What Is XERF? A Plain English Guide to Dual Frequency Skin Tightening
What Is XERF?
XERF is a nonsurgical radiofrequency treatment that firms loose skin on the face, jawline and neck. It sends two frequencies of gentle heat into the skin in a single pulse, so it can warm both the surface layers and the deeper support layers during one visit. That heat tightens tissue and signals your body to build new collagen, with no needles, no numbing and little to no downtime.
The name is short for eXperience Exponential RF. XERF is made by Cynosure Lutronic, the company behind several well known lasers, and it has quickly become one of the most talked about skin tightening treatments of 2026.
If you have seen it on social media and wondered what it actually does, this guide explains it in plain language: how it works, what it feels like, who it suits, who it doesn't, and what results look like in real life.
Key Takeaways
XERF is a radiofrequency skin tightening treatment for mild to moderate loose skin on the face, jawline and neck.
It combines two frequencies, 6.78 MHz and 2 MHz, to heat more than one layer of tissue at once.
Built in cooling keeps most people comfortable without numbing cream.
You may notice a little firmness right away; the real change builds over two to three months as new collagen forms.
It is not a facelift, and it isn't right for everyone. A consultation tells you whether it fits your skin.
How Does XERF Work?
Think of collagen as the springy framework that keeps skin firm. With age, sun and weight changes, that framework thins and skin starts to soften along the jaw and neck. Radiofrequency treatments use controlled heat to help rebuild it.
Two Frequencies, Two Depths
Most radiofrequency devices work at one frequency, which means they mainly heat one depth of tissue. XERF combines two. According to Cynosure Lutronic, it is the first multifrequency monopolar radiofrequency system, pairing 6.78 MHz with 2 MHz.
6.78 MHz stays closer to the surface, where it helps smooth and tighten the skin itself.
2 MHz travels deeper, toward the fibrous support layer beneath the skin that surgeons work with during a facelift.
Dermatologists interviewed by Allure describe this as the main thing that sets XERF apart from older single frequency devices.
Built In Cooling
Each pulse is paired with a burst of cooling that protects the surface of your skin while the heat works underneath. That is why most people get through a full treatment without numbing cream.
What the Research Shows So Far
XERF is new, so the research is still growing. Here is what has been published:
A 2024 animal study in Skin Research and Technology found that the dual frequency setting thickened and shortened collagen bundles right after treatment and reached deeper tissue layers than a single frequency.
A 2026 prospective multicenter study in PMC followed 39 adults who had two sessions. Clinicians rated most of them as improved at 30 days and even more at 90 days, with no lasting side effects. The authors call the results preliminary.
A 2026 retrospective review in Lasers in Medical Science reported better facial laxity and skin quality after one session, and also called for larger controlled studies.
That is encouraging, and it is also honest to say that long term data is still limited. We share it this way so you can make a calm, informed decision.
What Does a XERF Treatment Feel Like?
A full face and neck treatment at The Real Skin takes about 45 to 60 minutes. Here is how a visit usually goes:
Consultation and skin analysis. We talk through what you are noticing and take AURA skin analysis photos so you can compare later.
Prep. Your skin is cleansed, and a small grounding pad is placed on your body to complete the energy circuit.
Treatment. Your provider glides the handpiece across each area in passes. You feel deep warmth, then a cool burst with each pulse.
Back to your day. You may look a little pink or feel warm for a few hours. Most people go straight back to work or dinner plans.
Settings can be adjusted during the session, so tell your provider if an area feels too warm.
Who Is XERF For, and Who Is It Not Right For?
XERF tends to be a good fit if you have:
A jawline that is starting to soften, or early jowls
Mild to moderate loose or crepey skin on the neck
Skin that feels less firm after weight loss, including Ozempic face
A preference for subtle change with no needles and no downtime
XERF may not be right for you if you:
Are pregnant
Have a pacemaker or another implanted electronic device
Have metal implants in or near the treatment area
Have an active skin infection, open wound or rash in the area
Have significant excess skin, where surgery may give a result XERF cannot
Want a dramatic, facelift style change from one visit
If XERF isn't the best match, we will say so. Sometimes Sculptra and Radiesse, neurotoxin or Ultherapy will serve your goals better, and sometimes a combination works best.
When Will You See XERF Results?
XERF works on two timelines:
The same day: some people notice a subtle firmness as heated collagen contracts. Others don't, and that is normal.
