Consultation – Clear & Shine

Step 1 of 5 – Your Skin Concern

Comments

This field is for validation purposes and should be left unchanged.

What is your main skin concern?(Required)

Acne & Breakouts

Anti-Ageing & Fine Lines

Hyperpigmentation & Dark Spots

Rosacea & Redness

Skin Texture & Pores

Sensitive & Reactive Skin

What is your main skin concern?(Required)

Impurities & blemishes

Blackheads

Pimples (papules & pustules)

Redness or inflammation

Clogged pores

Acne scars & marks

Uneven skin texture

Enlarged pores

Other

How long have you wanted to improve your skin?(Required)

Less than 1 year

1–2 years

More than 2 years

How would you describe your facial skin?(Required)

Oily all over — shiny, enlarged pores

Dry & tight — flaky, uncomfortable

Combination — oily T-zone, dry cheeks

Balanced & normal — rarely reacts

How sensitive is your skin?(Required)

This includes redness, itching, tightness, or burning.
1 = Barely sensitive · 5 = Very sensitive

How satisfied are you with your skin right now?(Required)

This helps us track your progress over time.
1 = Very unhappy · 10 = Very happy

What is your gender?(Required)

Female

Male

Are you pregnant or breastfeeding?(Required)

Some ingredients cannot be prescribed during pregnancy or breastfeeding.

Yes

Are you currently trying to get pregnant?(Required)

Yes

Do you have any known allergies?(Required)

Especially allergies to medications or cosmetic/medical ingredients.

Yes

No, not that I know of

What are you allergic to?

Include any known allergies to medications, cosmetic or medical ingredients.

Do you have any medical conditions we should know about?(Required)

Conditions you regularly see a doctor for may affect our diagnosis.

Yes

Please describe your condition(s)

Include any conditions you regularly see a doctor for.

Are you currently taking any medications?(Required)

Select all that apply, this helps your dermatologist prescribe safely

None of the below

Contraceptive pill or hormonal contraception

Antibiotics

Oral retinoids such as Roaccutane

Other prescription medication

Are there any ingredients you'd like to avoid?(Required)

Yes, I have specific preferences

No, let the doctor decide

Which ingredients would you like to avoid?

E.g. retinol, fragrance, benzoyl peroxide.

Upload photos of your skin

No makeup. Natural daylight. Front and both sides.

Left side

Turn your head left. Natural daylight, no makeup.

Max. file size: 512 MB.

Front

Face the camera straight. Natural daylight, no makeup.

Max. file size: 512 MB.

Right side

Turn your head right. Natural daylight, no makeup.

Max. file size: 512 MB.

Name(Required)

First Last

WhatsApp (Phone Number)(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Consent(Required)

I agree to the Clear & Shine Terms & Conditions and Privacy Policy. I understand that my photos and personal information will be reviewed by a certified dermatologist for the purpose of creating my personalised treatment plan. I confirm that the information I have provided is accurate.

I agree to the Clear & Shine Terms & Conditions and Privacy Policy.

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Your skin has waited long enough.

+971 54 757 1772