Pre-Care Instructions

Pre-Care - Toxin

• Avoid medications that inhibit clotting such as vitamin E, aspirin (any product containing acetylsalicylic acid), or non-steroidal (NSAIDS) such as motrin, vitamin E, ginger, gingko bilboa, ginseng, and garlic 10-14 days prior to the procedure. These drugs and herbs may cause excessive bleeding or bruising.

• Schedule your Botox/Dysport appointment at least 4 weeks prior to a special event, such as a wedding or a vacation to allow for best results and refinement where necessary.

• As you prepare for your treatment please notify PARU of any changes to your medical history, health status, and personal activities that may be relevant to your treatment. Reschedule your appointment at least 24 hours in advance if you do not feel well by phone 919-439-8948, text 919-589-4184 or email mary@paruabeautystudio.com

Pre-Care - Filler

In order to minimize the risk of possible side effects and complications of facial fillers please follow these simple steps:

• Schedule your facial filler appointment at least 4 weeks prior to a special event that you may be attending, such as a wedding or a vacation. Bruising and swelling may be apparent for up to two weeks after your treatment and you may require refinement after the original treatment.

• Avoid alcohol for at least 24 hours prior to treatment, as it may thin the blood and increase the risk of bruising.

• Avoid anti-inflammatory/blood-thinning medications, if possible, for a period of 2 weeks before treatment. Medications and supplements such as Aspirin, Vitamin E, Ginkgo Biloba, Ginseng, St. John’s Wort, Omega 3/Fish Oil supplements, Ibuprofen, Motrin, Advil, Aleve, and other NSAIDS thin the blood and can increase the risk of bruising and swelling after injections.

• Discontinue Retin-A use 2 days before and 2 days after treatment.

• If you do not feel well, have a rash, cold sore, or blemish in the treatment area; Please reschedule at least 24 hours in advance.

• If you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another eruption of cold sores. Please let us know so you can be prescribed antiviral medication prior to treatment.

• Avoid dental procedures (including cleaning) and vaccinations 2-4 weeks pre-treatment and post-treatment.

• Be sure to have a good breakfast, including food and drink, before your procedure. This will decrease the chances of lightheadedness during your treatment.

• Please arrive at the office with a clean face this means NO makeup or tinted moisturizer.

• You are not a candidate for treatment if you are pregnant or breastfeeding.

As you prepare for your treatment please notify PARU of any changes to your medical history, and health status including any recent vaccinations, or personal activities that may be relevant to your treatment by phone 919-439-8948, text 919-589-4184, or email mary@paruabeautystudio.com

Pre-Care - Chemical Peel

Your Home Care Regimen:

To get the most from your chemical peel, we recommend incorporating a Retinoid into your home care regimen. However, you must stop the use of these products (Retin A, Tri Retinol Complex, etc.) five days prior to the chemical peel.

Use a physical sunscreen with at least an SPF 30+ every day rain or shine for at least three weeks prior to the chemical peel.

STOP the use of any benzoyl peroxide product (Purity Gel Spot TX, Acne Lotion, etc.) or any other product that can cause dryness, redness or irritation three days prior to the chemical peel.

If prone to cold sores, a prescription must be used two days before and five days after the chemical peel.

A melanin-suppressing agent may be recommended depending on your skin type. You must follow the appropriate instructions on the use of this product.

In Addition:

No facial waxing 1 week prior to the chemical peel

No filler 1 week prior to the chemical peel

No IPL or Laser Hair Removal 2 weeks prior to the chemical peel

Please do not hesitate to call our office if you have any questions or concerns about your treatments. by phone 919-439-8948, text 919-589-4184, or email mary@paruabeautystudio.com

