It's no secret that women look to celebrities for fashion and beauty tips. So when women get a chance to hear from celebrities like Gwyneth Paltrow, who at 40 looks as bright faced as she did in her 20's, they listen.
In an interview in this month's , Paltrow talks about the dichotomy of her health and beauty choices:
"I think it's a mix....You know, I use organic products, but I get lasers. It's what makes life interesting, finding the balance between cigarettes and tofu."
Paltrow admitted to trying many non-surgical cosmetic procedures, saying "I would be scared to go under the knife, but you know, talk to me when I'm 50. I'll try anything. Except I won't do Botox again, because I looked crazy. I looked like Joan Rivers!"
But Paltrow did approve of the treatment she got from her dermatologist in Los Angeles:
"[My dermatologist] gave me this amazing laser the last time I was there. It's called Thermage. It's not invasive. I went out to dinner right afterward and I didn't look crazy, but it's quite painful. It feels like someone's smacking your face with a rubber band that has an electric shock in it. But I would do it again, because I feel like it took five years off my face."
What is Thermage?
Thermage is the brand name of one of several non-invasive cosmetic procedures which uses radiofrequency technology.
A few words about skin aging: As we age, our skin becomes subject to photodamage -- a process known as solar (or actinic) elastosis. Clinically, this is seen as fine lines, rhytides (wrinkles), skin laxity, skin discoloration and the formation of telangiectasias.
At the microscopic level, one sees an accumulation of elastic fibers in the dermis and mid-dermis. The collagen fiber matrix becomes increasingly disorganized. It is also prone to increased breakdown, with decreased synthesis of new collagen to replace it.
The traditional method of surgical repair with procedures such as blepharoplasty, brow or chin lifts is being replaced by less invasive procedures as the demand for cosmetic procedures has increased.
Ablative laser resurfacing uses intense pulsed light to treat and remove wrinkles arising from photo-aging. The process induces controlled wounds on the skin, prompting it to heal itself by creating new cells. The main disadvantages include downtime that can last 4 to 6 weeks and complications that include oozing, bleeding, and infection.
Non-ablative lasers were developed to address these problems. However, because they create less energy penetration than ablative procedures, they are better suited for mild to moderate photo-aging, and may require more treatments (typically four to six) to get the desired effects. Recovery time is decreased -- only about 3 days after each session.
Radiofrequency Technology
Radiofrequency (RF) technology also produces thermal damage to the dermis; however it accomplishes that by using an electric current rather than light. The technology has been around since the 1920's, when it was used in electrocautery devices. Since 2002, when it was approved by the FDA, it has been used for non-ablative skin rejuvenation.RF devices produce an electric current using electromagnetic radiation (frequency range 3kHz - 300MHz). Depending on the characteristic impedance of a particular tissue, heat is produced by this current. Subcutaneous fat is a high-impedance tissue and generates greater energy and thermal effects.
During the procedure, a cooling spray is applied to the skin which protects the epidermis. Heat produced by the device causes partial denaturation of dermal collagen, which has been shown to lead to collagen contraction and thickening. Some of this contraction is seen immediately after the procedure. Further contraction and tightening occurs over the next few weeks, as the natural inflammatory response leads to wound healing and new collagen synthesis.
There are three forms of RF: monopolar, bipolar, and fractional. The main difference between mono- and bi- polar devices is the configuration of the electrodes. The difference between these and fractional devices is that the newer fractional approach creates areas of affected skin adjacent to unaffected areas. According to , "The treated areas have resulting thermal damage in the deep dermal collagen, which stimulates would healing, dermal remodeling and new collagen, elastin, and hyaluronic acid formation. The unaffected areas located in between affected areas initially maintain skin integrity but, in the long term, serve as a reservoir of cells that promote and accelerate wound healing."
Many studies (see the review by ) have shown the efficacy of RF procedures for use in the treatment of periorbial rhytides, skin laxity, acne vuglaris and atrophic scarring, cellulite and skin rejuvenation.
Side effects are generally mild and may include redness, swelling and mild/moderate pain during treatment. Potential risks include itching, blanching, blisters, bumps, burns, scabbing, scarring, bruising pigment changes, altered sensations, surface irregularities, and herpes reactivation.
Although the results of RF may not be considered as equivalent to those obtained with surgical procedures, its association with fewer side effects and significantly shorter recovery times make this procedure more palatable for many patients who may be considering having a cosmetic procedure.