INTIMATE/BODY BLEACHING TREATMENT

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Virginia Parks
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TREATMENT (PAGE 1) Vivant s Miami Bleach system consists of a series of professional body bleaching treatments in combination with a pre-conditioning regimen and post-treatment care.

1 TREATMENT (PAGE 1) Vivant s Miami Bleach system consists of a series of professional body bleaching treatments in combination with a pre-conditioning regimen and post-treatment care. Miami Bleach is the right treatment for clients who are prone to hyperpigmentation and are looking for a results-driven treatment that will provide an even skin tone. It targets discoloration in intimate areas of the body, as well as the under arms, inner thighs, elbows, knees and ankles. AREAS OF TREATMENT: Labia Majora, Inner Thighs, Anus, Perineum, Intergluteal Cleft (inner buttocks), Underarms, Elbows, Knees and Ankles MIAMI BLEACH AT-HOME REGIMEN PRODUCTS The Wash* The Body Bleach* The Calming Lotion* IN-OFFICE PRODUCTS AND ITEMS FOR TREATMENT Miami Bleach Prep* Miami Bleach Peel Step I* Miami Bleach Peel Step II* 4 x 4 woven gauzes Small portable fan Gloves 16 oz bottle of water Disposable garments PRIOR TO TREATMENT: 1. INITIAL CONSULTATION : The initial visit includes an explanation of the treatment including the pre-conditioning, the possible side effects and contraindications. The client should also be provided with the At-Home Regimen to prep the treatment area. During this visit, the client reviews medical history (see below) with the skin care specialist to determine whether or not the client is a candidate for this procedure. Contraindications and Side Effects: If the client indicates a history of diabetes, psoriasis, herpes or genital warts, do not proceed with the treatment. The peel will aggravate these conditions. If the client has had recent procedures (surgical or non-surgical) performed in the area to be treated, those areas need to be completely healed prior to the peel. Review the client s ethnic origin. Although a client could appear to be a Fitzpatrick 2, they might have a relative that is a Fitzpatrick 4. This might show up as reactive hyperpigmentation if the client is not preconditioned long enough. Depending on the Fitzpatrick, the results may vary. Possible side effects are redness, reactive hyperpigmentation, peeling, burning, and irritation. *Included in system

2 TREATMENTS (PAGE 2) 2. EXAMINATION & SCHEDULING: The skin care specialist will perform a physical examination of the area of concern to determine the Fitzpatrick skin type, tone of the dyspigmentation and identify any signs of irritation that need to be healed before the peel. The skin care specialist should wear latex-free gloves and provide the client with disposable garments for the examination. If the client is scheduling for a vaginal peel, the appointment should be made during a week when the client is not menstruating. Instructions to the client: Do not use The Body Bleach 7 days prior to waxing Do not tan during treatment Shave or wax 48 hours before the peel Wash the area with Miami Bleach The Wash before arriving for the treatment Wear loose clothing on the day of the peel Drink water and stay hydrated before and after the treatment Review the Informed Consent Form for Miami Bleach with their treatment specialist 3. AT-HOME SKIN CARE REGIMEN: Based on the Fitzpatrick and the area of concern, the skin care specialist should recommend an ideal prep time before scheduling a peel. The At-Home Regimen should be done every other night until the skin acclimates, then every night prior to professional treatment. For best results, all clients must precondition. The skin care specialist should inform the client that one treatment may not produce desired results. Depending on the skin type and the Fitzpatrick, a series of 3 or more treatments may be required to achieve optimum results. Length of Preconditioning by Skin Type: Fitzpatrick Skin Type TYPE 1: Always burns, cannot tan TYPE 2: Usually burns, sometimes tans TYPE 3: Sometimes burns, sometimes tans TYPE 5: Rarely burns, always tans Length of Preconditioning 1-2 weeks 2-3 weeks 4-6 weeks 8-12 weeks TREATMENT: 1. ARRIVAL: Review the Informed Consent Form once again with the client; they may have new questions and concerns. Once the client signs the form, they should be provided with a disposable undergarment to change into before the treatment. Encourage the client to ask questions and ensure their comfort in preparation for the procedure. You should also discuss posttreatment care at this point. 2. PROCEDURE: Important note: when performing a vaginal bleaching, no product should be applied to the inner vaginal lip area (the labia minora). Product should be applied only to outer vaginal lip area (the labia majora) to avoid injury to delicate skin.

