Online Skincare Consultation

This form is viewed only from Acne Specialist for consultation and monitoring your future skin progress

    How old are you?

    What is your sex?

    How long have you had acne?

    What are your skin concerns?

    Did you use any of these prescription acne products?

    Did you use any chemical peels in your acne treatment like glycolic acid or salicylic acid? Which ones and which strength? Any allergies, irritations or redness after using them?

    Did you get any of these professional treatments?

    Which of these applies to you?


    Please describe your daily AM and PM routine with the names of products

    How often do you use makeup? What is your typical makeup procedure?

    How looks your typical weekly diet? Please write a list of your meals/ingredients starting from the ones you have most often. Details help me.

    Have you noticed that some products, foods, or conditions have worsened your acne?

    Is there anything else you would like to tell me?

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