Pre and post procedure guideline/agreement for clients.Please sign below where indicated
Client name………………………………………Date…………………………….
Client signature……………………………………………………………………..
I …………………………………….confirm that I do not have the following (Contraindications)Listed below in points A to G and I will inform Cherry Woods before
treatment commences if I do, or, if I am in any way unsure.
a) Skin Cancers, warts, solar keratoses or any skin infection. The needles may
disseminate abnormal cells by implantation of these cells.
b) You are not on any anti-coagulant therapy e.g. Warfarin, Heparin. Or other
anti-coagulants. Presence of these drugs may cause uncontrolled bleeding.
Patience previously on such treatment should have their coagulation status
checked before the treatment to confirm they have a normal clotting profile.
c) You have not been taking Aspirin for at least 3 days before the
treatment.(Consult your Doctor before changing or stopping any
medication!)
d) Allergy to local anesthetic agent (I currently use Emla)
e) Patients on Chemotherapy, high doses of corticosteroids or radiotherapy
f) Active acne, herpes labialis infections in the face or impetigo lesions
anywhere on the body
g) Patients with uncontrolled diabetes.
1. 3 months before- Is the best time to start using Environ active vitamin A
cream twice a day to get the very best results (optional, but recommended)
Sign……………………………………………………………………..
2. 3 weeks before start using Environ active vitamin A (required) The higher
the level of vitamin A you are using on your skin before your CST treatment,
the better your results will be. If you are already on Level 3 AVST or CQuence, and haven’t started using the cosmetic Roll-CIT, now is a good time
to startSign………………………………………………………………………..
3. 2 weeks before start using at least 1000mg of oral Vitamin C, unless there is a
medical reason why you cannot take this. (optional, but highly
recommended)
Sign…………………………………………………………………………
4. 10 days before- avoid direct sunlight. Cover up with a scarf and use a large
brimmed hat and wide sunglasses to protect the facial skinSign………………………………………………………………………….
5. You may have an Ionzyme DF 11 vitamin facial (Bloom Facial) in the week
before your treatment, up to the day before! (optional, but recommended)
6. 3 days before, with advice from your Doctor, those on Aspirin should be
stopped until after the treatment. PLEASE CHECK WITH YOUR
DOCTOR BEFORE changing or stopping any medicationSign……………………………………………………………………………
7. On the day of the procedure please arrive with no makeup on your face (NB
if you wish, you may bring your Makeup brushes in so that they may be
professionally cleaned. BEFORE AND AFTER PICTURES MAY BE
SUGGESTED.
Sign…………………………………………………………………………….
8. Immediately after your procedure your skin will have the appearance of sun
burn. It may feel tight and a little uncomfortable or sensitive. Please sign to
confirm that you understand thisSign…………………………………………………………………………….
9. You can shower that same evening and just use water to wash your skin.
Please only apply your Environ Vitamin A product on the day of your
procedure. If you are using level 5, wait until the next day to apply, instead,
use AVST 4 or AVST body oil. This is because needling allows your vitamins
to penetrate faster and deeper, therefore this could result in a retinoid
reaction. Do not use any AVST toner. I also recommend Hydrating oil
capsules and C-Boost, collostrum and AVST body oil from the day after
your procedure and on going.
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10. Do not touch your skin unless you have washed your hands. It is possible that
small white heads may occur in the first 24/48 hours. I recommend using
Environs Sebuwash to clear this. Do not pick them! If they become inflamed
and infected, inform Cherry Woods immediately. call your Doctor if you
have a temperature.
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11. You can return to work the next day. Apply your regular AVST or Ionzyme
C-Quence gel along with Sunblock (RAD 16 or Epionce SPF50) mineral
makeup can be worn to conceal, if needed. Please make sure your Makeup
brushes have been professionally cleaned (free of charge) by your
practitioner.-
Sign ……………………………………………………………………………
12. Avoid Sunlight for at least 10 days after the procedure. Use a wide brimmed
hat, sunglasses and a scarf. As mentioned, 100% mineral makeup can be
worn the next day or Environ Rad SPF 15 (winter) or Epionce SPF 50
(Summer) both have been specially formulated for post procedure protection
Sign…………………………………………………………………………….
13. In the first 3 days following the treatment avoid the following;
a) Any other moisturizer or product other than your recommended
Environ vitamin A treatment.
b) Any extreme exercise or activity which would cause excess sweating
(including steam, sauna etc.)
c) Avoid washing your hair for 12 hours (just water is fine) Avoid any
styling products, Such as hairspray.
d) DO not colour or Perm your hair or use any chemicals on your hair or
scalp for at least 7 days after the procedure as this could cause an
extreme reaction Sign………………………………………………………….
e) Avoid biological washing detergents on items which may come into
close contact with the area which has been treated eg Pillow cases)
14. The procedure can be repeated after 14 days. Your Environ Medical Roll-Cit
can be used up to 6 times, so the device will be kept for you in a sterile state
at The Cherry Woods Skin Clinic, should you wish to have further
treatment.
15. Within 3 days your skin should return to normal colour.
16. Please to not take any antihistamines or anti-inflammatory medication for at
least 7 days after the procedure as this will interfere with the inflammatory
processes that has been set up.
17. It is a very good idea to have a deeply hydrating vitamin facial within 2
weeks after the procedure (but no sooner than 3 days after the treatment) as
the skin can go through a little transient dryness due to so many
physiological changes which will already have started to take place.
18. After 6 weeks I recommend you pop back for a free skin check, where I can
give further advice and take any ‘After’ pictures if required.
19. After 3 months it is recommended you take some further ‘After’ pictures.
Thank You!