Pre-Care - Microneedling

No area to be treated should receive any type of chemical peel for two weeks prior to or after treatment. Waxing and/or use of chemical depilatories must be avoided for one week prior to and after the micro channeling treatment. Shaving is allowed immediately before treatment and 48–72 hours after treatment, as long as there is no skin irritation. Topical prescriptions including but not limited to Retin-a, Renova and Tazorac must not be used for three days prior to treatment. Avoid abrasive scrubs or other exfoliating products three days prior to treatment The area to be treated must be clean and or free of any lotion, makeup, or sunscreen. Please remove prior to treatment. You may not be pregnant or breastfeeding for micro channeling. Notify the provider of any tattoos, including cosmetic tattooing, in the vicinity of the area to be treated as tattoos must be avoided. If you have a history of cold sores, we may recommend prophylactic antiviral therapy in the form of Valtrex® or Acyclovir if your mouth area is being treated. Follow the directions for your prescription. During the course of your micro-channeling treatment, notify PARU of any changes to your medical history, health status, and personal activities that may be relevant to your treatment.

Please do not hesitate to call our office if you have any questions or concerns about your treatments. by phone 919-439-8948, text 919-589-4184, or email mary@paruabeautystudio.com

Pre-Care - PRF

PRF therapy for the face is a treatment that involves withdrawing a patient's own blood, processing it so that only the enriched cells (platelet-rich fibrin) remain, and infusing it into the facial tissue through Micro Needling. PRF contains essential proteins that stimulate new cell growth, helping to improve your complexion, skin texture and to restore lost facial volume. Due to the natural variation in quality of platelet-rich plasma, results will vary between individuals. Some patients may require multiple sessions to obtain desired outcomes.

Contraindications: You should not have PRP treatment done if you have any of the following conditions: • An impaired immune system due to immunosuppressive diseases, HIV, HTV, or immunosuppressive medications • Skin conditions and diseases including: Facial cancer, existing or uncured. This includes SCC, BCC and melanoma, systemic cancer, and chemotherapy. • Steroid therapy, dermatological diseases affecting the face (i.e. Porphyria), communicable diseases, blood disorders and platelet abnormalities, anticoagulation therapy (i.e. Warfarin) • A history of medication over the past 2 months that could affect the skin, i.e., Accutane • Pacemakers, a history of a severe heart disorder, arrhythmias • Pregnant or lactating • Blood thinning medications or blood clotting disorders • Any active skin disease or disorder around the treatment site; acne, eczema, psoriasis • A history of keloids or abnormal wound healing • Any surgical procedure in the treatment area within 3 months

Prior to Treatment, Inform Your Provider of the Following: • If you have a history of facial and/or nasal herpes or fever blisters to receive advice on antiviral therapy prior to treatment. • If you have a history of any significant allergy or skin sensitivity • If you have any implants that could be metal • If you are taking broad beta-blockers such as Inderal (Propranolol), please inform your provider as this medication may need to be changed to a select beta-blocker in advance of the treatment. • If you have recently had a facial peel or surgery • Recent use of self-tanning lotions, tanning booths, or prolonged sun exposure 24 hours prior to treatment • All current medications and supplements including blood thinning, Accutane and use of Retin-A products • If you have had Hormone replacement therapy • If you have a history of Keloid scarring • If you are pregnant or lactating

7 DAYS BEFORE TREATMENT: • Avoid chemical peels, waxing, electrolysis, Laser treatments, or threading • Discontinue blood thinning agents such as vitamin E, vitamin A, Ginko, Garlic, Flax, Cod Liver Oil, and Essential Fatty Acids, and multivitamins, a minimum of 7 days (preferably 14 days) prior to treatment. It is fine to continue iron and vitamin D. • If you are taking any blood thinners, please let your provider know immediately, as they may represent a contraindication to this treatment. These medications include Plavix, Coumadin and Heparin. • Avoid aspirin, Advil, Motrin, Iburprofen, Naproxen, Voltaren and other anti-inflammatory medications. We want inflammation to occur – as this is one mechanism by which PRP works. • You may use Tylenol (acetaminophen) as needed prior to the treatment. • Prescription medications (including heart and blood pressure medication) should be taken as prescribed right up to, and including, the day of and the day after your treatments. • Avoid excessive sun or heat exposure.

