Microneedling Consent

Elite Clinique | Consent Form

This consent form is specific to microneedling (collagen induction therapy). This form must be completed in addition to the General Treatment Consent form.

Microneedling uses fine, sterile needles to create controlled micro-channels in the skin. This triggers the body's natural wound-healing cascade, stimulating the production of new collagen and elastin. It is used to improve the appearance of fine lines, acne scarring, enlarged pores, stretch marks, and general skin texture.

ALTERNATIVES: Alternative treatments may include chemical peels, laser skin resurfacing, PRP therapy, topical retinoid therapy, or no treatment. Your practitioner will have discussed any alternatives relevant to your presentation.

Risks & Side Effects

Very Common

Affects more than 1 in 10 people

Redness similar to moderate sunburn (typically resolves within 24-72 hours)
Skin tightness, dryness, and mild flaking in the days following treatment

Common

Affects up to 1 in 10 people

Minor pinpoint bleeding during the procedure (this is expected and normal)
Temporary heightened skin sensitivity
Mild swelling, particularly around the eyes and forehead

Uncommon

Affects up to 1 in 100 people

Post-inflammatory hyperpigmentation (more common in darker skin types — Fitzpatrick IV-VI)
Reactivation of herpes simplex (cold sores) if prone

Rare

Affects fewer than 1 in 1,000 people

Infection at the treatment site
Scarring (more likely in individuals with a history of keloid or hypertrophic scarring)

Contraindications

Treatment may not be suitable if you:

✕Active acne, rosacea, or skin infection at the treatment site
✕Eczema, psoriasis, or dermatitis at the treatment site
✕History of keloid or hypertrophic scarring
✕Use of isotretinoin (Roaccutane) within the last 6 months
✕Active cold sores or history of frequent herpes simplex outbreaks (prophylactic antiviral medication may be recommended)
✕Pregnancy or breastfeeding
✕Current use of blood-thinning medication (discuss with your practitioner)
✕Active skin cancer at or near the treatment site
✕Uncontrolled diabetes or immunosuppression

Patient Declaration

By signing this consent form, I confirm that:

1I understand that a course of 3-6 treatments, spaced 4-6 weeks apart, is typically recommended for optimal results, and that a single session may produce limited improvement.
2I will avoid direct sun exposure and apply a broad-spectrum SPF 50 sunscreen daily for a minimum of 2 weeks following treatment. I understand that sun exposure increases the risk of post-inflammatory hyperpigmentation.
3I will avoid makeup, self-tanner, and all non-prescribed topical products for at least 24 hours following treatment.
4I will use only the post-treatment skincare products recommended by my practitioner for the first 48-72 hours.
5I will avoid swimming pools, saunas, steam rooms, and strenuous exercise for 48 hours following treatment to minimise the risk of infection.
6I will avoid active skincare ingredients (including retinoids, AHAs, BHAs, and vitamin C serums) for 5-7 days following treatment, or until my skin has fully healed.
7I understand that results develop gradually over several weeks as collagen remodelling occurs, and that no guarantee of a specific outcome is given or implied.

Note: This is an informational copy of our consent form. The formal consent process takes place in person with your practitioner before treatment.