pigmentation form quiz

New Pigmentation Questions

Full Name

Email ID

Age

WhatsApp Number

Gender

Select your skin type

Sensitive Skin

Normal Skin

Dry Skin

Combination Skin

Oily Skin

How long have you been experiencing pigmentation?

Less than 3 months

3-6 months

6-12 months

More than 1 year

How severe is your pigmetnation?

Mild (light spots, barely noticeable)

Moderate (visible spots but not severe)

Severe (dark and very noticeable spots)

Have you previously used any treatments for pigmentation?

Yes

No

How much direct sun exposure do you get daily?

Minimal (less than 1 hour/day)

Moderate (1-2 hours/day)

High (more than 2 hours/day)

Do you use sunscreen regularly?

Yes, Daily

No

Rarely

Current skincare routine for pigmentation:

Basic (cleanser, moisturizer)

Advanced (including serums, treatments)

None

Are you pregnant or breastfeeding?

Yes, pregnant

Yes, breastfeeding

No

Do you experience any skin changes during to your menstrual cycle?

Yes

No

Have you tried any hormonal treatments (like birth control pils) ?

Yes

No

Upload your face image *

Choose File box of the right and left images.

Right side image of your face issues

Choose File

Left side image of your face issues

Choose File

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