Consent for Laser Treatment
Consent for laser treatment
This consent includes general descriptions of various dermatological laser treatments. Your doctor or nurse will describe and discuss the specific details of your procedure with you and answer your questions.
Please read the applicable sections of this consent form carefully. This form may contain words that are unfamiliar to you. Please ask your doctor or one of his/her staff to explain any words or information that you do not clearly understand. You may even discuss the treatment with family and friends before making your decision.
Treatment of skin
Non-ablative laser treatment is a technique for eliminating blemished areas from the skin and improving skin texture. This is a useful treatment method for both aging and sun-damaged skin. It is also useful for the treatment of rosacea, redness, acne, broken capillaries, and pigmentation. Non-ablative lasers are designed to target a specific skin problem whilst leaving normal skin intact.
Benefits of this treatment include the possible reduction of fine wrinkles and reduction or elimination of pigmented lesions like sunspots or uneven skin colour. Small red and blue vessels may be reduced or diminished. The bacterium that causes acne can also be destroyed by laser treatment. There can also be a degree of improvement in skin tone and tightness, although the effects of this are not usually seen for six months or more.
The laser system is designed to treat veins safely and effectively. The laser light penetrates the vessels and generates heat, resulting in blood coagulation and vessel wall damage. This leads to the collapse of the blood vessels. There is a limit to the size of vessel that can be effectively treated. Generally, laser is best used for the treatment of smaller spider veins.
There is a possibility that if the smaller veins are being fed by larger varicose veins, then they will return after treatment. Benefits of this treatment include the possible reduction or elimination of superficial and/or deep veins. There may be possible permanent hair removal at the site.
A topical anaesthetic may be applied prior to treatment to reduce discomfort during the procedure. Photographs of the treatment area may be taken for your medical chart and future comparison. Multiple treatments may be necessary to achieve complete satisfaction. Short-term redness can be expected.
Laser Hair Removal/Treatment of Pseudo-Folliculitis (in-grown hairs)
The laser system is designed to target and destroy the hair follicle. The Gemini’s Nd:YAG laser has the advantage over IPL or other hair removal lasers as it is the safest laser in removing hair from people with darker skin types. The incidence of pigmentation problems after treatment is very low.
The procedure involves shaving the hair from the treatment area. A topical anaesthetic may be applied to reduce discomfort associated with laser treatment. Photographs of the treatment area may be taken for your chart and future comparison.
Possible benefits of this treatment are delayed re-growth of the hair, lightening of the hair, decreased density of the hair and long term or permanent reduction in the number of hairs growing in the treatment areas. Multiple treatments are required to achieve hair removal. Short-term redness and some swelling may be expected.
A topical anaesthetic may be applied prior to treatment to reduce discomfort during the procedure. Photographs of the treatment area may be taken for your medical chart and future comparison. Multiple treatments may be necessary to achieve complete satisfaction. Short-term redness can be expected.
General risks may include;
– Eye injury due to the use of laser is a risk to the patient and to the clinician, however, the risks are almost completely eliminated with the use of proper eyewear.
– Induction of seizure
– Please inform your doctor if you have history of epilepsy
– Laser treatment is not recommended in pregnancy
Specific risks may include;
– Pain during and after treatment
– Blister formation
– Scabbing of the treated area. Do not pick at scabs as this increases the chance of scarring
– Swelling in the treated area (especially for facial treatments)
– Subsequent infection
– Bacterial or viral infection leading to scarring of skin.
– Please inform your treating doctor if you have a history of cold sores prior to treatment
– Pigmentary changes including decrease or increase in skin colour at the site of treatment
– Poor cosmetic outcome or ineffectiveness of the laser on your selected problem area.
– The need for additional treatments in excess of those predicted by your treating doctor.
– Recurrence of the treated problem at the treated sites is also a possibility.
I have informed my doctor of the following medical conditions I may have to the best of my knowledge as these may preclude me from treatment;
o Pregnancy
o Immunodeficiency
o Abnormal bleeding conditions
o Lupus or any other auto-immune conditions
o Treatment with Roaccutane in the past year
o A history of keloid (thick/raised) scarring
o Psoriasis or vitiligo o Pulmonary embolism/deep vein thrombosis
o Leg ulcers or phlebitis o Treatment with blooding thinning medication e.g warfarin
o Treatment with gold therapy for rheumatoid arthritis