Only one of these two has a record we can show you. "XeRF" does not appear in the published literature, and we could not match it to an FDA record. We could not establish who makes it, whether it holds a US clearance, what any clearance covers, what frequency or power it runs at, or whether it uses needles. Rather than guess at any of that, this page sets out what is verifiable about monopolar radiofrequency tightening as a category, what Thermage's paperwork actually says, and exactly what to ask a clinic to close the gap.
Thermage is documented in detail, and one part of that documentation is unusual. The ThermaCool System clearance (K052936, 12 June 2007) reads: "Dermatologic and general surgical procedures for electro coagulation and hemostasis" - surgical language for sealing tissue and stopping bleeding - then "Non-invasive treatment of periorbital wrinkles and rhytids including the upper and lower eyelids" and "Non-invasive treatment of facial wrinkles and rhytids". The Thermage FLX clearance (K170758, 22 September 2017) carries the same first two lines for radiofrequency energy alone, and broadens the third from facial wrinkles to "non-invasive treatment of wrinkles and rhytids".
Naming the eyelid is the part worth noticing. No radiofrequency microneedling clearance names the eyelid or the periorbital area, so needle-based radiofrequency treatment near the eye is off-label. Thermage's clearance names it directly. That does not mean Thermage works well around the eyes - a 510(k) clearance is a finding that a device is similar enough to an earlier one, not a demonstration of benefit. It means a regulator reviewed the device for that area, which is a real difference in what has been looked at.
Thermage's mechanism is well understood, and it is the honest baseline for any monopolar RF device. Current passes from a single treatment tip through the tissue to a return electrode on the patient's back. The skin's own resistance to that current generates heating throughout the dermis and into the fibrous bands beneath it, while a cryogen spray keeps the surface cool. Collagen fibres contract at coagulative temperature and then remodel over the following months. It runs at 6.78 MHz with a maximum average power of 400 W, and the tip is applied in a stamping motion rather than glided.
We could not confirm the manufacturer, the technology type, whether needles are involved, or the US regulatory status.
The tip is stamped across the treatment area with cryogen cooling of the surface between pulses.
Monopolar radiofrequency in general heats tissue by passing current through it to a return electrode, using the tissue's own resistance to generate heat. Whether this device works that way, at what frequency and with what cooling, is not something we could confirm.
Cryogen spray protects the surface while the deeper tissue heats. Collagen contracts immediately at coagulative temperature and remodels over the following months.
Monopolar radiofrequency heats a volume rather than a chosen plane, hottest in the upper dermis with the surface cooled. That makes it broadly usable across skin types, and much less controllable in depth than a needle-based device.
We could not confirm a US clearance, so no number and no indication wording is quoted. That is not a claim that none exists.
Those are the cleared words, from K052936 in 2007 and repeated for radiofrequency alone in the Thermage FLX clearance K170758 in 2017. A separate mode combining radiofrequency with skin vibration adds temporary improvement in the appearance of cellulite, relief of minor muscle aches and spasms, and temporary improvement of local circulation.
Results build over roughly two to six months. This is the conventional clinical description, not a figure stated in the Indications for Use.
Not a labelled figure.
Six questions. The first two matter most:
If a clinic cannot answer the first question, that is itself an answer about how much is knowable.
Worth being realistic about the category, whichever device is in the room.
It heats the dermis and the fibrous bands underneath through intact skin. Collagen contracts and then remodels, so the change is gradual and modest rather than dramatic, and it arrives over months rather than days. It is broadly usable across skin types, because radiofrequency heating does not depend on pigment the way light-based treatments do.
What it does not do: it cannot treat surface texture or scarring at all, because it does not injure the surface. It cannot be dialled to a chosen depth the way a needle device can, because it heats a volume rather than a plane. And it does not replace lost volume.
Documented rare adverse events with Thermage are burns, blistering, and subcutaneous fat atrophy producing visible depressions. Those figures are not quantified in the published literature, so no incidence is given.
Tell your provider if you have a pacemaker or an implantable defibrillator, or any metal implant near the area to be treated. Radiofrequency current can interfere with cardiac devices and can be conducted by metal, causing focal heating. These are labelled contraindications for radiofrequency devices generally. They are precautionary rather than tested - no published study has treated patients with cardiac implants - and the right people to advise you are your cardiology team, not a clinic.
If you get cold sores, say so when you book, not on the day. Antiviral medicine is started in advance, so it has to be prescribed before the appointment. Neither of these treatments is described as breaking the skin, and there is no published data on cold-sore reactivation after radiofrequency tightening specifically - the precaution is carried over from laser resurfacing, where reactivation is well documented. It is your provider's call, which is why they need to know beforehand.
Also mention current or previous skin cancer in the treatment area, and any severe cardiac condition.
Neither treatment is described as breaking the skin, so infection is unlikely. If a burn or blister does occur and then shows signs of spreading infection, treat that as urgent rather than routine: