What Is XERF? Our Highly Requested Deep Dive Into the Tightening Treatment

Say the phrase “structural skin tightening,” and consider our interest piqued. XERF, the coveted, FDA-cleared, non-invasive skin-tightening and lifting treatment developed by Cynosure Lutronic from Korea, has landed stateside, and we couldn’t be more intrigued. Given collagen loss and reduced elasticity are common skin concerns as we age, any treatment that touts an instant lift with zero downtime is certainly worth investigating. Ahead, learn all you need to know about XERF, from what the acronym stands for to our writer’s full experience with the treatment.

What Is XERF?

“XERF is a next-generation, FDA-cleared as of August 2025, noninvasive skin tightening treatment by Cynosure Lutronic,” says board-certified dermatologist Anna Karp, DO. “What makes it genuinely exciting and different from the many RF devices that have come before it is that it’s the world’s first multifrequency monopolar radiofrequency system.”

Yet what does that mean, exactly? “Most RF devices work at a single frequency, meaning they can only target one depth of tissue,” Karp explains further. “XERF simultaneously delivers two frequencies (6.78 MHz and 2 MHz), allowing us to address both the superficial dermis and the deeper SMAS layer (the same structural layer a surgeon lifts during a facelift) in a single session.”

Highly sought-after at Journelle Skin, XERF is bringing something to frequency treatments that we haven’t seen before. With the latest technology comes the importance of proper training and execution to make the treatment as effective as possible. “XERF is the newest and fastest-growing treatment in skincare,” notes Journelle Skin’s co-founder, board-certified dermatologist Sapna Palep, MD. “We are the authority on XERF treatments, having worked extensively with this new technology and offered it to patients pre-launch, so we are all highly trained.”

How XERF Works

 “XERF uses dual-frequency radiofrequency technology that delivers heat to the skin at varying depths, thereby triggering the production of collagen and elastin,” Palep explains. “The easiest way to put this into perspective is to think of elastin like a rubber band. You naturally lose it as you age, but if you can produce more of it, you get more of a ‘stretch back’ effect on the skin that helps tighten it and improve appearance.”

So why exactly would someone want a boost in collagen production, and what would that accomplish? “The boost in collagen production helps reduce dips and bumps, making skin overall look firmer,” Palep tells us. “With dual-frequency waves, XERF can target deep skin tissue for smoothing and tightening, as well as surface skin tissue to lift the skin’s structure.”

Designed with more than just the face in mind, XERF can be useful to treat the body as well. Palep recommends that on the face, XERF is best for the jawline, jowls, neck, and cheeks. On the body, the treatment works well on the abdomen (front) as well as the lower back, often called “love handles.” It also can be effective on the upper arms, just above the knees, and the thighs.

The Benefits

Lifting and tightening are wonderful benefits to any treatment addressing loss of collagen and elasticity, yet “the primary benefit is true structural lifting and tightening, not just superficial skin smoothing,” Karp says. “Clinically, we see improvement in jawline definition, early jowls, nasolabial folds, under-chin laxity, and neck crepiness. Because XERF reaches the SMAS layer, the results can be more meaningful than those from treatments that only address the superficial dermis.”

If you have a phobia of needles or can’t commit to extensive aftercare, XERF is an ideal treatment. “Beyond efficacy, one of the biggest advantages is the experience: no needles, no numbing cream, and essentially no downtime,” Karp explains.

Explaining more in-depth about the ideal candidates, “XERF is best for someone with mild to moderate skin laxity – anyone who is seeing early signs of skin sagging around the jawline or neck, or fine lines and collagen loss,” Palep says. “XERF helps build up collagen in targeted areas so skin looks fuller, plumper, and more youthful. You’ll start to see results within a day or two, with improvement over the following weeks or month.”

What to Expect During XERF

With no needles, numbing cream, or downtime to recover, XERF feels like a warm massage while the technology works to lift and tighten. You’ll first have a brief consultation to address your goals and skin laxity, and a treatment plan will be customized to your concerns.

“Sessions typically run 20 to 45 minutes, depending on the treatment area,” Karp tells us. “Patients describe the sensation as a series of warm pulses, a flash of heat followed by cooling as the device moves across the skin. Thanks to the integrated cooling system, no topical numbing is required, which also keeps appointments efficient. Most patients come in, get treated, and walk right out.”

When it comes to how many treatments to plan on getting, Karp says that Journelle Skin typically recommends “a series of one to two sessions spaced six weeks apart, depending on the degree of laxity and individual goals.” And if you’re worried about discomfort, Palep describes any heat sensation as minimal: “You feel the heat more so on the face and neck than other parts of the body, but it goes away quickly.”