3 DAYS BEFORE TREATMENT:

• Avoid topical products such as Tretinoin (Retin-A), Retinols, Retinoids, Glycolic Acid, Alpha Hydroxy Acid, Salicylic Acid, or other “anti-aging”, “acne”, and “bleaching” products. Also AVOID waxing, bleaching, tweezing, or the use of hair removal cream on the area to be treated. • Avoid excessive sun exposure and wear a broad-spectrum sunscreen daily of SPF 30 or higher.

DAY OF TREATMENT

• Please arrive to the office with a “clean face”. Do not wear makeup. No lotions, makeup or other topical products should be applied on the day of the procedure. • If the area to be treated requires shaving due to hair involvement, please shave the area the evening prior to your visit, to avoid any trauma or rash from shaving. • A topical anesthetic cream will be applied for about 30-45 minutes prior to your procedure.

Please do not hesitate to call our office if you have any questions or concerns about your treatments. by phone 919-439-8948, text 919-589-4184, or email mary@paruabeautystudio.com

Day of Treatment Instructions

• Arrive at your appointment with a “clean face”, please do not wear makeup. You may bring your own makeup to apply after your treatment with Botulinum Toxin Type A (please note, makeup is not permitted immediately after facial filler treatment)

• You will feel multiple fine needle injections and mild discomfort. Tenderness can last for a few hours or a few days.

• Redness and swelling similar to a mosquito bite are normal for 5-15 minutes after toxin treatment. Some mild bruising may also occur.

Post-Care Instructions

Post-Care - Toxin

No rubbing or massaging of the injected area for 4 hours after treatment, including facials.

No strenuous exercise for 24 hours after treatment including Weight training, cross training, long-distance running, yoga (positions where the body is inverted)

Keep upright for 4 hours — NO lying down.

Avoid headwear that is tightly fitted across the forehead.

Avoid excessive alcohol for 24 hours post-treatment to prevent bruising.

Avoid Ibuprofen, Advil or Motrin, Tylenol is acceptable to take if experiencing discomfort (if not contraindicated)

·Ideally, avoid makeup for an hour or so. However, mineral makeup can be applied immediately after treatment. Again, it is recommended that you do not apply too much pressure during these activities in order to ensure that the product does not disperse from the treated area.

·In general, you can start to see the effects of the treatment as early as 3 to 4 days after injection. It can take a full 14 days after treatment for the full results to become apparent. DO NOT RESCHEDULE A FOLLOW-UP APPOINTMENT BEFORE 2 WEEKS

·This is a temporary procedure result that will last approximately 3-4 months. If you maintain your treatment appointments with the frequency recommended by your provider results should improve over time.

·Your satisfaction is important to us! We would like you to return to the office in 2 weeks for a follow-up assessment appointment, especially after your first treatment. This will ensure we are able to see how your facial muscles react to your treatment. If you require additional units to fine-tune/adjust your treatment results there will be additional charges at the regular rate.

Side effects- Most side effects are temporary and should relieve themselves shortly.

Temporary pain or tenderness at the injection site. This can be treated with usual over-the-counter pain relievers such as acetaminophen.

Bruising — For the majority of patients, the area of injection will appear no different. For a small minority, some minor bruising may occur. Ice, arnica, pineapple juice, and arnica can all help to expedite the healing process.

Bumps — A few minutes after treatment small bumps may be visible on the skin. These will fade quickly.

Headache/Flu-like symptoms—Temporary headache is the most commonly reported symptom following treatment, though the number of patients who report headaches is very small compared with the number of treatments performed. The headache can be treated with usual over-the-counter pain relievers such as acetaminophen.

On occasion, some of the neurotoxins may unintentionally seep into the upper eyelid and paralyze the muscle that holds the upper eyelid up. This can cause heaviness, droopiness, or asymmetry of the brow position. eyelids should disappear within four to six weeks, but you can alleviate symptoms by trying these treatments: Apraclonidine- eye drops that can help drooping eyelids and/or more neurotoxin to counteract the relaxed muscle.

