Patient Resources

Your Treatment Journey

Everything you need to prepare, recover, and get the most from your results. Find your treatment below for simple before and after-care instructions designed to ensure a smooth experience and optimal results.

Pre-treatment care

Before your XERF session

• Avoid sun exposure and tanning — including beds and self-tanners — for at least 2–4 weeks prior.

• Use a broad-spectrum SPF 30+ daily on the areas to be treated.

• Discontinue retinoids (Retin-A, tretinoin), glycolic and salicylic acids, and other exfoliants 5–7 days before.

• No chemical peels, microdermabrasion, or waxing in the area for 1–2 weeks before.

• Drink plenty of water in the 24–48 hours leading up to your appointment.

• Inform your provider of any metal implants, pacemakers, or defibrillators.

• Antiviral medication may be prescribed if you have a history of cold sores.

• Shave hair-bearing areas within the treatment zone 1–2 days prior.

• Arrive with clean skin: no makeup, lotion, deodorant, or oil on the treatment area.

Post-treatment care

After your XERF session

• Mild redness (erythema) and swelling (edema) may appear immediately and can persist for 1–3 days.

• Do not apply a cooling or ice pack to the treated area afterward.

• A gentle, non-occlusive moisturizer may be applied to soothe the area. Moisturize daily.

• Anything that raises blood flow or body temperature may increase redness temporarily.

• Avoid cosmetics containing alcohol for at least one week after treatment.

• Avoid sun exposure and wear broad-spectrum SPF 50+ at all times throughout the treatment series to minimize the risk of hyperpigmentation.

• Contact the office with any questions or concerns.

Absolute Contraindications for XERF

Active Implanted Electronic Devices: Patients with cardiac pacemakers, internal defibrillators (ICDs), deep brain stimulators, or any active implanted electronic monitoring equipment.

Metal Implants in the Treatment Zone: Permanent metallic implants, metal plates, screws, surgical clips, or gold/metallic thread lifts directly within or adjacent to the target treatment area.

Pregnancy & Nursing: Pregnant or breastfeeding patients (due to lack of clinical safety data on fetal exposure and altered pain/healing dynamics).

Active Skin Malignancy: Active skin cancer, melanoma, or suspicious, undiagnosed lesions in or around the target site.

Patients who have received permanent fillers or facial implants in the treatment area.

Relative Contraindications

Active Infections or Skin Conditions: Open wounds, active herpes simplex outbreaks (cold sores), severe inflammatory acne, psoriasis, eczema, or active localized skin infections in the treatment pathway.

Impaired Healing / Systemic Illness: Uncontrolled diabetes, active systemic autoimmune disorders (e.g., lupus, scleroderma), or severe immunosuppression that compromises normal tissue repair.

Recent Systemic Isotretinoin Use: Treatment with oral isotretinoin (e.g., Accutane) within the past 6–12 months, as it impairs dermal wound healing and increases scarring risk.

Sensory Deficits / Impaired Thermal Perception: Local nerve damage, neuropathy, or numbness in the treatment area that prevents the patient from accurately perceiving heat intensity.

Coagulopathy & Medications: Active bleeding disorders or heavy use of systemic anticoagulants (blood thinners) that increase risk of bruising or localized hematoma.

Injectables / Fillers: Recent application of cosmetic injectables (neurotoxins, hyaluronic acid fillers, or biostimulators like Sculptra/Radiesse) in the immediate area. Note: Usually requires a mandatory cooling-off period (4 weeks for toxins/HA; longer for biostimulators) to avoid premature degradation or displacement.

Patients with detected pathological abnormalities.

Patients who are unable to or not willing to follow pre- and post-treatment care instructions.

Patients with unrealistic treatment expectations.

Patients with blood disorders and taking aspirin or blood disorder medications.

Patients with uncontrolled autoimmune diseases, cancer or malignant diseases.

Precautions

If the patient has a metal implant outside the electrical pathway, treat with caution and monitor the patient for discomfort.

If the client is allergic to adhesives, such as glues on medical tape, they should be alerted that a rash may occur on the Neutral pad site and an over-the-counter solution may be used to treat the area.

Patients with keloids and a history of keloid scarring.

Male patients should be clean shaven prior to treatment, as hair can impact the treatment.

If the client is prone to fever blisters or herpes virus, they should receive a prophylactic antiviral medication regimen prior to treatment.

Patients who have received fat grafting or skin grafting to the treatment area within the past 6 months.

Patients who have undergone facelift surgery within the past two (2) months should not be treated with XERF.

Patients who have been taking anti-inflammatory drugs over the long term.

Patients with recent tattoos and cosmetic tattoos in the treatment area.

All jewelry should be removed prior to treatment.

Pre-treatment care

Before your ULTRA session

• Avoid exposure to the sun and tanning (including tanning bed and self-tanners) for at least 2-4 weeks prior to treatment.

• Use a broad-spectrum SPF 30+ daily on areas to be treated.

• Discontinue use of retinoids (Retin-A, tretinoin), glycolic/salicylic acids, and other exfoliants at least 5-7 days before treatment.

• If treating melasma or pigment, a topical lightening agent (e.g., hydroquinone) may be prescribed 2–4 weeks before treatment.

• Avoid chemical peels, microdermabrasion, or waxing in the treatment area for 1-2 weeks before the session.

• Inform your provider of any photosensitizing medications (doxycycline, minocycline, etc.) or blood thinners.

• Antiviral medication may be prescribed if you have a history of cold sores.

• For hair-bearing areas, it is recommended to shave the treatment site 1 to 3 days before your appointment.

• No makeup, lotions, deodorant or oil is allowed on the area to be treated the day of treatment.

Post-treatment care

After your ULTRA session

• Mild erythema (redness) and edema (swelling) may appear immediately following treatment and can persist for up to 2-3 days.

• The treated area may feel like a sunburn for a few hours post-treatment.

• Post- treatment cooling or the application of a cold compress may help alleviate any discomfort or pain.

• After the first day, cleanse the skin using a gentle cleanser and pat dry for the next two days.

• Keep the treated area hydrated with a gentle moisturizer.

• Avoid cosmetics that contain active ingredients such as Retinol or AHA without prior permission from the provider.

• Normal skin care regimes, including makeup, moisturizers, deodorant, and shaving may be resumed the day after treatment if there is no redness, blistering, or crusting present.

• To minimize the risk of hyperpigmentation, avoid sun exposure. Apply a broad-spectrum sunscreen with SPF 30 or higher at all times throughout the treatment series.

• Avoid scrubbing, picking, or scratching the treated area to prevent irritation and potential scarring.