Thermage, a non-invasive radiofrequency treatment for skin tightening, has evolved significantly since its inception in 2002. Early versions were notably painful, but advancements have made the procedure more comfortable. The introduction of Comfort Pulse Technology (CPT) in later models reduced discomfort by delivering energy in a series of pulses with cooling intervals. Additionally, techniques such as applying topical anesthetics or using cooling devices during treatment have further minimized pain.
The Volnewmer treatment utilizes a water cooling system to enhance patient comfort by reducing pain during the procedure. This system effectively cools the skin’s surface, minimizing discomfort associated with the treatment. Additionally, the device’s design includes curved, gold-plated tips that ensure even energy distribution, further enhancing the overall comfort and effectiveness of the treatment.
These innovations aim to provide effective skin tightening with minimal discomfort, addressing concerns of those hesitant due to pain.
So, can Thermage easily achieve a «comfortable and painless» experience? In fact, based on the working principle of Thermage, it is entirely possible—and not difficult at all.
Hay algunos factores clave que hacen que Thermage sea capaz de lograr «comfortable and painless» resultados:
- Pases de tratamiento suficientes: Para la mayoría de los clientes, el número de pases utilizados en los tratamientos Thermage es el adecuado. Esto significa que no es necesario utilizar energía extremadamente alta (como niveles superiores a 5) para lograr resultados efectivos.
- Principio de funcionamiento único: La mayoría de los dispositivos de belleza por radiofrecuencia calientan el «moléculas de agua polares» in the skin by causing them to spin rapidly in an alternating electric field, creating friction and generating heat. This process helps to heat the dermis and fat layers, boosting fat metabolism. However, Thermage uses capacitive heating with monopolar radiofrequency. Its mechanism doesn’t rely on water molecules generating heat through friction; instead, it generates heat through electrical resistance as the current passes through tissues. This type of resistance-based heating is commonly used in various electric heating devices, such as electric blankets. Although Thermage uses much higher power than household appliances, we can effectively use the impedance and conductivity of different tissues to enhance efficacy and reduce pain—this is crucial.
- El dolor proviene de la temperatura alta: Thermage normalmente calienta los tejidos entre 60 °C y 70 °C para lograr efectos terapéuticos. Sin embargo, esta alta temperatura también es la que provoca el malestar. Si bien el cabezal de tratamiento avanzado de Thermage sopla aire refrescante sobre la piel durante el tratamiento, este efecto refrescante se vuelve menos efectivo a medida que el calor se acumula y la temperatura de la piel aumenta. Por tanto, para evitar el dolor, necesitamos encontrar una manera de enfriar la piel. Quizás te preguntes, «Si bajamos la temperatura de la piel a un nivel en el que no sea doloroso, ¿no afectaría eso la eficacia del tratamiento?» ¡Sigue leyendo y tus dudas quedarán aclaradas!
- Las terminaciones nerviosas sensibles al dolor se encuentran en la epidermis: The main nerve trunks are located in the dermis, but the pain-sensing nerve endings are in the epidermis. If we can lower the temperature in the epidermis without reducing the temperature in the dermis and subcutaneous fat layers, we can reduce pain while still enhancing the treatment’s effectiveness!
Comfortable and Painless Thermage Methods and Techniques
- Impedance and Conductivity of Different Tissues
It’s important to note that radiofrequency (RF) belongs to the electromagnetic wave category, meaning it is an electrical current. Different tissues in the body have different electrical conductivities. Impedance is typically inversely proportional to conductivity.
- Impedance values: Bone > Gordo > Skin (fibrous septa) > Tendons > Músculo > Blood Vessels > Nerves
La imagen de arriba es crucial porque demuestra cómo utilizamos la conductividad variable de diferentes tejidos para guiar la corriente eléctrica de manera efectiva.
Como se ve, la sangre tiene la conductividad más alta (aunque esto no está directamente relacionado con la técnica Thermage). Le siguen la piel húmeda y los tabiques fibrosos, mientras que los huesos, la grasa y la piel seca tienen una conductividad mucho menor. En otras palabras, la piel seca tiene una alta impedancia, lo que provoca altas temperaturas y dolor.
- Comprender la conductividad
Many people have an incorrect understanding of conductivity and impedance. In reality, tissues with high conductivity will allow more current to pass through. The more current that flows through, the more energy accumulates, which leads to higher temperatures. The human body can be described as a parallel circuit. When the current encounters tissues with high impedance, it bypasses them and chooses tissues with lower impedance and higher conductivity.
- Increasing the Conductivity of the Epidermis
Este es el punto más importante de este artículo. Cuando la epidermis está seca, su conductividad es baja y la impedancia es alta, lo que puede provocar altas temperaturas debido a esta impedancia, lo que provoca un dolor notable. La piel seca también puede ser más propensa a sufrir quemaduras debido a las altas temperaturas.
Según las diferencias de conductividad e impedancia entre la piel seca y húmeda, podemos aumentar la epidermis.’ Conductividad mediante hidratación. Esto reducirá la impedancia y permitirá que la corriente penetre más profundamente en la dermis y las capas de grasa.
