PRE PROCEDURE INSTRUCTIONS Picosure Tattoo Removal HOW IT WORKS: The ink used in tattoos is made from minerals. To understand how tattoo removal works think of the ink as tiny “rocks.” Traditional lasers used for tattoo removal are known as Q-switches. These nano-second lasers rely on photothermal action and deliver heat into the pigment and surrounding tissue. With multiple treatments the “rocks” are broken down into smaller and smaller “pebbles.” Many treatments are required to slowly clear the ink and total clearance is rarely possible. Picosure operates at speeds measured in trillianths of a second. This pressure-wave technology creates an intense photomechanical impact that shatters the target into tiny ink particles. The “rocks” are not reduced to “pebbles,” but instead become “sand.” These tiny ink particles are easily eliminated from the body. Tattoos are cleared in fewer treatments, with less fluence, and without injuring the surrounding skin. Picosure is effective on previously treated tattoos that failed to clear and even stubborn inks can be removed with fewer treatments. Tattoos can be cleared in about one third the time and with less discomfort. PRE-TREATMENT INSTRUCTIONS:  Pre-Treatment Consultation: A consultation is required to determine the price per treatment for removing your tattoo and estimate the number of treatments that will be required. There is no cost for this consultation. If you wish to book your first treatment on the same visit a deposit of $50 will be required. This deposit will be applied towards the cost of your treatment or refunded to you after your consultation if you decide not to proceed. If you do not show up for your scheduled treatment a non-cancellation fee will be charged and this deposit will be forfeited in full. If you cannot make your appointment you may avoid this fee by giving us 48 hours notice of cancellation.  Pre-Treatment Documentation: In order to determine if there are any precautions that need to be taken, we require the completion of some pre-treatment screening forms. Prior to your consultation all necessary forms will be emailed to you and we ask that you fill them out and bring them with you when you come for your consultation and/or treatment.  Tanning and SPF: Picosure is suitable for fair to medium skin types and tanned skin but sun exposure without SPF 30 or above is not advised for at least 10 days pre-treatment. Sun exposure decreases the effectiveness of the laser and can increase the risk of post-treatment complications. Sunless tanning cream should also be avoided pre-treatment.  Body Hair: Chemical or mechanical epilation within six weeks prior to treatment may interfere with the post-treatment healing process so do not use dilapatory creams (such as Naire) or have electrolysis prior to treatment. Please shave the treated area the day before the treatment.  Medications / Nutritional Supplements: Anything with an anticoagulant property may cause excessive bleeding and interfere with post-treatment healing. To minimize this risk avoid taking the following for several days prior to your treatment: Asperin, Excedrin, Motrin, Ibuprophen, Willow Bark, Omega 3 Fish Oils, Garlic, B6, Ginger, and Ginko Biloba. Avoid alcohol (especially red wine) the day before and the day of the procedure.  Preparation: It is recommended that you bathe or shower the morning of the procedure. Do not apply any creams, lotions, foundation, powders or other products to the treatment area prior to the treatment.  Clothing: We suggest that you wear comfortable clothing that will not rub against the treatment area after the procedure.  Comfort Management: While discomfort during a Picosure treatment is more tolerable than traditional lasers you may wish to purchase some numbing cream and apply it to the treatment area for 45 minutes before your appointment. Maxilene is available for purchase at most pharmacies and at Skinpossible. Cover it with cling wrap to prevent it from getting on your clothing. Alternatively we can apply medical-grade numbing cream for a nominal additional cost. ©Skinpossible Laser & Light Solutions 2010-2014 Read the post-care instructions and be prepared to comply with all advice before you commit to the treatment. POST PROCEDURE INSTRUCTIONS Picosure Tattoo Removal WHAT TO EXPECT: Healing time after a Picosure treatment is similar to that of traditional Q-Switch lasers but far fewer treatments are required. Complete clearance of the ink is not only possible but can be expected. Dark colours such as black and dark blue will fade the fastest and may require only 1 to 3 treatments. Other colours fade more slowly and may require 5 (or more) treatments. Red and white will fade much slower than other colours and may require additional treatments. You will appreciate the clearer look of your skin as the pigment diminishes gradually. Depending on the location of the tattoo six to ten week intervals between treatments in required. The ink in tattoos closest to the heart (ie: on the torso) clear faster than tattoos in the extremities (ie: the ankle). AFTER TREATMENT:  Comfort Management: Cool air will be applied during and immediately after the treatment. Your skin will feel quite hot post-treatment. After several hours the hot feeling will decrease and a “sunburned” feeling will remain that may last up to 24 hours. Any discomfort you experience after leaving the clinic may be relieved with acetaminophen.  