Over two to three months: new collagen builds, and skin along the jaw and neck looks smoother and firmer.
Long term: results usually last about a year, and skin keeps aging naturally, so many people book a yearly maintenance session.
Dermatologists quoted by TODAY make the same point: don't judge XERF in the mirror that evening, because the deeper collagen work shows up weeks later. You can see real results from our practice in our before and after gallery.
How Is XERF Different From Other Skin Tightening Treatments?
XERF: two radiofrequency frequencies in one pulse, shallow and deep, Warm with cooling, no numbing, little to no downtime
Single frequency radiofrequency: one radiofrequency frequency, mainly one depth, Warm, often more passes, little downtime
Ultherapy: focused ultrasound aimed at deep lifting layers, Can feel sharper; numbing or pain relief often used
Radiofrequency microneedling: very fine needles deliver radiofrequency energy into the skin, Numbing used, a few days of redness
None of these is best for everyone. The right choice depends on how much laxity you have, your skin type and how much downtime you can take. We will publish a full XERF, Ultherapy and Morpheus8 comparison soon.
XERF at The Real Skin
Location: 1565 Adams Ave, Suite 12, Costa Mesa, CA 92626
Phone: 714.869.1121
Hours: 10am to 7pm daily, by appointment
Provider: Paveena, NP, Founder and Lead Injector
Treatment time: about 45 to 60 minutes for full face and neck
Full face and neck (900 shots): $1,625 per session
Full face and neck package: $3,300 for two XERF sessions, two IV drips and an AURA skin analysis
Full face (600 shots): $1,300 per session, or $2,700 for two sessions with two IV drips and an AURA skin analysis
Chin and neck (300 shots): $975 per session, or $1,860 for two sessions with an AURA skin analysis
Every visit: a consultation, AURA skin analysis and progress photos
Prices are current as of November 2026 and may change. Ask about bundle specials when you book your consultation.
For a full breakdown of local prices, read our guide to XERF cost in Orange County. If you are mainly concerned about your jawline, start with how to get rid of jowls without surgery. When you are ready, learn more about XERF skin tightening in Costa Mesa or book a consultation.
FAQs About XERF
What is XERF?
XERF is a nonsurgical radiofrequency skin tightening treatment made by Cynosure Lutronic. It sends two frequencies of gentle heat into the skin at once, which firms tissue and encourages new collagen. Most people treat the face, jawline and neck, with no needles, no numbing and little to no downtime.
Is XERF the same as Thermage?
No. Both are monopolar radiofrequency treatments, but Thermage works at a single frequency of 6.78 MHz. XERF combines 6.78 MHz with a deeper 2 MHz frequency in the same pulse, so it can heat more than one layer of tissue during one visit. Your provider can help you compare them.
Does XERF hurt?
Most people describe XERF as deep warmth with a cool burst after each pulse, not pain. The handpiece releases cooling with every pulse, so numbing cream usually isn't needed. Some areas, like the jawline, can feel warmer, and your provider can adjust the settings as you go.
How many XERF sessions do I need?
Many people see a change after one session. Cynosure Lutronic's protocol and the published clinical study used two sessions about a month apart, and many providers recommend that series for the best collagen response. After that, a yearly maintenance session helps keep results as your skin keeps aging.
When will I see XERF results?
Some people notice a subtle tightening the same day. The bigger change comes from new collagen, which builds over about two to three months. In a 2026 multicenter study, clinicians rated more people as improved at 90 days than at 30 days, which matches that gradual timeline.
Who should not get XERF?
XERF may not be right for you if you are pregnant, have a pacemaker or other implanted electronic device, have metal implants in the treatment area, or have an active skin infection or open wound. If you have a lot of loose skin, a surgical consultation may serve you better, and we will tell you honestly.
How much does XERF cost in Costa Mesa?
At The Real Skin, a full face and neck XERF session of 900 shots is $1,625, and a package of two sessions with two IV drips and an AURA skin analysis is $3,300. Full face treatment starts at $1,300, and chin and neck at $975. Ask about bundle specials when you book your consultation.
Medically reviewed by Paveena, NP, Founder and Lead Injector, The Real Skin Medical Center.
This article is for general education and is not medical advice. XERF is not right for everyone, individual results vary, and a consultation with a licensed provider is needed to decide whether it fits you. Pricing reflects published rates at the time of writing and may change.
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