“Are you turning me into a robot?” I ask David Kim, MD, a board-certified dermatologist in New York City, as he places an oversized adhesive bandage connected to a cord on my lower back…and plugs it in. No, this isn’t The Jetsons, and no, I’m not in an AI lab.
It’s the Wednesday before Thanksgiving, and instead of heading to the airport for a flight to see my family for the holiday, I’m at Dr. Kim’s office getting ready for my first XERF treatment. (Don’t worry, I totally went home for Christmas.)
XERF is a radio-frequency (RF) skin-tightening device by Cynosure Lutronic, which also makes the Genesis and PicoSure Pro brightening lasers, as well as Clarity II for hair removal. XERF made its debut in South Korea in 2024, but it wasn’t FDA-cleared for use in the US until last August. Unlike drugs, devices don’t need the FDA’s approval, which requires proof of both minimal risk and meaningful benefit; but they do need its clearance, which requires proof of only minimal risk or similarity to an existing device.
If you’ve ever engaged with (or even thought of) in-office aesthetics content, you’ve probably seen XERF on your feed since the device arrived in the US. It already has celebrity fans, such as Kim Kardashian. (Incidentally, she also helped push skin-tightening devices Morpheus and Sofwave to prominence with her social media thumbs-up, which some believe was not an entirely organic endorsement.)
All that said, as a 35-year-old beauty editor who has tried more than a few in-office skin treatments over the past decade in an effort to flatten fine lines and tighten my jawline, I had no concerns about trying this new option—with a board-certified dermatologist, of course. They had me at “Korean” and “no downtime.” Here’s everything you need to know about XERF, including its benefits, possible side effects, pricing, and more.
What is XERF?
XERF, which is a shortened version of eXperience Exponential RF, is a monopolar radio-frequency device designed for non-invasive skin-tightening and rejuvenation. “In monopolar systems, energy travels from a single treatment tip into the deeper layers of the skin and exits through a grounding pad placed elsewhere on the body,” explains Jenna Queller, MD, a board-certified dermatologist based in Boca Raton, Florida. “This allows for deeper penetration of heat compared to other [systems].”
She continues, “What makes XERF unique and, honestly, quite interesting from a science standpoint, is that it uses dual frequencies—6.78 MHz and 2 MHz—to deliver energy at multiple depths of the skin simultaneously.” Most other tightening devices use one frequency and can thereby work on only one layer of skin at a time. Dr. Queller has not yet invested in XERF for her practice, but she has reviewed its clinical studies.
“It’s a refinement of existing radio-frequency technology in which they’re delivering radio-frequency energy from the surface of the skin using two frequencies intended to heat multiple tissue depths simultaneously,” says Shereene Idriss, MD, a board-certified dermatologist in New York City. In her opinion, though, “this is not exactly a brand-new scientific breakthrough. Radio-frequency energy has been used for many, many years, if not decades at this point.” Like Dr. Queller, she has not brought the machine into her office yet: “I always hesitate to treat my patients with a device that hasn’t been around long,” she says. “I generally wait at least six months to a year to make sure the results are consistent, and there are no unexpected risks.”
But let’s get back to XERF, specifically, in which the dual frequencies have two different jobs: tightening (targeting fine lines) and lifting (triggering collagen remodeling). As Dr. Kim explains it, “at 6.87 MHz, [the RF energy] goes very superficially, so it helps tighten the skin, but 2 MHz goes down deeper” to the subcutaneous layer where collagen is produced. The RF energy is delivered into the skin via an oversized flat tip that produces heat while also emitting cooling gas for comfort—so there’s no numbing, needles, or pain. That last part is particularly impressive because I’ve tried RF with microneedling in the past—like the Cutera Secret RF—and it left me in tears. XERF didn’t. (More on that later.)
