Consent Form

LaseMD

I understand that LaseMD ULTRA ™ treatment is intended for treatment of skin rejuvenation, wrinkles, acne scars, skin tone and skin texture and that treatment is commonly performed over facial and non facial areas.

Herpes Simplex Herpes simplex eruptions may occur in rare cases in a treated area that has previously been infected with the virus. This reactivation can be avoided by taking an anti viral medication prior to the procedure, for which I can get a prescription from this office by request.

Pain Some patients feel a burning sensation from each laser pulse, which may produce a moderate to severe amount of discomfort. This mild burning sensation is similar to a sun burn and may last for up to 24 hours post treatment.

Redness and Swelling Immediately after treatment your skin will be red and feel hot. This is temporary, but may last for the first few days. The first day after treatment your treated area will be swollen and for the next few days the treated area will be red in color. After the first day, the redness can be camouflaged with opaque makeup.

Cold packs can reduce these symptoms as will daily use of an antihistamine until they resolve.

Hyperpigmentation The treated areas will probably heal without any pigment changes. However there is always the chance that hyperpigmentation (skin darkening) may occur. These are temporary conditions and will fade within 2-6 months. Avoid sun exposure before and after treatment as exposure to the sun may intensify the pigment changes. It is rare that this change is permanent.

Blistering or Scarring Blistering occurs occasionally and needs to be reported to the office for additional post care instructions. Scarring is very rare and can be avoided by following all the post treatment instructions carefully.