An allergic reaction to neurotoxin injections is possible, though it is not very common. A delayed allergic reaction to a neurotoxin is highly unlikely. However, If you experience any of the following symptoms, you could be having an allergic reaction:

If you experience severe swelling of the face Hives, Itching, Wheezing, or difficulty breathing, call 911.

Post-Care - Filler

The majority of reactions to dermal fillers are redness, swelling, bruising and tenderness after the injections. These usually subside a few days after the treatment, but can last up to a week. If any of these symptoms persist longer than a week, or if you develop other symptoms, please contact our office.

Cold compresses may be used after the treatment to reduce swelling and decrease soreness. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day.

You may take Tylenol (if not contraindicated) every 4-6 hours after the treatment to help with any discomfort you may have.

Make-up should not be applied 24 hours after the treatment.

In the first 24 hours following treatment, limit exposure to sunlight or UV lamps. Extensive sun or heat exposure and alcoholic beverages may cause a temporary increase in redness, bruising or swelling at the injection sites. If there is persistent swelling or redness after the injections, you should limit exposure to sunlight or UV lamps until these symptoms subside (for at least 5-7 days). If sun exposure is unavoidable, use a sun block with an SPF of 30 or greater, combined with zinc oxide and/or titanium dioxide.

Patients should avoid strenuous exercise for 48 hours to prevent moving the filler or increasing blood flow to the face.

Avoid taking aspirin (unless medically necessary) or other non-steroidal anti-inflammatory drugs such as Ibuprofen, Advil®, Motrin®, Nuprin®, Aleve®, Celebrex®, Fish oil, Gingko Biloba , St. John’s Wort and high doses of vitamin E for 5 days after the treatment, as these may cause an increased risk of bleeding or bruising at the injection sites.

Avoid excessive touching or massaging the treated areas for about 6 hours after the injections. The treated areas can be washed with a gentle cleanser such as Cetaphil® Cerave® or Dove® unscented.

Avoid dental procedure (including cleaning) 2 weeks post filler

Your satisfaction is important to us! We would like you to return to the office in 4 weeks to see whether a touch-up is necessary. If follow up treatments are necessary, there will be additional charges at the regular rate. Additional costs of medical treatment would be patients’ responsibility would complications develop after dermal filler procedure.

Studies have shown that having a follow-up treatment before the product has fully dissipated will enhance the lasting effect.

Please contact us immediately by phone 919-439-8948, text 919-589-4184 or mary@paruabeautystudio.com if you experience:

Fever/chills; area appears red, hot to touch, and angry looking.

Severe pain or increasing pain at the site; purple blotches at areas not injected; or blanching (whitening or bluish tinge) of the area injected.

Post-Care - Sculptra

• Massage the injected site 5 times a day, for 5 minutes, for a total of 5 days. Arnica gel may be used to massage the areas to help reduce bruising and swelling. This may be uncomfortable for the first couple of days, but is still necessary. The easiest time to massage is when the face is moistened with cleanser or moisturizer.

• Expect swelling and tenderness for 48 – 72 hours. Possible bruising may last about 7 days.

• Elevate the head with two pillows while sleeping during the first few days to minimize swelling.

• Skin redness, bruising, swelling, tenderness, and/or itch are common. If the symptoms persist longer than 2 weeks, please contact our office.

• Minimize movement of the treated area. However, if there is a visible bump, firmly massage the area.

• Avoid applying heat to the treated area until bruising or any swelling have resolved. Avoid activities that cause facial flushing on the day of treatment including consuming alcohol, hot tub or sauna use, exercising, hot wax, and tanning. Avoid extreme cold like skiing or hiking outdoors.

• Gently apply a cool compress or wrapped ice pack to the treated areas for 15 minutes every few hours as needed to reduce discomfort, swelling, or bruising up to a few days after treatment. When bruising occurs it typically resolves within in 7-10 days.

• Avoid hot foods or gum chewing for the first several hours as mouth trauma may occur in the anesthetized areas.

