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Featured Dermalogica Products

Dermalogica Solar defense booster SPF 30
Dermalogica Multivitamin power firm

£26.99

Combat visible lines around the eye area with this powerful firiming complex of skin- rebuliding antioxidant vitamins and protective silicones and red seaweed extract.

Top Dermalogica products to prescribe

Dermalogica Skin Resurfacing Cleanser
Dermalogica Map- 15 Regenerator
Dermalogica Super Rich Repair

Dermalogica Multivitamin body block SPF 20

Dermalogica Antioxidant HydraMist

£25.50

A refreshing antioxidant shield with flash-firming properties to improve skin texture,fight damaging free radicals and intensely hydrate alipoid,dehydrated skin. 


Top Dermalogica products to prescribe

Dermalogica Skin Resurfacing Cleanser
Dermalogica Dynamic Skin Recovery SPF30
Dermalogica Power Rich

Dermalogica After sun repair (100ml)
Dermalogica Dynamic Skin Recovery SPF30

£44.50

Encourages firmness, elasticity and hydration while helping to defend against the primary causes of skin aging with this medium-weight, emolient daily moisturiserwith SPF30 

Top Dermalogica products to prescribe

Dermalogica Skin Resurfacing Cleanser
Dermalogica Map- 15 Regenerator
Dermalogica Super Rich Repair

 

Dermalogica Gift Certificates

Dermalogica Gift Certificates

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Online Consultation card


Your Health
1. Within the last year, have you been under a dermatologist or other physician’s care?
yes no
2. Within the last nine months, have you undergone any surgery?
yes no
If yes, please specify
3. Have you had any health problems in the past or present? yes no
4. List any medications, supplements, vitamins, diuretics, slimming tablets etc. that you take regularly
5. Do you smoke? yes no
6. Do you exercise regularly? yes no
7. Do you follow a restricted diet? yes no
8. Do you wear contact lenses? yes no
9. Do you have metal implants, a pacemaker or body piercings? yes no
10. Rate you level of stress on a scales of 1 to 4 (1=low stress, 4=high stress).

Your Skin
11. Do you have any special skin problems pertaining to your face or body? yes no
If yes, please specify
12. What skin care products are you currently using?
face: soap cleanser toner moisturizer masque exfoliator
eye products

body: soap shower gel scrubs oil body moisturizer
depilatory products self tanners

Exfoliation History
13. Have you ever had chemical peels, microdermabrasion, or any resurfacing treatments?
yes no Was this in the last month yes no
14. Do you use Accutane, Retin A, Renova, Adapalene or any other prescription skin products?
yes no Was this in the last 3 months yes no
15. Are you currently using any products that contain the following ingredients?
glycolic acid lactic acid any exfoliating scrubs any hydroxyl acid product
vitamin A derivatives (i.e. retinol)

Moisture Hydration
16. How much plain water do you consume daily?
Litres
17. How many alcoholic beverages do you consume weekly? Litres
18. Do you ever experience these conditions on your skin?
flakiness tightness obvious dryness
19. What spf sunscreen do you use on your face?
19a What spf sunscreen do you use on your body?
20. Do you sunbathe or use tanning beds? yes no
Capillary Activity
21. Do you burn easily in moderate sunlight? yes no
22. Do you blush easily when nervous? yes no
23. Do you have a tendency to redness? yes no
24. Do you suffer from sinus problems yes no

Oil Secretion
25. Do you ever experience oily shine during the day? yes no occasionally
26. Do you ever experience skin breakouts? yes no occasionally

Nerve Activity
27. Do you drink more than 4 caffeinated beverages daily? (coffee, tea , soft drinks)
yes no
28. Do you ever experience a burning, itching sensation on you skin?
yes no
29. What is you pain threshold? low medium high
30. Have you ever experienced claustrophobia? yes no
31. What type of massage pressure do you prefer? yes no occasionally
32. Have you ever had a reaction to any of the following?
cosmetics medicine iodine pollen food hydroxy acids animals
fragrance sunscreens other

Female Clients Only
33. Are you taking oral contraception? yes no
34. Are you pregnant or trying to become pregnant? yes no
35. Are you lactating? yes no

Male Clients Only
36. What is your current shaving system? electric wet shave
37. Do you experience irritation from shaving? yes no
38. Do you experience ingrown hairs? yes no

Questions To Discuss Every Visit
39. Are you currently having or due for you menstrual period? yes no
40. Have you started any new medication since you last visit? yes no
41. Have you had any recent dental x-rays? yes no
42. What are your skin care goals?


Personal Details
Name: *
Address: *
Email Address: *
Telephone: *
Comments / Questions
* Compulsory fields