The first published human clinical study of XERF dual-frequency radiofrequency analyzed 16 women over three months. After one session, participants showed statistically significant improvements in brow position (averaging 1.11 to 1.44 mm of lift), superior eyelid crease elevation, and computerized measures of wrinkles, skin evenness, pores, and oiliness. Participants reported looking approximately 3.28 years younger at three months, with mean satisfaction of 4.19 out of 5. Adverse events were mild and transient. The study was retrospective and small, without a control group, but offers the first preliminary data on XERF’s clinical effects in humans.
The first published human clinical study of XERF dual-frequency radiofrequency reviewed outcomes in 16 women who underwent one treatment session. At three months, participants showed measurable improvements in brow position, upper eyelid position, and computerized skin quality scores, along with high satisfaction ratings and reports of appearing younger. Adverse events were mild and transient, with no thermal injury or fat atrophy observed.
The study is retrospective and small, with no control group. It offers preliminary data, not proof of superiority or permanent results. We can use it to set realistic expectations for clients considering XERF over surgery.
Who Was in the Study
Sixteen women, median age 54.5 years (range 25 to 73), with Fitzpatrick skin phototypes II through V. Facial laxity ranged from mild to severe. None had undergone other facial aesthetic procedures in the six months before treatment or during the three-month follow-up.
The study reviewed clinical photographs, three-dimensional imaging, standardized measurements, questionnaires, and medical records collected routinely.
What the Treatment Involved
All participants received one session using XERF’s deep dual-frequency mode, which sequentially delivers 6.78 MHz and 2 MHz. Energy levels were adjusted to each patient’s tolerance.
This is a single-session protocol. Some clients may need more than one, but the study tracked results after one treatment only.
What Changed Immediately After Treatment
Three-dimensional analysis showed a pattern of increased lateral facial volume and reduced medial volume right after treatment. By three months, the medial volume reduction remained statistically significant. The lateral increases were no longer significant at the group level. Total facial volume did not show a significant net change at three months.
This suggests a redistribution of facial contours rather than a loss or gain of overall tissue volume. It also suggests variability across individuals, which is typical of energy-based treatments and related to factors like age-related structural changes and tissue response.
Brow and Eyelid Position at Three Months
Periorbital measurements showed progressive changes. At three months, mean changes reported for the combined measurements included approximately 1.11 mm for mid-pupillary brow elevation, 1.44 mm for lateral canthal brow elevation, and 1.41 mm for superior palpebral crease elevation.
These are small but measurable shifts. For context, 1 to 1.5 mm of brow lift is subtle, not dramatic. It can make the eye area look more open without looking overdone.
Skin Quality Measures
Computerized skin analysis found statistically significant improvements over time in wrinkles, skin evenness, pore size, and oiliness. Pigmentation did not significantly change.
These are surface-level improvements that matter to clients who care about texture and clarity. The lack of pigmentation change is neutral, not negative. XERF was not designed as a pigment-correcting modality.
For clients who want to address pigmentation alongside tightening, we typically layer in Clear + Brilliant treatments or integrate topical protocols with Vitamin C Face Wash and The Daily Serum.
How Participants Rated Their Results
FACE-Q measures showed increased satisfaction with facial appearance and improvement in aging appraisal at one and three months.
Participants reported appearing approximately 2.81 years younger at one month and 3.28 years younger at three months on the study’s perceived-age visual analog measure. Mean overall satisfaction was 4.25 out of 5 at one month and 4.19 out of 5 at three months.
All 16 participants said they would repeat the treatment and recommend it to others. This is high concordance, though it comes from a self-selected group who completed the protocol.
Pain and Adverse Events
Mean procedural pain was 4.31 out of 10 on a visual analog scale. Most participants described mild to moderate discomfort.
Reported adverse events were mild and transient. Two patients experienced short-lived erythema, and one patient had transient erythema with mild edema. The investigators reported no thermal injury, persistent complications, or clinical or imaging evidence of fat atrophy during the study period.