Potential Side Effects

The potential side effects one might experience after their XERF treatment are mild and temporary. “XERF has a very favorable safety profile. The most common post-treatment effects are redness, warmth, and mild swelling in the treated area, all of which typically resolve within a few hours to a day,” Karp explains. “Because it’s noninvasive and uses controlled energy delivery with surface cooling, the risk of burns or significant adverse events is low when performed by a trained provider. As with any energy-based device, proper patient selection matters, so we assess skin type, degree of laxity, and underlying anatomy before every treatment.”

The Cost

XERF pricing will vary by the provider or practice and market region. Generally, patients can expect to invest between $1500 and $3000 per session, with full-face and neck treatments often costing around $2500.  Maintenance is usually once or twice a year after the initial sessions. “At Journelle Skin, we always do a thorough consultation first to make sure XERF is the right fit and to build a treatment plan that makes sense for the patient’s goals and budget,” Karp notes.

Aftercare

With XERF requiring little to no downtime, there are still a few things to keep in mind when you’ve reached the aftercare stage of your treatment. “After treatment, you can immediately resume normal activity like wearing makeup or working out,” Palep says. “A treatment can fit right in the middle of your workday, as most people don’t even experience major redness.”

Still, it’s best practice to avoid the sauna and a few other things: “I advise patients to avoid applying ice or cooling products to the skin for 24 hours after treatment to not lose the heat in the skin that triggers the collagen production, but to also avoid high heat from places like saunas and steam rooms for 24 hours post-treatment,” Palep tells us. “Protect your skin from the sun and apply a moisturizer to keep your skin barrier protected.”

My Review

I certainly fall into the category of my skin concerns revolving around loss of collagen. After turning 41 this year, I started to notice laxity around my jawline. While I have not developed significant jowls, my goal with getting XERF was to leave with a much more defined jawline than when I came. I wasn’t going to turn down the added tightening benefits, either, so XERF felt like the perfect treatment to address my concerns.

I have a routine skincare and treatment regimen that I rarely skip, as I’ve learned over time that consistency is key to keeping your skin in its best shape. I use the Jill Black Holistic EC/DC Microcurrent Device regularly to keep my skin tight and lifted, as well as Current Body Skin’s LED Red Light Therapy Face Mask to address texture and fine lines. Currently, my routine includes double cleansing my face, applying Solsoller’s Skinlit Bellini Probiotic Glazing Dew, a dermatologist-prescribed 15% Azelaic Acid, retinol, and Maya Chia’s The Super Blend Pressed Serum Concentrate.

I have gotten both IPL and Fraxel dual laser treatments in the past, along with Botox and dermal fillers—though I haven’t received Botox in over a year, or fillers in over two. With collagen loss and concerns about my jawline, I was excited to see if XERF could add some instant definition and lift. After discussing my concerns with Palep, she suggested a total of two XERF treatments, six weeks apart.

My experience with both XERF treatments at Journelle Skin was exactly as Palep and Karp described. It felt like a soothing, warm massage over my face and wasn’t painful at all. A grounding pad hooked up to the machine was attached to my back, allowing me to lie back and relax during my session. I experienced a more intense heat sensation around my temples and on parts of my jawline, but it was nothing I couldn’t handle.

I discontinued the use of retinol and acid-based serums a few days before my treatment and focused on hydration in my skincare, including drinking water before I went in. The treatment lasted about 45 minutes, and we focused primarily on my jawline, as it was my main concern. The treatment left my skin with zero redness, as you can see in my picture from immediately afterward.

I was able to continue my daily activities, felt no pain or swelling, and my skin looked completely normal when I walked out of the office. I noticed a much tighter jawline after my first session, and significant definition in the following days. After my second XERF treatment, my jawline was even more snatched, exceeding my expectations.

The Final Takeaway

 XERF is an investment, but the results are well worth it if true structural lifting and tightening are your main concerns and goal after treatment. Beyond the face, XERF can target areas of the body that you want to tighten, and the lack of pain or downtime is one of the biggest selling points. I noticed immediate results after my first XERF treatment, especially on my jawline, which was my biggest concern. After two sessions, I felt like I had the jawline I had back in my 20s.

This treatment is ideal for anyone who wants noticeable tightening without going under the knife, using numbing creams, or following an extensive aftercare routine. Typically, only one session per year is needed to maintain your results, and the benefits far outweigh the cost—so all in all, it’s worth looking into if it aligns with your budget and goals.