Acne facial consent form: scope, expectations and the aftercare that does the work
An acne client often arrives hoping one facial will fix it. A good acne facial consent form gently corrects that before you start, and draws a clear line around what an esthetician does with acne.
This exact form is built into SlickChart, so you can send it to your client's phone to sign before the visit.
Start with scope
Acne sits right on the border between cosmetic care and medical care. My form says it plainly, and the client agrees to it in their own checkbox:
I understand an esthetician doesn't diagnose or treat medical acne, and I may be referred to a doctor.
That line backs you up when you suggest a dermatologist, and keeps the conversation about skin care rather than diagnosis. The "about your facial" section repeats the point from another angle: deep, painful or cystic acne needs a doctor.
Describe the facial step by step
Mine describes a facial for mild to moderate breakouts: cleanse, acne exfoliant, extraction of clogged pores, calming mask and optional blue LED. Each step earns its place: the exfoliant explains the salicylate allergy question, the extractions explain the scabbing risk, and the LED explains the light sensitivity question further down.
The "what you'll feel" line warns about tingling from the exfoliant and firm pressure during extractions, and invites the client to tell you any time to ease up or stop. Clients who know they can stop trust you more.
Set the timeline in writing
This is the heart of an acne consent. Mine says acne improves slowly, to plan on a series of facials plus daily homecare for 6 to 12 weeks, and the client separately agrees that results depend on daily homecare and aren't guaranteed, with clearing usually taking 6 to 12 weeks or more.
Writing it down protects both of you: the client knew the plan from day one. Alternatives belong here too: over-the-counter homecare only, or a dermatologist for prescription care.
Risks worth naming
My list covers redness, dryness or peeling; a temporary flare of breakouts; small scabs or bruising after extractions; dark marks, more likely in deeper skin tones; irritation or allergy to a product; and infection or scarring, which is rare.
Talk through the temporary flare out loud, or the client will assume the facial made things worse.
Screening: who should wait or be referred
My checklist opens by saying a yes doesn't always mean no facial: I may adjust the treatment, skip LED, or refer to a dermatologist. A few of the items, and why they're there:
- Isotretinoin now or in the past 6 months, and a prescription retinoid in the past 7 days.
- Antibiotics or sun-sensitizing medicine, and light sensitivity or light-triggered seizures. These connect to the optional LED step.
- Allergy to aspirin or salicylates. Connects to the exfoliant.
- Deep, painful lumps or cysts. The referral line.
- Dark marks that linger after breakouts. A reason for care, not refusal.
The full list also covers pregnancy, recent waxing, peels or laser, and active sunburn, rash, cold sores or wounds. Your role is to screen and refer, never to name a condition.
The closing agreements
Before signing, my client confirms their health and medication history is complete and they'll tell me about changes before each visit, and that they'll wear SPF daily, won't pick, and can stop any part of the treatment at any time. Then a photo choice (private chart only, social with face hidden, social with face visible, or no photos) and a guardian name for anyone under 18. Photos are often how an acne client sees progress; more in what to chart after every facial.
Aftercare that does the real work
My guide opens with the line I most want acne clients to remember: clear skin is built at home between visits. It walks them through each stage:
- First 24 hours: pinkness and small red marks where pores were cleared are normal. Avoid makeup for 12 to 24 hours, picking, sweaty workouts, sauna and pools.
- Days 2 to 3: restart acne products on the night I told them, and don't layer actives we didn't plan.
- Weeks 1 to 4: use the routine every day, and don't switch products every week. A practical tip: benzoyl peroxide can bleach towels and pillowcases, so use white ones.
- Weeks 6 to 12: fewer new breakouts. Dark marks fade slowly and can take months.
It also lists when to call me or see a dermatologist, including deep, painful cysts, acne that scars or keeps getting worse, no improvement after about 3 months, or signs of infection. Acne care is a series, so rebooking matters too; see rebooking for solo estheticians.
Questions to decide for your own practice
- Where is your referral line, and what will you say when a client crosses it?
- Will you offer LED as part of this facial, and how will you handle a light-sensitive client?
- How will you recheck medications at every visit in the series?
Consent requirements and scope of practice vary by state, so check with your state board. This is not legal or medical advice.
Using it digitally
SlickChart has this exact form and aftercare built in for esthetician subscribers. The client signs on their phone before the visit, or on your device in the room, and any checked contraindication is flagged for you. The aftercare goes to the client's own app, styled with your logo, and it works alongside the Square account you already have. If that sounds easier than paper, try SlickChart.
Prefer paper? The printable acne facial set, with the consent form, protocol and aftercare, is in my Etsy shop, ready to print or edit in free Canva.