Online Skincare Consultation This form is viewed only from Acne Specialist for consultation and monitoring your future skin progress How old are you? 14 - 1819 - 2526 - 3333+ What is your sex? MaleFemale How long have you had acne? 3 months -1 year1 - 2 years3 - 5 years6 + yearsI don't have acne What are your skin concerns? Sporadic bumpsFew bumps but stuborn, stay for longer timeMild or Moderate AcneSevere or Cystic acne (large, red, tender bumps)Rough texture with small white bumps underneath ( visible when you stretch skin)Whiteheads/Closed Comedones (non-sore, non-inflammatory, clogged bumps under the skin)BlackheadsOily SkinLarge poresDiscoloration/ Brown SpotsRed discoloration after clearing blemishesEasily irritated by products/sensitive skinScarsBack or chest acneMore breakouts before cycle Did you use any of these prescription acne products? Benzoyl peroxideRetinoids (Tazorac, Epiduo, Avage etcTopical antibiotics ( Benzaclin, Duac, Acanya, Benzamycin etc)Oral Antibiotics (Minocycline, Doxycycline etcIsotretinoin (Accutane)Oral contraceptives (Ortho Tri-Cyclen, Yaz, others)SpironolactoneNone of the above 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? Acne facialAcne ExtractionsLaser TreatmentsChemical PeelsCortizone injectionsNone of above Which of these applies to you? I often squeeze or extract pimples by myselfI extract pimples only when it gets yellow topIf I don't see improvement within a week I change or combine other productsI like natural products as much as it is possibleMy top priority is quick solution, products with acne facialsI follow specific regimen even I don't see big improvements in first 20 daysI turn red or blush easily QUESTIONS BELOW ARE IMPORTANT BUT NOT REQUIRED 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? UPLOAD IMAGES (max 4)