How Much do Tweakments Hurt? Here’s the 0-10 Pain Scale

After my article about whether tweakments need to hurt in order to be effective (No Pain No Gain?), some of you have asked how much, on a scale of one to 10, some tweakments hurt compared to others… so here’s The Tweakments Pain Scale.

At which point, I’d also just like to add that there are a lot of people who think I’m somehow extra tough and must do all these procedures because I have a super-high pain threshold and just don’t feel the burns, zings, and stabs that can come along with tweakments. Rest assured, I do…

0/10 – LED light therapy. Low-level Laser Therapy

No sensation at all, except for a bit of warmth from red LED. It’s very possible to go to sleep during this sort of treatment.

1/10 – Advanced facials

If these are the sort of treatments that just add, say, an excitingly bit of warming radiofrequency, like a hot stone massage, to the end of an otherwise pampering facial, definitely a 1.

2/10 – Wrinkle-relaxing toxin injections

Yes, I know injections means needles, but these needles are tiny. You hardly notice them. It’s just a series of pinpricks. If you’re having toxin in your over-tight jaw (masseter) muscles, there can be a bit of a crunch and a pop as the needle goes in, but the relief afterwards will be worth it.

3/10 – Fillers

It slightly depends on where they’re being placed, but once the needle is in your face and you’re adjusting to the odd sensation of having the filler working its way out of the needle and into wherever it’s going, it’s not painful as long the injector goes slowly, and your chosen filler contains lidocaine, which anaesthetises as it goes in.

What about lips? They’re much more sensitive and you can always have some sort of numbing. 20 years ago, practitioners always used to do full dental blocks before injecting lips, but that’s overkill unless you’re hugely nervous. I don’t have any sort of numbing before fillers, even if it’s my lips, but maybe that’s because I’ve become used to it.

4/10 – Microneedling, low-level IPL

Microneedling is a tweakment where I’ll always want numbing cream, and even with that on, I’m always taken aback by how bracing it is, having a device with an oscillating head full of tiny needles creating a couple of thousand holes a second in my skin as it glides, buzzing, around my face. It’s not exactly painful but it’s uncomfortable when it goes over bits of the face that are less padded and more bony than others. Low-level IPL is much the same. It’s not exactly like being flicked with elastic bands, which is the usual analogy, but each zap feels like a small insult, nonetheless.

5/10 –  Fat-freezing

Cryolipolysis, aka fat-freezing, is mainly pretty comfortable except for the beginning and definitely the end. At the start, your nice warm flesh is sucked into the treatment head and supercooled to the point you think ‘Ow!’… but then it goes numb and it is quite possible to go to sleep for the rest of the treatment cycle. At the end of the treatment though, the therapist massages the treated area briskly for a minute or two to break up the frozen fat. That can be agony.

6/10 –  Radiofrequency microneedling

This is a treatment that’s cramming a good deal of RF energy into the skin, and it’s doing it through a bunch of tiny sharp needles, so yes there’s a lot of potential for discomfort, though this varies from brand to brand and also depends on the length of the needles and the intensity of the RF that is being used. I haven’t tried Morpheus 8 which has a reputation for being painful and leaving bruising, but I’ve tried Profound RF, an intense one-off treatment with 7mm needles where you need local anaesthetic all over the face (so you feel very little) and yes, there’s lots of bruising and swelling, but also fab results. I’ve also tried Sylfirm X which uses much shorter needles and I didn’t need any numbing cream on my neck, but I did on my face, which made it perfectly comfortable (I just don’t have my results yet).

7/10 – High-intensity energy treatments.

What do I mean by high-intensity? Well, anything like laser skin resurfacing, broadband light, or plasma treatment where your practitioner turns up the energy during treatment in order to see a bigger result in a shorter space of time. You’ll need numbing for this, and possibly a spot of local anaesthetic in more sensitive areas, such as the upper lip, if you’re having your barcode lip lines zapped.

8/10 – Fat-dissolving injections

I haven’t had any of these but I’m reliably informed, whichever brand of fat-dissolving you opt for, that you will swell significantly in the treated area and that the injections will sting like mad and itch for a week or two.

9/10 – Ultrasound treatments

Some ultrasound treatments hurt more than others. I’ve had HIFU treatments where I didn’t feel a thing, but Ultherapy, in its original incarnation, was shockingly intense (here’s an article I wrote when it launched in 2013). What I’m talking about here is a level of discomfort that makes me repeatedly question my sanity, and whether I’m seriously going to stay put for the rest of the treatment. It’s a tweakment where numbing cream won’t work as the waves of ultrasound energy are meeting at a point beneath the skin’s surface (so numbing the surface is no help). The company modified the energy intensity a couple of years later, but it can still be remarkably uncomfortable (some clinics automatically offer Valium pre-treatment).

10/10 – i.e. Unbearable

I really don’t think I’ve had a 10, ever. I can’t imagine myself sitting through it

And there’s more!

Here’s my article on What makes tweakments hurt more – or less?

And here’s a crucial one – from stress balls to numbing – How to make Tweakments more Comfortable