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Carbon Laser Peel Consultation & Consent Form

Carbon Laser Peel is a non-invasive laser treatment designed to deeply cleanse pores, reduce acne, improve skin texture, stimulate collagen production, and rejuvenate the skin for a smoother, brighter complexion.

Treatment Information

Carbon Laser Peel uses a medical-grade carbon lotion combined with laser energy to exfoliate dead skin cells, reduce oil production, improve enlarged pores, diminish acne and pigmentation, and stimulate collagen production.

The treatment generally takes 30–45 minutes, with little to no downtime.

Risks & Possible Side Effects

Although Carbon Laser Peel is considered a safe procedure, all cosmetic treatments carry some risks.

Possible temporary side effects include:

  • Mild redness
  • Slight swelling
  • Warm sensation
  • Skin dryness
  • Temporary sensitivity
  • Mild peeling
  • Temporary darkening or lightening of pigmentation
  • Rare blistering
  • Infection (extremely rare)
  • Allergic reaction to topical products
  • Failure to achieve desired results

These effects are usually temporary and resolve within a few days.

Precautions & Contraindications

Carbon Laser Peel may not be suitable if you:

  • Are pregnant or breastfeeding
  • Have active skin infections
  • Have open wounds
  • Have cold sores in the treatment area
  • Have active eczema or psoriasis
  • Have recently used Accutane (within 6 months)
  • Have undergone chemical peels or laser resurfacing recently
  • Have excessive recent sun exposure
  • Have a history of keloid scarring
  • Have uncontrolled diabetes
  • Have active skin cancer
  • Have photosensitive disorders
  • Are taking medications causing photosensitivity

Pre & Post Care Information

Before Treatment

• Avoid tanning and excessive sun exposure for 2 weeks.

• Stop using Retinol, Retinoids, AHAs and BHAs for 5–7 days.

• Avoid waxing or chemical peels for one week.

• Arrive with clean skin free of makeup.


 
After Treatment

• Wear SPF 50+ daily.

• Avoid direct sunlight for at least two weeks.

• Avoid hot showers, steam rooms, saunas and exercise for 24–48 hours.

• Keep the skin hydrated.

• Avoid exfoliating products for one week.

• Do not pick or scratch peeling skin.

• Follow your clinician’s aftercare instructions.


Consent:

I understand that the final result of my LED treatment cannot be guaranteed.
I understand that after the treatment, I will be required to refrain from un-protected sun exposure.
I have read all of the above and had all my questions satisfactorily answered. In signing this informed consent, I am stating I have read the informed consent information and I fully understand the possible risks, complications and benefits that can result from the LED system.

Note:

Do not sign this form until you have read and understood all of the above.

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