Please fill out the form below so our dermatologist would know how best to serve you. Please enable JavaScript in your browser to complete this form.How would you describe your skin most of the time?Balanced. (Your skin tends to be not too dry and not too oily, with no strong sensitivity.)Dry. (Your skin might feel rough/tight, flake or become itchy, especially in colder weather.)Oily. (Your skin produces lots of natural oil, often giving you a shiny complexion )Combination. (Your skin is dry in some areas and oily in others, often the nose, chin and forehead.)How sensitive is your skin?Not sensitive - I rarely react to any skincare productsSensitive - My skin sometimes reacts to skincare productsVery sensitive - My skin usually reacts to skincare productsOther areas of concernDark spots (hyperpigmentation)WrinklesWhich of these pictures best depicts your acne?Inflamed spots (red or swollen or pus-filled)Non-inflamed spots (blackheads and whiteheads)Do you have any discolouration (hyperpigmentation) that remains after acne spots have healed which can last for weeks or months?YesNoHave you ever used medicine (over the counter or prescription) on your skin?YesNoWhat are your biggest skin concerns? (You can select more than 1)Fine linesDull skinHyperpigmentation or dark spotsOpen poresDeep-set wrinklesSkin firmnessMelasmaAcneDo you wear sunscreen every day?YesNoHave you experienced any outbreaks of facial eczema, psoriasis or perioral dermatitis in the last 6 months?YesNoDo you have burning sensation when you apply water to your faceYesNoDo you apply sunscreen? If yes what typeFile Upload Click or drag a file to this area to upload. Please Upload a picture of the affected area on your skin.Submit
