A 16-year-old, a deposit, and a request for before-and-after photographs
Your Instagram account receives a direct message from a 16-year-old asking to book a "deep-cleansing facial with salicylic peel", and she pays a €30 deposit from her own debit card. She arrives with a friend, says her mother knows but cannot attend, and her phone is switched off. She has moderate inflammatory acne with several excoriated papules on the chin, and asks you to "squeeze everything" and to take before-and-after photographs for your page, promising to sign "whatever paperwork you need". She then asks you not to tell her mother because "she'd freak out". Your published price list states that under-18s may receive peels with written parental consent; your insurer requires signed consent for all minors and separate written consent for photography. The friend is filming on her phone.
1. Can you treat her today? Justify your decision against consent, capacity and insurance requirements.
Read the worked answer
No. I do not perform the peel or the extraction session today.
Consent for a minor is not simply a signature; it requires a person with legal authority. In Cyprus a 16-year-old is a minor for these purposes, and my own published terms and insurer both require written parental/guardian consent before a peel on an under-18. "My mother knows" delivered by the client is not verification - it is hearsay, and the mother is uncontactable. A deposit paid from her own card proves nothing about authority either; I refund it or hold it against a future consented booking.
Capacity to understand is not the same as legal authority to consent. Even where a young person understands the treatment, proceeding without the required consent would breach my insurer's conditions and leave me personally exposed if there were a complication - a burn, pigment change or scarring on a minor's face.
The acne also matters clinically: excoriated papules are open skin, and aggressive extraction over inflamed lesions risks scarring and PIH in a client who is already picking. My answer is that I would want a gentle, appropriate plan after assessment with a guardian present, not "squeeze everything" today.
What I can do: a short consultation, written information about the options and aftercare, and an appointment offered at a time the mother can attend. I state this once, kindly and without lecturing, and I do not negotiate.
2. The photographs, the deposit and the friend filming - how do you handle each, and what do you document?
Read the worked answer
Photographs: I decline. Clinical images are personal data, and images of a minor revealing a skin condition are sensitive; consent must come from the person with legal authority, must be specific about where the image will appear, must be freely given, and can be withdrawn. "I'll sign whatever" from a 16-year-old who is keen to be featured is not freely given consent in any meaningful sense. No photograph is taken, including on a personal phone, and no image is posted. I explain that this is a rule I apply to everyone, which removes any sense that I distrust her.
Filming: I ask the friend politely to stop and to delete anything showing the treatment area, and explain that filming is not permitted in treatment rooms. If she refuses, the consultation ends; I do not allow recording of a minor or of my premises.
Deposit: refunded in full or held with a clear written note that it is transferable to a booked appointment with guardian consent. I never retain a minor's payment as leverage.
Record: date, that the client attended unaccompanied, her age, that parental consent was required and not available, that the mother could not be reached, the treatments requested, what was declined and why, the photography refusal, the filming request, the refund position, and the information given. I keep it factual and non-judgemental, avoid speculating about her home situation, and store it under data-protection rules with restricted access. If there were any safeguarding concern beyond ordinary teenage friction, I would follow our safeguarding lead rather than handle it alone.