Bandages: After the treatment we will apply aquaphor to the treated area and cover it with a non-stick (Telfa) bandage. This will keep the area hydrated and sanitary and it is recommended that you keep this bandage on for 24 hours post treatment. Thereafter it is best to expose the treated skin to the air to allow it to breath. If the treatment is in an area that will be rubbed by clothing, however, continued use of a bandage may be required to prevent irritation.  Bleeding and Blisters: It is very likely that you will develop a blister or blisters on the treatment area. Please see the reverse for blister care. Pinpoint bleeding is also possible. If crusting occurs do not shave and DO NOT PICK the area. Do not rub or scratch the treated area. Let the scab fall off on its own. Picking the scab could result in scarring.  Prevent Infection: You must keep your skin as sanitary as possible. Do not go swimming or use a hot tub or whirlpool until the wound heals. In the event of an infection please call the clinic as the doctor will need to see you and will prescribe an antibiotic. If the clinic is closed it is recommended that you go to a walk-in clinic.  Inflammation: For larger tattoos it is recommended that the treated area be kept elevated as much as possible for the first 24 hours to prevent excessive swelling.  Exercise: Avoid large repetitive movements of the affected area (e.g. strenuous physical exercise or physical labour).  Hydration: In most cases the skin will feel a little rough for a few days after the treatment. Keep the skin hydrated with Aloe Vera gel.  Cleanse: Clean the treated area daily. Showering is recommended. Allow water to run over the wound, and then pat the area dry with a clean towel. A gentle cleanser such as Cetaphyl may be used. Do not soak.  SPF Protection: After the procedure the skin should not be exposed to the sun until healing is complete. The use of sunscreen for a minimum of 4-6 weeks and preferably longer is required. We recommend Colorescience Sunforgetable Mineral SPF or Tizo Mineral SPF both of which can be purchased at Skinpossible. Premature sun exposure without SPF increases the risk of hyperpigmentation which could be permanent. If you have any concerns or questions do not hesitate to call the clinic at 403-938-1112 ©Skinpossible Laser & Light Solutions 2010-2014 POST PROCEDURE INSTRUCTIONS Picosure Tattoo Removal—Blister Care It is not uncommon for clients to develop fluid-filled blisters over the treatment area after having their tattoo removal treatment. If you develop a blister or blisters after treatment, please follow the directions below:  A small unbroken blister, less than one inch (2.5 cm) across will usually heal on its own.  Unbroken skin over a blister provides a natural barrier to bacteria.  If you have a large blister(s) we can you fit you in to have it (them) drained in the office using a sterile needle, leaving the overlying skin in place.  A topical ointment will be applied (Polysporin Complete) to decrease the risk of infection and the affected area(s) will be covered with a sterile gauze pad, allowing the skin to breath. AT HOME:  Wash your hands with a fragrance-free soap and water and then wash the affected area, pat dry.  Apply a thin layer of Polysporin ointment daily.  Secure gauze with paper tape to cover the affected area , avoid having the tape contact any open area.  Use caution if you choose to wrap a limb with gauze due to constriction of the blood vessels if the limb swells.  Don’t forget to elevate the limb and avoid exercise and strenuous activity to decrease swelling.  Monitor for signs of infection - pus, redness, increased pain, warmth, a low-grade fever of 37.8 degrees celcius or above.  Take Acetaminophen as directed unless you have a temperature, Acetaminophen can mask a fever. If a possible infection is a concern contact the office during business hours, if you are unable to contact us seek medical attention with a Medical Doctor. Polysporin Complete  heal-fast formula containing Lidocaine for pain relief  aids in promoting healing and forming a protective coating  3 antibiotics- Polymycin, Bacitran zinc and Gramicidin If you have any concerns or questions do not hesitate to call the clinic at 403-938-1112 ©Skinpossible Laser & Light Solutions 2010-2014 .