• After treatment, oral pineapple juice, Bromelain, and/or topical Arnica Montana may help reduce bruising and swelling. You can find Arnica in the natural foods section of your grocery store or local pharmacy.

• You may also take acetaminophen (Tylenol) to reduce pain. Avoid consuming alcohol, taking aspirin, ibuprofen, naprosyn, or anti-inflammatory medications within the next 4 hours as they may increase bruising.

• Routine washing and showering is fine with gentle cleanser and moisturizers. Sunscreen and makeup may be applied 24 hours post procedure.

• Results may begin to appear 6-8 weeks after treatment and will gradually improve for up to 12 months. Results last up to 2 years after initial treatment.

• A possible side effect can be the delayed appearance of tiny nodules under the skin, which can appear 6-12 months after treatment. They are palpable, but not visible and development can be minimized by following the post treatment massage instructions. Any worsening or prolonged symptoms should be reported to the office.

• Schedule your next appointment in 2-3 months to determine if additional treatments are needed. Most patients require a minimum of two treatments.

Please contact us immediately by phone 919-439-8948, text 919-589-4184 or email mary@paruabeautystudio.com if you experience:

• Fever/chills; area appears red, hot to touch, and angry looking.

• Severe pain or increasing pain at site; purple blotches at areas not injected; or blanching (whitening or bluish tinge) of the area injected. Eye pain or vision loss.

Post-Care - Microneedling

Immediately after your treatment, you will look as though you have a moderate to severe sunburn and your skin may feel warm and tighter than usual. This is normal and will subside after 1 to 2 hours and will normally diminish within the same day or 24 hours. You may see slight redness after 24 hours but only in minimal areas or spots.. Your provider will discuss post-procedure skincare following the treatment to help soothe, calm, and protect the skin. Normal skincare can be resumed again after day 3.-5 days.

Please adhere to the below instructions to ensure the best result and the least amount of complications

following the procedure:

1. Use a gentle cleanser and tepid water to cleanse the face for the following 72 hours. Gently dry

the treated skin. Always make sure that your hands are clean when touching the treated area.

2. Keep the face moist with a gentle facial moisturizer for the next 3-5 days.

3. Apply facial sunscreen daily (broad spectrum UVA/UVB) and use rigorous sun protection for the next 7 days. Avoid intentional and direct sunlight for 48 hours. NO tanning beds.

4. Avoid the use of makeup for the first 24 hours following treatment.

5. For at least 3 days post-treatment, do NOT use any Alpha Hydroxy Acids, Beta Hydroxy Acid, Retinol (Vitamin A), benzoyl peroxide, or anything perceived as 'active' skincare.

6. Do not go swimming for at least 24 hours post-treatment.

Post-Care - PRF

• You may expect a certain degree of discomfort, redness, and/or irritation during and after treatment.

• You may have a bruise at the blood draw site.

• You will look as though you have a moderate to severe sunburn and your skin may feel warm and tighter than

usual. This typically diminishes within the same day or within 24 hours.

• If you experience any pain or discomfort you may take Tylenol or other Acetaminophen-containing products as directed. Cold compresses can be applied to reduce swelling if necessary.

• Do not take any anti-inflammatory medications such as Ibuprofen, Motrin or Advil. These agents will interfere with the natural inflammatory process that is critical and responsible for your skin rejuvenation.

• Light scabs may form in the treated area and remain for 24 to 48 hours.

• Do not pick or scratch treated skin but instead keep it moisturized.

• Avoid vigorous exercise, sun, and heat exposure for at least 24 hours following your treatment.

• Make sure you only use clean linens and towels during the healing process.

• Avoid pets and small children having contact with treated skin for the first 12 - 24 hours.

• During the healing phase, be sure to disinfect your cell phone or landline phone with alcohol wipes before use. Try to avoid your treated skin’s contact with the phone by choosing a hands-free option.

After Treatment Care:

• Continue to avoid aspirin, Advil, Motrin, Iburprofen, Naproxen, Voltaren and other anti-inflammatory

medications for 3 days after your procedure (if possible try for 7 days).

