Ellen Barkin caught my eye in O (Oprah's magazine). As she would, given she's a rather handsome woman. She was being extremely candid about her beauty and anti-aging routine, admitting to having regular Thermage sessions that she didn't think were having much effect and that were really painful "like burning hot elastic bands snapping against my face". On the other hand, Barkin said, Fraxel doesn't hurt and it has made a huge difference.

I've always thought that Thermage is for the feeble-minded. Every time you see those before and after photos, the after ones look worse (you can see an example by clicking here). Even its advocates say that the results are subtle. The pain, however, is not.

I just came across a Dr Robert Mindall, commenting on a message board on a professional website for plastic surgeons. He said he was embarrassed by the amount of money he's taken from Thermage patients for such a pointless procedure. He has now thrown his Thermage machine away. Good on ya, doc. Would that all in your profession were so ethical.

Dr Mindall also had a strong point of view on Fraxel, but I shall come back to that. First of all what is it?

Fraxel is a kind of laser treatment that, instead of putting out a solid beam, it puts out lots of very tiny beams that punch microscopic holes in the skin. This approach means that damaged tissue can be targeted, leaving healthy tissue unscathed. Three to five sessions are required about two weeks apart.

Although marketed as an anti-aging treatment, Fraxel has better results at treating acne. Sufferers from acne generally give it very good reviews. Patients who want to rid themselves of wrinkles are often more disappointed. The big upside is that, unlike Thermage, the post-session downtime due to redness and swelling is, at most, a couple of days.

Even Fraxel's proponents say it cannot treat lines around the eyes or lips, anything beyond the mildest age lines, roacea or red capillaries, nor will it tighten the skin.

So what did Dr Millard say about Fraxal: "Expensive machine, multiple painful procedures. Can do a better job for a lot less $$."

Ultimately, I wouldn't waste my $$ on either Thermage or Fraxel.