What should be used during Thermage procedure,gel creme or nothing at all?

A coupling gel is applied to the skin during treatment with Thermage. I have found that being generous with the amount of this gel applied to the skin tends to reduce patient's pain level. The use of this gel is part of Solta's treatment protocol for the use of Thermage. 

Thermage CPT is radiofrequency
energy that tightens skin and stimulates collagen. Coupling gel is applied
before the treatment to help glide the hand piece and distribute energy evenly.
It is not an individual preference to use it or not, it is part of the
treatment protocol.

Thermage is a wonderful laser that tightens the skin.  First a grid is put on the skin to mark the treated area and then coupling fluid is used throughout the procedure.  I have been very happy with Thermage especially with the new CPT tip.  It is important to find an experienced Board Certified Dermatologist for the best results.