3 TREATMENTS (PAGE 3) Position your client on the treatment bed according to the type of peel you are going to perform (see IIllustrations PDF). The area to be treated should first be cleansed and prepped with Miami Bleach Prep. Position a fan to relieve any possible burning sensation. Next, use a folded 4 x 4 woven gauze pad to apply Miami Bleach Peel Step I. Hold skin tight. Using gentle wiping motion, apply one layer to the area of treatment. Wipe from top to bottom; then, from bottom to top. Maximum Number of Miami Bleach Peel coats: Area Miami Bleach Peel Step I Miami Bleach Peel Step II Labia Majora 2 2 Inner thighs 3 3 Anus 3 3 Perineum 2 2 Inter-gluteal cleft (inner buttocks) 2 2 Underarms 3 3 Elbows & Knees 2 to 3 2 to 3 Allow the client to relax, with the fan between each layer of application. Following the same procedure as above, apply two to three coats of Miami Bleach Peel Step II. After all applications are complete, client should rest on their side with the fan continuously blowing on the treated area for about ten minutes. Once the client can sit up, the skin care specialist should provide the client with a bottle of drinking water and instruct them to stay hydrated for the rest of the day. Instruct the client not to wash the area for at least six hours. They may sleep without underwear, if intimate or inner thigh treatment was performed. 3. POST-PEEL REGIMEN: The client should be advised not to have sex or swim for six days. If itching occurs, the client can calm the area with cold compresses or an ice pack and by applying Miami Bleach The Calming Lotion. Between days three and five, the client s skin will flake. Instruct them not to pick or pull at the flakes. The skin care specialist should instruct the client to continue using Miami Bleach The Wash and Miami Bleach The Calming Lotion as needed to soothe the discomfort. Loose clothing should be worn for a week to avoid causing irritation to the area of treatment. If excessive irritation occurs, the client should schedule an appointment with the skin care specialist as soon as possible. If there are no issues with the treatment, the client should schedule a follow-up visit in a week.

ILLUSTRATIONS WITH STEPS (PAGE 4) UNDER ARM BLEACHING STEP 1 Ask client to undress from the waist up and remove jewelry Cover the upper body and put on a protective cap over the hair Place arm over a

the treatment area. Swipe from bottom to top then top to bottom. STEP 3 Place fan approimately 15 inches in front of the area being treated to ease the burning sensation.

4 ILLUSTRATIONS WITH STEPS (PAGE 4) UNDER ARM BLEACHING STEP 1 Ask client to undress from the waist up and remove jewelry Cover the upper body and put on a protective cap over the hair Place arm over a small pillow or folded towel STEP 2 Dampen a 4 x 4 gauze pad with Miami Bleach Prep and wipe the underarm area Dampen a 4 x 4 gauze pad with Miami Bleach Peel Step I and wipe with firm pressure over the treatment area. Swipe from bottom to top then top to bottom. STEP 3 Place fan approimately 15 inches in front of the area being treated to ease the burning sensation. Let the client relax with the fan for a few moments between each layer of application Repeat using Miami Bleach Peel Step II Finish one side, then move to the other side Maximum number of coats of Miami Bleach Peel: Area Miami Bleach Peel Step I Miami Bleach Peel Step II Underarms 3 3

ILLUSTRATIONS WITH STEPS (PAGE 5) VAGINAL AND INNER THIGH BLEACHING STEP 1 Ask client to undress from the waist down and to put on the disposable under garment Have client lie down and raise leg as

product to the labia minora (inner vaginal lip area) Hold the skin with the hand as shown, so that the skin is stretched evenly For the inner thigh, swipe from top to bottom and repeat from bottom to

Repeat from top to bottom STEP 3 Dampen a 4 x 4 gauze pad with Miami Bleach Peel Step I and apply one layer with firm pressure to labia majora and inner thigh in same manner as in the prep step

