected. I have been given the opportunity to ask any questions. This document is a written confirmation of these discussions. I am aware that Oka Beauty Bar has a 48/hr cancellation/no show policy of 50% of the service charge. I understand that not making it to my appointment or canceling before 24 hours notice means I will have to pay a 50% fee for the service I missed. I am aware to not bring any children or pets to my appointment. I agree to pay for this treatment. I understand that I have the right to refuse or stop treatment at any time, but that no refunds will be provided once the payment is made (including and even if I am dissatisfied with the result of my treatment). All treatments, Treatment packages and products purchased are final sale and non-provided by Oka Beauty Bar. I certify that I have read this entire informed consent and that I understand and agree to the information provided in this form.

BY SIGNING BELOW, I ACKNOWLEDGE AND CERTIFY THAT I HAVE READ AND UNDERSTAND THE CONSENT, RELEASE, AND INDEMNITY AGREEMENT WITH OKA BEAUTY BAR, ITS PRINCIPLES AND STAFF FROM ANY CLAIMS WHICH MIGHT ARISE IN RELATION TO ANY ALLERGIC REACTION AND/OR ANY OTHER POTENTIAL LIABILITY IN CONTEXT TO THE TREATMENT(S) RECEIVED. I ACCEPT ANY SUCH LIABILITY AND SIGNING IT VOLUNTARILY.