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CLEAR SKIN ULTRA GEL
  • CLEAR SKIN ULTRA GEL
CLEAR SKIN ULTRA GEL
$65.00

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
Clear Skin Ultra Gel Minimize imperfections associated with acne-prone skin with this exclusive complex of clinically proven plant extracts and the next generation in AHAs – the patented* AHAminoPlex™ molecule, developed by the pioneers of AHA skin therapy, Drs. Van Scott and Yu. \n

Actions


    • Time-released exfoliants work deep to clear skin of imperfections

    • Reveals fresh, healthy-looking, clear skin in days

    • Eliminates flaking and achiness

    • Clarifies skin tone

    • Smoothes coarse skin, minimizes enlarged pores and fine aging lines

Skin Conditions

Mild Acne-Prone | Oily | Moderate Acne-Prone | Clogged or Enlarged Pores | Severe Acne-Prone | Pustular Rosacea | Unwanted Pigmentation | Flaking and Ashiness | Skin Previously Unable to Tolerate Glycolic or Salicylic Acid. \n

Facial Procedure

Give acne-prone skin an ultra-smooth finish by applying a small amount (the size of a small green pea) of Perfect Skin over moisturizer and Solar Defender SPF 30 at the end of the facial. NOTE: Even though this is a low-irritation formula, some people may show signs of sensitivity when they first use this gel. Have the client stop using the product until signs of sensitivity clear. Once clear, re-introduce Clear Skin Ultra Gel by applying once every other day for a week, then once a day for a week. At three weeks, the skin should be sufficiently adjusted to use this gel once or twice a day regularly. 

Action Ingredients

AHAminoPlex™ | glycolic/amino acid complex ensures maximum AHA delivery with minimum discomfort Lactic Acid | lactic/amino acid complex ensures maximum AHA delivery with minimum discomfort Lichochalcone | powerful skin-calming molecule from Chinese licorice. Targets the multiple causes of imperfections to deliver fast-acting results Betaine Salicylate | natural skin conditioner from sugar beets complexed with keratolytic BHA; provides time-released exfoliating action long after masque is removed Spirea Ulmaria | dermatologist-tested extract of meadowsweet, an herb rich in skin calming and pore purifying phenolic acid and a natural skin-defense booster Sodium Hyaluronate | bioactive moisturizer. Binds up to 1000 times its weight in water to the skin Zinc PCA | sebum-reducing zinc is combined with a hydrating delivery vehicle for maximum activity Allantoin | powerful soothing molecule originally derived from comfrey root \nBeta-1,3/1,6- D-Glucan | patented Biological Response Modifier (BRM) from Baker’s Yeast; challenges skin to correct itself Panthenol (ProVitamin B5) | chirally-correct form of Panthenol calms and encourages repair of skin’s surface; delivers deep hydration
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.

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