Skip to product information
ANTIOXIDANT HYDRATING CLEANSING MOUSSE
  • ANTIOXIDANT HYDRATING CLEANSING MOUSSE
ANTIOXIDANT HYDRATING CLEANSING MOUSSE
$42.00

Latisse Patient Consent Form

Thank you! Your medical questionnairehas been submitted successfully.
Please fill out all required fields.

1. Ocular History (Eyes)

Are you currently using any prescription eye drops for Glaucoma or ocular hypertension? (e.g., Lumigan, Xalatan, Timolol)
Have you ever been diagnosed with high eye pressure (Ocular Hypertension) or Glaucoma?
Have you had any eye surgery in the last 6 months (Cataract, LASIK, etc.)?
Do you have a history of eye inflammation (Uveitis or Iritis)?
Do you have any active eye infections or chronic "dry eye" symptoms?
Do you wear contact lenses? (Note: Lenses must be removed before application)

2. Medical History

Do you have any known allergies to Bimatoprost or other prostaglandins?
Are you currently pregnant, planning to become pregnant, or breastfeeding?
Do you have a history of skin sensitivity or eczema on your eyelids?

3. Informed Consent & Risks

Please initial next to each point to acknowledge you understand the potential side effects:

Permanent Pigmentation: I understand that Latisse may cause increased brown pigmentation of the colored part of the eye (the iris), which is likely permanent.
Skin Darkening: I understand that darkening of the eyelid skin may occur but is typically reversible if the product is discontinued.
Hair Growth: I understand that hair growth can occur in any skin area that Latisse frequently touches; I will blot any excess solution.
Common Irritation: I understand that eye redness, itchiness, and dryness are common side effects.

Patient Attestation

I certify that the information provided above is true and accurate to the best of my knowledge. I have been informed of the potential side effects and the proper application technique.

Details
The first step in barrier-rebuilding and protecting corneotherapy treatment, this luxurious cleansing mousse protects and replenishes moisture, protects barrier lipids from toxic oxidation, and encourages barrier repair after cleansing. \n

Actions


  • Cleanses, tones, and removes makeup in one step
  • Omega-rich antioxidants protect barrier lipids from toxic oxidation, so skin stays soft, moist, and comfortable long after cleansing
  • Luxurious foam purifies pores, protects from moisture loss, and revives hydration
  • Sulfate-free formula dissolves makeup and impurities on contact
  • Skin feels remarkably clean, energized, and softly retexturized

Skin Conditions

All Skin Types | Dry |Dehydrated | Moisture & Nutrient-Depleted | Dull, Tired. \n

Home Care

With moistened fingers, gently massage 1-2 pumps onto the skin. Add water to lather for 30-60 seconds. Rinse with warm water. To remove eye makeup, gently rub cleansing mousse onto the eye area and lashes. Will not remove waterproof eye makeup. \n

 Ingredients

Panthenol (Vitamin B5) | draws moisture into the skin, and protects from dehydration during cleansing

Black Cumin & Black Raspberry | rich in Omega 3, 6, 9 to support skin’s suppleness while providing antioxidant protection 

Borage Oil | provides essential lipids to smooth rough skin and reinforce skin’s natural barrier

Rosehip | rich in Vitamins A & C, linoleic and linolenic acids, keeps skin smooth and youthful looking

Olive Oil | rich in moisturizing lipids; smoothes skin’s texture

Algae & Mugwort | unique anti-sting complex helps reduce discomfort in sensitive skin

Moisturizing Lipids | found naturally in the skin, these lipids hold comforting moisture between skin cells
Materials + Care

We prioritize quality in selecting the materials for our items, choosing premium fabrics and finishings that ensure durability, comfort, and timeless appeal.
Shipping + Returns

We strive to process and ship all orders in a timely manner, working diligently to ensure that your items are on their way to you as soon as possible.

You might also like...