This matches what we see in practice. XERF is generally well tolerated, and downtime is minimal compared to ablative procedures. Clients with sensitive skin or darker skin tones should still consult before booking, because individual response varies.
What This Study Does Not Tell Us
It does not include a control group, so we cannot separate XERF effects from the natural course of time or placebo effects.
It is retrospective, meaning data was collected after the fact from routine records, not prospectively designed with predefined endpoints.
The sample size is small. Sixteen women is not enough to capture the full range of responses across ages, skin types, and laxity grades. It is enough to suggest a signal worth following up on.
The study tracked participants for three months. It does not tell us what happens at six months, one year, or beyond. It does not tell us how long results last or how many sessions are ideal for different clients.
It does not compare XERF to other modalities like microcurrent, ultrasound, or surgical lift. It tells us what happened in this group, not whether XERF is better or worse than alternatives.
What Clients Can Reasonably Expect
Based on this study, clients who undergo one XERF session may see modest improvements in brow position, upper eyelid position, and skin texture measures over three months. Most clients report high satisfaction and perceive themselves as looking younger.
Results are progressive, meaning they build over weeks rather than appearing instantly. This is typical of collagen-stimulating treatments and should be communicated clearly during consultation.
Discomfort is manageable for most people, and side effects are mild and temporary.
Not everyone will respond identically. The study showed group-level trends, but individual variation exists. Some clients may see more or less change, and some may need additional sessions to achieve their goals.
How XERF Fits Into a Broader Treatment Plan
XERF works best when integrated with other approaches. Clients who maintain consistent topical routines, protect their skin from sun exposure, and address internal factors like hydration and nutrition tend to see better outcomes from any skin-tightening modality.
For clients who want to maximize the tightening effect, we often pair XERF with exosome treatments or other facials that support collagen remodeling and skin health. Topicals like Rejuvenating Antioxidant Oil Serum or Supernova Retinol Serum can support long-term firmness when used consistently.
Clients who are candidates for XERF are typically those with mild to moderate laxity who want a non-surgical option with minimal downtime. It is not a replacement for a surgical facelift in cases of advanced laxity, and we do not position it as such.
What We Tell Clients at Joanna Vargas
We explain that XERF is a tool, not a guarantee. The first human study gives us a clearer picture of what one session can do, but each person’s skin responds differently based on age, collagen density, hormonal status, and lifestyle factors.
We recommend booking a consultation to assess whether XERF is a good fit for your goals and skin type. We also discuss realistic timelines, the possibility of multiple sessions, and how to support results with at-home care.
If you are curious about XERF or any of our other transformative treatments, book an appointment or take the Skin Code Quiz to find the right starting point for your skin.
Frequently asked questions
How long do XERF results last?
The first human study tracked participants for three months and found sustained improvements in brow position, eyelid position, and skin quality measures at that time point. The study does not provide data beyond three months, so we do not yet know the full duration of results. In practice, collagen-stimulating treatments like XERF typically produce progressive improvements over several months, and maintenance sessions may be recommended to sustain results over time.
How many XERF sessions do I need?
The published study reviewed outcomes after one session. Some clients may achieve their goals with a single treatment, while others may benefit from additional sessions depending on the degree of laxity, skin type, and individual response. A consultation can help determine the right protocol for your specific needs.
Is XERF painful?
In the study, mean procedural pain was 4.31 out of 10, and most participants described the discomfort as mild to moderate. Energy levels are adjusted to each person’s tolerance during treatment, so the experience varies. Most clients tolerate XERF well, and any discomfort is temporary.
Can XERF replace a facelift?
XERF is not a replacement for a surgical facelift, especially in cases of advanced laxity. The study included participants with mild to severe laxity and found modest but measurable improvements in brow and eyelid position. XERF is best suited for clients seeking a non-surgical option with minimal downtime and realistic expectations about the degree of lift achievable without surgery.
Are there side effects with XERF?
The study reported mild and transient side effects. Two participants experienced short-lived redness, and one had redness with mild swelling. There were no reports of thermal injury, persistent complications, or fat atrophy. Most clients experience minimal downtime and can return to normal activities shortly after treatment.