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SKINEVALUATION

Welcome to Skin Evaluation

Dermapen® has partnered with Skin Evaluation to provide a quick and convenient way to find local skin care professionals and give them advanced notice of any skin issues you may be experiencing.

In the evaluation ahead, you'll have the chance to identify problematic areas, what skin type you are and what types of treatments are available.

Then we'll show you which skin care professionals are near you are near you and help you schedule an appointment.

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Name:



Gender:

Male Female

STEP 1 :

Lets get to know you

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

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Oily

Select this option if your skin has excess sebum (oil) production. You skin will have a shiny, wet appearance.

Combination

Skin tends to be shiny on the sides of the nose, chin and forehead while the rest of the face is normal or dry.

Normal

Select this option if you feel your skin isn’t oily or dry.

Dry

Skin often feels tight. It may occassionally peel or have rough flaky patches.

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

STEP 2 :

Skin Type

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Face

Arms

Chest

Stomach

Legs

Back

Butt

Feet

Check all that apply:

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

STEP 3 :

Problem Areas

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Acne

Stretch Marks

Excessive Hair

Scarring

Skin Discoloration

Sun Spots

Fine Lines/Wrinkles

Hyperpigmentaion

Check all that apply:

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

STEP 4 :

Skin Pathology - Skin Conditions

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Porcelain
Very Fair
Fair
Medium
Medium (Olive)
Light Brown
Dark Brown
Dark

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

STEP 5 :

Skin Pathology - Skin Tone

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PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

STEP 6 :

What Treatments Have You Tried At Home

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PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

STEP 7 :

What Medical Treatments Have You Had?

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Aspirin

Hydroquinone

Salicyclic Acid

Retin-A

Hydrogen Peroxide

Beta Hydroxyacids

Benzoyl Peroxide

None Of These

Check all that apply:

STEP 8 :

Health - Do You Have Allergies To The Following?

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

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Thank You

Your results will be emailed to you after being reviewed by our specialists

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done

STEP 9 :

Your Done

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Thank You

Your information has been submitted and someone will contact you soon.

PROGRESS

About You

Skin Type

Problem Areas

Skin Pathology

Products Used
at Home

Previous Clinical
Treatments

Health

Your Done