• Use a gentle cleanser (i.e. Avene Clean-Ac Cleanser) and tepid water to cleanse the face for the following 72 hours.

• Use a gentle moisturizer as needed.

• Avoid excessive sun exposure, including tanning booths, and wear a broad-spectrum sunscreen daily of SPF 30 or higher.

• Avoid warm environments (i.e., hot tubs, jacuzzis, steam rooms, hot yoga, saunas, etc.) for 3 days post treatment.

• By day two or three, your skin may feel a bit dry. This is normal and will resolve on its own.

• You may return to your skin care products and makeup when your skin is not irritated, typically 4 -5 days after treatment.

• You will begin to see improvements in the overall texture and tone shortly after your treatment, but the overall effects take up to 3 months, for optimal improvement.

• New collagen formation takes 4-6 weeks to develop; please be patient.

• It is recommended to have a minimum of 3 treatments, 4 weeks apart for maximum benefit

Post-Care - Chemical Peel

The peeling may take anywhere from 7-10 days on average or longer depending on internal and external factors such as skin type, age, weather, lifestyle, and hormones. Slight redness and skin sensitivity and flaking can occur as your treatment eliminates dead surface skin cells. Each treatment may vary. Other areas of the body will react differently because your skin has a different texture on your face and scalp than on your chest, back, arms, and legs. The healing process may take longer in those areas.

Your skin may take on a rough, patchy, darkened quality a few days after this treatment. This is normal and expected and it will resolve on its own. The first areas to peel are usually around the nose and mouth, but can begin anywhere. Most people begin peeling on the 2-3 days after treatment. It is also possible to not peel at all. If this occurs, you will still benefit from the treatment because the skin has exfoliated microscopically.
Possible side effects include but are not limited to: mild to extreme redness, temporary tightness, itching, swelling, and dryness of the skin similar to a sunburn or windburn. This will usually subside in 2-3 days. A prescription of hydrocortisone, or over-the-counter hydrocortisone (Vanicream HCⓇ) may be recommended if the skin is inflamed or irritated.
You may GENTLY apply a cold compress to the treated area(s) as needed for any burning or irritation associated with your treatment.
Make sure to avoid excessive heat on the treated area and direct sun exposure of any kind, as well as tanning beds and self-tanners to the treated areas for 4 weeks after treatment.
Do NOT engage in strenuous exercise for 2-3 days after treatment because it may exacerbate the inflammatory and can cause your skin to become extremely inflamed.
Sweating excessively after treatment can irritate the skin or cause blistering due to the sweat being unable to escape through the top layer of dead skin. Try to avoid sweating until after you have stopped peeling to avoid lifting the skin prematurely, as this can cause scarring.
Do NOT use any acidic products such as retinoids or tretinoins, acne medication products such as Retin-AⓇ, TazoracⓇ, RenovaⓇ, AtralinⓇ, ZianaⓇ, VeltinⓇ, DifferinⓇ, the antibiotic Doxycycline, AHAs (lactic, glycolic, tartaric, etc.), BHAs (salicylic), benzoyl peroxide, vitamin C products, lightening agents such as hydroquinone or any exfoliative products including loofahs or coarse sponges to your skin for 2 weeks after your chemical peel, or more if you notice your skin becomes sensitive to application. These medications and products increase your photosensitivity, which can significantly increase the likelihood of complications.
Do NOT tweeze, pick, rub, exfoliate, wax, use a depilatory, undergo electrolysis, or schedule a facial or cosmetic service such as laser resurfacing, or IPL on a treated area(s) for 4 weeks after your treatment. To reduce the risk of scarring, you do not want to remove the dry, rough, dead skin faster than your body wants to.
Do NOT get your hair dyed until a week after you have finished peeling, if your treatment was performed on the face or neck. For most people, week 3 post-peel is the best time to have your hair color treated.
This procedure can stimulate cold sores. If you have an outbreak after your treatment, please call the office to inquire about obtaining a prescription.