Do Skin Tighteners Really Work?

In the past, the only way to tighten loose skin was by surgically excising it. While that is still the most reliable option to date, nonsurgical machines tighteners and devices that firm slack skin have definitely made their mark. But do they really work? Here's what you need to know about the two main options, Thermage and Ultherapy. 

Thermage

What it is: A radio frequency–based treatment that can be used on the eyelids, around the eyes and on the face and body to improve saggy skin. Taking 15 to 60 minutes to perform, depending on the area treated, skin is first cooled before it is heated (this stimulates collagen creation) and then cooled again. It’s the heating of collagen fibers that helps smooth and tighten the skin. Thermage has gone through many changes since it first entered the market—the third generation of the machine is currently used.

The Pro: “Thermage may be better for patients in their 30s and 40s, because the collagen fibers are more responsive,” says Hermosa Beach, CA, dermatologist Annie Chiu, MD.

The Con: “It can create new collagen in the skin, however some patients need tightening beneath the skin and would benefit from other types of treatments. It comes down to making the right diagnosis,” says New York facial plastic surgeon Lee Ann Klausner, MD.

The Verdict: It works but have realistic expectations. “While Thermage does heat the skin to create collagen, it may not be able to go as deep as some patients may need it to, so you may not get the desired result,” says Dr. Klausner.

Related: What are Skin Tighteners? 

Ultherapy

What it is: An FDA-approved, noninvasive technology that uses ultrasound to lift and tighten skin on the neck. A handpiece is placed on the skin and a display allows your doctor to see where energy is delivered. Because Ultherapy is not totally pain-free—there’s a vibrational feeling and deep heat—you may be given pain medication. It works best on those with loose skin rather than excess fat.

The Pro: Dr. Chiu says that Ultherapy does work and does have good science behind it. “But the problem with any of these treatments is that the results are not predictable on every patient. Some have really good results, others have minimal results.”

The Con: Smithtown, NY, dermatologist Marina Peredo, MD, says that while Ultherapy is more tolerable now than when it first came out, it is still not totally pain-free. “Be aware of discomfort. It hurts because it’s sending ultrasound waves with high energy into the deeper layers of skin to tighten the muscle and form collagen. Great results outweigh the discomfort.”

The Verdict: It works, but you have to be the right candidate and you will need more than one treatment. “I use Ultherapy a lot in my practice and see good success in those with more advanced signs of elasticity loss when more than one treatment is done,” says Dr. Klausner