XERF vs Ultherapy

In short

Different energy entirely. Ultherapy uses focused ultrasound. XERF uses monopolar radiofrequency at two frequencies at once.
XERF treats three depths in a single pass. Ultherapy treats set depths, one at a time.
Comfort is the biggest practical difference. XERF is around one to two out of ten and needs no numbing. Ultherapy is commonly described as sharp at depth.
Timing differs. Some change from XERF is visible the same day. Ultherapy results typically appear over two to three months.

The core difference

Ultherapy is focused ultrasound. It delivers energy to precise points at set depths, creating small coagulation points that the body then heals, tightening tissue as it does. It is well established and it is good at lifting at specific deep points.

XERF is monopolar radiofrequency, and it is the first device to deliver two frequencies at once, 6.78 MHz and 2 MHz. Because the two frequencies behave differently in tissue, the practitioner can treat shallow, middle and deep layers in the same pass rather than choosing one depth and working through the face at that setting.

Put simply: Ultherapy lifts at points. XERF works across layers. That is why they suit different faces.

How XERF compares.

If you have already had skin tightening in London, this is the part worth reading. The technologies are not interchangeable and they do not behave the same way.

Aspect	XERF	Ultherapy (HIFU)	Thermage	RF microneedling
Frequencies at once	26.78 MHz + 2 MHz, monopolar RF	—Focused ultrasound, not RF	1Monopolar RF	1RF through fine needles
Depths per pass	3Shallow, middle and deep together	1Set depths, treated one at a time	1One fixed depth	1Whatever the needles are set to
Pain level	1–2 / 10Warm, like a hot stone massage	HigherCommonly described as sharp at depth	ModerateBrief heat spike with each pulse	ModerateTolerable once numbed
Numbing needed	NoCooling is built into the tip	SometimesPain relief is sometimes used	Not usuallyHeat is felt in pulses	YesTopical numbing is required
Needles	None	None	None	Yes
Sessions	1For most patients	1	1	3+Normally a course
When results show	Same dayThen building over the months after	2–3 months	2–6 months	Several weeksAfter completing the course
Downtime	NoneBack to work the same day	NonePossible tenderness	NonePossible redness	2–3 daysRedness and swelling
Mainly works on	Structural firmness and lift across several layers.	Lift at specific deep points.	Surface tightening and skin quality.	Texture, scarring and pores.

Comparison describes each technology in general terms and reflects typical protocols rather than any one clinic's. Not every treatment listed is offered at Dermamina. Suitability is confirmed at consultation.

Comfort, and why it matters more than it sounds

Ultherapy has a reputation for being uncomfortable, and patients commonly describe it as sharp when the energy is delivered at depth. Pain relief is sometimes used. It is tolerable, and plenty of people have it without difficulty, but it is not a relaxing hour.

XERF is around one to two out of ten. Most patients describe it as a warm hot-stone massage. Cooling sits at eight points built into the treatment tip, and energy is delivered in controlled pulses so the temperature rises steadily rather than spiking. No numbing cream or injection is needed at any point.

This matters beyond the hour itself. Discomfort is the single most common reason people put off a treatment they have already decided they want, and the most common reason they do not return for maintenance.

When you see the change

With Ultherapy the result is a healing response, so it appears gradually, typically over two to three months. Nothing much happens in the mirror on the day.

With XERF, tissue contracts during the treatment itself, so some lift is normally visible the same day, before you leave. Collagen-driven firming then continues building over the months that follow, and results generally hold for around a year. You can see what that looks like on our XERF results page, including a patient photographed immediately after a single treatment.

Which one suits you

Ultherapy may be the better choice if

You want lift concentrated at specific deep points rather than broad structural firming.
You have had Ultherapy before, responded well to it, and are due maintenance.
Your clinician assesses that focused ultrasound suits your tissue better than radiofrequency.

XERF may be the better choice if

You want firmness and definition across the lower face, jawline and neck rather than at isolated points.
Comfort is a deciding factor, or you have avoided treatment because of it.
You want to see something on the day rather than wait two to three months.
You would rather have one treatment than commit to a course.

Neither of these is a verdict. Which treatment suits you depends on your facial structure, your skin firmness and what you actually want changed, which is what the consultation is for.

Questions, answered.

Neither is better in every case. They use different energy and behave differently: Ultherapy is focused ultrasound that lifts at set deep points, XERF is dual-frequency radiofrequency that treats three depths in one pass. XERF is significantly more comfortable and shows some change on the day; Ultherapy is long established. Suitability is assessed at consultation.

Yes. XERF is around one to two out of ten and needs no numbing, because cooling is built into the treatment tip. Ultherapy is commonly described as sharp when energy is delivered at depth.

In most cases yes. Tell your clinician what you have had and when, and it will be taken into account when your plan is set.

XERF results generally hold for around a year before most patients consider maintenance. Both treatments are progressive rather than permanent, because skin continues to age.

No. Both are normally a single treatment for most patients.