5 ILLUSTRATIONS WITH STEPS (PAGE 5) VAGINAL AND INNER THIGH BLEACHING STEP 1 Ask client to undress from the waist down and to put on the disposable under garment Have client lie down and raise leg as shown Drape client, exposing only the inner thigh or outer vaginal lip (labia majora) STEP 2 Dampen a 4 x 4 gauze pad with Miami Bleach Prep and wipe the labia majora and inner thigh DO NOT apply product to the labia minora (inner vaginal lip area) Hold the skin with the hand as shown, so that the skin is stretched evenly For the inner thigh, swipe from top to bottom and repeat from bottom to top For the labia majora, start at the bottom of the outer lip and gently wipe upward. Repeat from top to bottom STEP 3 Dampen a 4 x 4 gauze pad with Miami Bleach Peel Step I and apply one layer with firm pressure to labia majora and inner thigh in same manner as in the prep step Again, DO NOT apply product to the labia minora (inner vaginal lip area) STEP 4 Position a fan to relieve burning sensation Allow client to relax a few moments with the fan between each layer of application and repeat on other leg Repeat steps three and four using Miami Bleach Peel Step II Maximum number of coats of Miami Bleach Peel: Area Miami Bleach Peel Step I Miami Bleach Peel Step II Labia Majora 2 2 Inner thighs 3 3

ILLUSTRATIONS WITH STEPS (PAGE 6) ANAL AND INNER BUTTOCKS BLEACHING STEP 1 Ask client to undress from the waist down and

STEP 2 If preferred, client may kneel with forearms resting on the treatment bed STEP 3 Dampen a 4 x 4 gauze pad with

Dampen a 4 x 4 gauze pad with Miami Bleach Peel Step I and swipe once over anus, inner buttocks and perineum with firm

layer of application Repeat steps four and five using Miami Bleach Peel Step II Maximum number of coats of Miami Bleach

6 ILLUSTRATIONS WITH STEPS (PAGE 6) ANAL AND INNER BUTTOCKS BLEACHING STEP 1 Ask client to undress from the waist down and to put on the disposable under garment Have client lie down on her/his side Position drape to leave buttocks exposed STEP 2 If preferred, client may kneel with forearms resting on the treatment bed STEP 3 Dampen a 4 x 4 gauze pad with Miami Bleach Prep and apply to anus, inner buttocks and perineum with gentle wiping motion Have fan set up ready for use Dampen a 4 x 4 gauze pad with Miami Bleach Peel Step I and swipe once over anus, inner buttocks and perineum with firm pressure STEP 4 Position a fan to relieve burning sensation Allow client to rest a few moments with the fan between each layer of application Repeat steps four and five using Miami Bleach Peel Step II Maximum number of coats of Miami Bleach Peel: Area Miami Bleach Peel Step I Miami Bleach Peel Step II Anus 3 3 Inter-gluteal cleft (inner buttocks) 2 2 Perineum 2 2

7 CLIENT INSTRUCTIONS MIAMI BLEACH PEEL APPOINTMENT DATE AND TIME: Stop using Miami Bleach The Body Bleach 5 days before the peel. You may resume approximately 5 days after your peel Please resist picking or scratching your skin the week before the Miami Bleach Peel Do not get sun tanned, sun burned, wind burned or otherwise red in the area you are peeling this week Drink 8 glasses of water (64 fl oz) with 24 hours of the peel. Make sure to drink plenty of water before and after the treatment Wear loose clothing to your appointment. Do not wear underwear on the day of the peel, if receiving an intimate bleaching. Wash the area with Miami Bleach The Wash before arriving to the clinic Do not shave, wax or irritate the area of treatment for up to 48 hours before the appointment Make sure you have been instructed of your post peel skin care regimen. Continue to wear loose clothing for a week after your procedure to avoid excessive irritation If excessive irritation occurs, schedule an appointment with your skin care specialist as soon as possible. If there are no issues you should schedule your follow-up visit with in a week of your procedure We look forward to seeking you soon!

8 DAY-OF CHECKLIST CLIENT NAME: DATE: Is the Informed Consent form signed twice? Yes No Confirm that your client does not have a history of diabetes, herpes, psoriasis, or gential warts. Yes No Have before photos (with client s consent) been taken and are they in focus? Yes No Is your client aware of the down time post peel? Yes No Are all the client s questions regarding the procedure noted and addressed? Yes No Has the client removed all intimate body piercings (intimate bleaching only)? Yes No Have you reviewed the Miami Bleach Post-Peel instructions with your client? Yes No

Prepared by the Gynecology/Oncology Clinic Nursing Staff of the Ottawa Hospital Shirley E. Greenberg Women s Health Centre, Riverside Campus

Prepared by the Gynecology/Oncology Clinic Nursing Staff of the Ottawa Hospital Shirley E. Greenberg Women s Health Centre, Riverside Campus Vulvar Care Disclaimer This is general information developed by The Ottawa Hospital. It is not intended to replace the advice of a qualified healthcare provider. Please consult your own personal physician