But can increasing the conductivity of the epidermis lead to excessive energy accumulation and burns because more current flows through it? No. The epidermis is much thinner than the dermis and fat layers, so it doesn’t accumulate much energy. Additionally, the cooling mechanism of the Thermage treatment head blows cold air onto the epidermis, further reducing the risk of burns.
- How to Moisturize the Epidermis
A paper published in 1975 titled «Skin Impedance and Moisturization» mentioned that «an increase in environmental humidity leads to an increase in the water content of the stratum corneum, which results in reduced impedance. If dry skin is not moisturized, reduced environmental humidity will cause impedance to increase. Barrier moisturizers can correct dry skin, thus lowering the impedance of the stratum corneum.»
From this early paper, we learn that moisturizers with water-retaining functions can increase the water content in the epidermis, thereby lowering impedance and increasing conductivity.
Therefore, using a highly moisturizing occlusive cream (preferably) for 2-4 weeks before a Thermage treatment can significantly enhance the skin’s hydration.
However, I recommend a simpler and faster method for increasing the water content in the epidermis. In skincare routines, we often use masks to hydrate the skin. Although I don’t recommend frequent masking, using a mask before Thermage is a great way to quickly hydrate the skin. Studies have found that just 5-10 minutes of hydration can significantly change skin impedance.
Thus, applying a mask for 10 minutes before a Thermage session can rapidly increase the skin’s water content, enhancing conductivity and lowering impedance (which is key).
This technique is referred to by Thermage manufacturers as the «Impedance Reduction Method.»
However, during the procedure, the high temperatures from Thermage will cause the skin’s moisture to evaporate. To maintain the epidermis’ high water content, doctors should frequently apply hydrating coupling agents during the procedure. The coupling agent mainly consists of gel and water, providing excellent hydration and heat conduction. This allows heat to be better transferred to the air while keeping the epidermis hydrated. Frequent application of the coupling agent during the procedure is a critical method to maintain skin hydration.
As a rule of thumb, avoid waiting until the coupling agent visibly decreases before reapplying. Regular reapplication is essential.
- Moisturization Alone Isn’t Enough!
- Los pómulos, un área principal para el tratamiento Thermage, tienen una capa de grasa más delgada en comparación con otras áreas. Si Thermage se aplica repetidamente en el área de los pómulos, incluso con una hidratación adecuada de la piel, es posible que la corriente no penetre lo suficientemente profundamente, lo que provoca una acumulación de energía en la epidermis. Esto puede aumentar el dolor en el área. Por ello, al realizar Thermage en el pómulo, es recomendable levantar suavemente la piel debajo del pómulo, aumentando el espesor del tejido antes de proceder. Esta técnica puede reducir significativamente el dolor y también ayudar a reposicionar la piel, levantando el tejido graso caído.
- Since the Thermage treatment lasts for a relatively long time and heat is gradually accumulated to achieve high temperatures, skin moisture will evaporate over time. Although the coupling agent helps retain moisture, it’s not as fast-acting as a mask. During the procedure, it’s impractical to stop the treatment and apply a mask due to the patient’s pain. Here’s an exclusive tip: When pain becomes unbearable due to high skin temperature, use a handheld fan to blow air onto the skin for 30-60 seconds. The fan’s low power and short duration won’t affect the deeper layers of the skin, but it will cool the epidermis and relieve pain.
During the treatment, if a client feels significant pain, they should immediately inform the doctor. The doctor can repeatedly use the fan to cool the skin, which has proven to be highly effective.
With these methods, you can achieve a comfortable and painless Thermage experience without significantly lowering energy levels.
Resumen:
- By adjusting the conductivity and impedance of the epidermis, more Thermage current can be directed into the dermis and fat fiber layers, which can significantly reduce pain and improve treatment effectiveness.
- Las investigaciones muestran que la piel seca tiene baja conductividad y alta impedancia, mientras que la piel húmeda tiene alta conductividad y baja impedancia. Dado que el dolor lo perciben principalmente las terminaciones nerviosas de la epidermis, podemos aumentar el contenido de humedad de la epidermis para aumentar su conductividad y reducir su impedancia, evitando así que la corriente de RF se acumule y genere calor en la epidermis.
- Los métodos para aumentar el contenido de humedad de la epidermis incluyen:
- (1) Aplicar un humectante oclusivo que retenga el agua, como vaselina, un mes antes del procedimiento.
- (2) Inmediatamente antes del procedimiento, aplique una mascarilla durante 5 a 10 minutos para aumentar rápidamente el contenido de humedad de la epidermis.
- (3) Aplicar repetidamente un gel de acoplamiento rico en humedad durante el procedimiento.
- Most bony areas have thinner fat layers compared to other regions. If repeated operations are performed in these areas, even if the epidermis has a high moisture content, the reduced penetration of the current into deeper layers will lead to an increase in current accumulation in the epidermis, causing more pain. Therefore, when working on the cheekbone area, it helps to lift and pile the skin tissue below the cheekbones to thicken the layer before proceeding, which can significantly reduce pain in this area.
- Exclusive Tip: When unbearable pain occurs due to high skin temperature during treatment, using a handheld fan to blow cool air onto the face for 30-60 seconds can help reduce the skin’s surface temperature. This method can effectively relieve pain without significantly affecting the temperature of the deeper dermis layers. Have you learned this trick?
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