What Is Thermage? We Asked a Derm About This Nonsurgical Way to Tighten Skin

With celebrity fans like Jennifer Aniston and Demi Moore, Thermage has a reputation for being one of the best nonsurgical treatments available for those looking to target loose skin without going under the knife. To get a better understanding of what it is and how it works, we asked Macrene Alexiades, MD, PhD, FAAD (and one of the first doctors to work with the technology) to share her insights.

“Thermage is a non-invasive radiofrequency therapy that treats wrinkles and loose skin on the face, around the eyes and on the body by promoting new collagen growth,” explains Dr. Macrene. (As a refresher, collagen is a naturally occurring protein in our skin that’s responsible for giving it structural support. As we age, we produce less collagen, which is when wrinkles form and skin begins to sag.) By using radiofrequency energy to heat up the deeper layers of skin—and thus, stimulate collagen production—areas of skin that were previously loose can appear smoother and tighter over time.

When Thermage was first approved by the FDA back in 2002, it was known for being fairly painful. However, Dr. Macrene assures that it has since “been modified to decrease discomfort and improve safety and efficacy” so most patients can tolerate it well.

Technically, Thermage is suited for anyone who has mild-to-moderate skin laxity (basically, loose skin or mild sagging) and is looking for some tightening. “Radiofrequency is also the optimal tightening treatment for pigmented skin,” adds Dr. Macrene, and “Thermage is considered the first radiofrequency nonsurgical ‘facelift’ for lower face and jawline tightening.” That said, for best results, it is usually combined with filler or other modalities.

“You don’t have to do anything specific to prep for Thermage, though a topical anesthesia is recommended once you arrive for treatment,” says Dr. Macrene. “Afterwards, your skin can be sensitive to the sun, so you want to apply sunscreen with a higher SPF of 50 or greater. You should also avoid using any harsh or irritating ingredients on your skin initially, though it is fine to apply makeup following your treatment to conceal any redness,” she adds. (Dr. Macrene recommends the High Performance Tinted Moisturizer from her line as “a gentle option for coverage that also delivers active ingredients like resveratrol, peptides and hyaluronic acid to boost results.”)

“The range for a single treatment is between $1000 and $5000 based on the size of the treatment area and where you live,” says Dr. Macrene. While this is definitely a sizable investment, the good news is that Thermage doesn’t require multiple follow-up appointments. At most, patients elect to get the treatment once a year as part of a maintenance program.

One final thing to note is that the results take time. Though you may notice minimal tightening directly following your treatment, full results will take anywhere between three to six months to show, so be patient and plan accordingly if you have a special event coming up.