The Bottom of the Ship

Therma Cool TC: For Skin Tightening, Active Acne, and Scars
Sherry S. Collawn, MD, PhD
Radio frequency treatments with the nonablative Thermage Therma Cool TC
system have been used to tighten lax skin, decrease wrinkles, treat active
acne, improve acne scars and other scars, and treat axillary hyperhidrosis in
a total of 36 patients since October 2003. Seven of these patients have had
multiple treatments. The patients who have undergone full face Therma Cool
treatments for wrinkles and skin laxity have at two months post treatment
demonstrated a reduction in lateral canthal lines, with an increased tightness
of the skin of the periorbital region, cheeks and neck. Along with the skin
tightening and improved skin texture there has been a decrease in
hyperpigmentation and telangiectasia. Patients often show eyebrow
elevation after a single treatment and this has been more pronounced after
two treatments. Patients with active acne have shown improvement in their
acne after one treatment and with two treatments the improvement in the
inflammatory acne and acne scars has been dramatic. In one patient
treatment of the axilla with Thermage lessened the symptoms of axillary
hyperhidrosis for three months. Complications (blisters) have been few and
have resolved quickly.
Method: Patients presenting with laxity of the facial skin, wrinkles, acute
inflammatory acne and acne scars have undergone single and multiple
treatments with Thermage Therma Cool TC. The treatment parameters used
in these first 36 patients were those recommended by Thermage and
consisted of two to three passes at high energy settings using the standard
treatment tip. In addition to topical anesthetics, full face treatments often
also required nerve blocks. After the American Society for Laser Medicine
and Surgery meeting in April 2004, Thermage recommended using lower
energy settings for 4 to 5 passes. This is the protocol currently being used
with the new fast tip and usually requires no more than topical anesthetics.
Results: The patient shown in figure 1A underwent one treatment of the
forehead and cheeks with 2 passes of Therma Cool TC at high settings of 14
and 15(106 and 124 joules). In 2B she is shown 2 months after the procedure
and she demonstrates increased skin tightness of the periorbital and cheek
region with improved skin pigmentation. Some eyebrow elevation has
occurred and there is an increase in the vertical aperture of her eyes.
The patient in figure 2A underwent 2 treatments of Therma Cool TC around
the eyes. The second treatment was at 1 month and she is shown in figure 2B
at two months. Lateral eyebrow elevation has occurred.
The patient in figure 3A presented with acute inflammatory acne and acne
scarring. In figure 3B three months after two treatments given one month
apart he shows good improvement in the acute inflammatory acne and
reduced acne scarring.
Conclusion: The Thermage Therma Cool TC has been helpful in tightening
lax skin, and in the treatment of wrinkles, active acne, and scars. In
addition, other skin conditions such as axillary hyperhidrosis respond to
radio frequency therapy.
Figure 1A. Pre-Treatment.
Figure 1B. Two months after one
Therma Cool TC treatment of the
Forehead and Cheeks.
Figure 2A. Pre-Treatment.
Figure 2B. Two months after two
Thermage Therma Cool TC
treatments of the periorbital region.
Figure 3A. Pre-Treatment
Figure 3B. After two Thermage
Therma Cool TC treatments.
1. Ruiz-Esparza, J. and Gomez, J.B. Nonablative Radiofrequency for Active
Acne Vulgaris: the use of Deep Dermal Heat in the treatment of Moderate to
Severe Active Acne Vulgaris (Thermotherapy): a report of 22 cases.
Dermatol. Surg. 29: 333-339, 2003.