Skin Photoaging and its consequences(Required)
Actinic keratosis(Required)
Acne / Post-acne(Required)
Other pigmentation disorders(Required)
Pre-malignant lesions(Required)

Application site


Full Face(Required)
Periorbital area(Required)
Perioral area(Required)


Neck/ Decolletage(Required)

Efficiency and satisfaction: Physician (MD)/ Patient (Information reported to physician)

MD: How to qualify the efficiency of the product?(Required)
MD: Level of satisfaction regarding SKIN CONDITION(Required)
MD: GENERAL level of satisfaction after the treatment (Taking into account: efficiency, ease of use, adverse events)(Required)
Patient: Level of satisfaction regarding SKIN CONDITION(Required)
Patient: GENERAL level of satisfaction after the treatment (Taking into account: comfort during/after treatment, adverse effects, skin condition)(Required)


Where Practice(Required)

Your phone number

Phone number
On behalf of Dermazone Trading LLC, we treat the personal data that you provide to us with the purpose of conducting the survey of which you are taking part. The data provided will be kept for as long as the present relationship is maintained or for as long as it is considered necessary to comply with the legal obligations and attend to the possible responsibilities that may derive from the fulfilment of the purpose for which the data was collected. You can exercise your rights of access, to rectification, to erasure, to restrict processing, to data portability, to object, and those in relation to automated decision making and profiling before by addressing to the email address , attaching a copy of your ID or equivalent document.

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