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PibuMD AESTHETICS Microneedling Consent

I hereby authorize the practitioner, and any delegated associates, to perform Microneedling on me. I understand that this procedure works on promoting smoother, healthy looking skin by creating micro-injuries in the skin, making the skin undergo a "self-repair" function to stimulate the formation of new collagen. I understand that multiple treatments are required and it is possible the result will be minimal or not help at all. Results can vary from individual to individual and are not guaranteed. Microneedling is not permanent and natural degradation may occur over time.


I am aware of the following possible experiences/risks:

  • DISCOMFORT – Sharp pin prick sensations may be experienced during treatment. A topical anesthetic is applied to minimize discomfort.

  • REDNESS/SWELLING/BRUISING – Short term redness (erythema) or swelling (edema) of the treated area is common and may occur. There also may be some bruising. Skin tightness and sensitivity may be experienced in certain areas.

  • PIGMENT CHANGES (Skin Color) – During the healing process, there is a possibility that the treated area can become either lighter (hypopigmentation) or darker (hyperpigmentation) in color compared to the surrounding skin.This is usually temporary, but, on a rare occasion, it may be permanent.

  • WOUNDS – Treatment can result in bleeding of the treated areas. If any of these occur,please call our office.

  • INFECTION – Infection is a possibility whenever the skin surface is disrupted, although proper wound care should prevent this. If signs of infection develop, such as pain, heat, or surrounding redness, please call our office.

  • SCARRING – Scarring is a rare occurrence, but it is a possibility if the skin surface is disrupted. To minimize the chances of scarring, it is IMPORTANT that you follow all post-treatment instructions carefully.


The following points have been discussed with me:

  • Potential benefits of the proposed procedure

  • Possible alternative procedures such as topicals or surgery

  • Probability of success

  • Reasonably anticipated consequences if the procedure is not performed

  • Most likely possible complications/risks involved with the proposed procedure and subsequent healing period

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