Home · XERF and Skin Boosters: Laxity vs Skin Quality
Two different problems, two different tools. The useful question is not which treatment is better, but which of the two things is actually wrong with your skin.
Short answer. Yes, XERF and skin boosters such as Profhilo, Rejuran or Nucleofill can belong in the same plan — but only when a face has both of the problems they treat. XERF tightens lax skin and soft tissue; boosters improve skin quality: hydration, texture, elasticity and fine crepiness. They are usually spaced apart rather than done in one sitting, and many people need only one of them.
An international consensus defined skin quality through four perceptual categories: skin tone evenness, surface evenness, firmness and glow (Goldie 2021). Laxity is about structure: how well skin and the tissue beneath it hold their position.
| Structural laxity | Skin quality | |
|---|---|---|
| What you see | Softened jawline, early jowls, loose skin under the chin or on the neck | Dullness, dehydration, fine crepey lines, rough texture, uneven tone |
| Which layer | Dermis and deeper soft tissue | Epidermis and upper dermis |
| Typical tools | XERF and other energy-based tightening | Profhilo, Rejuran, Nucleofill, resurfacing, skincare |
| What it will not fix | Texture, glow, fine crepiness | Sagging |
A tighter face with dull, crepey skin can still look tired. Beautifully hydrated skin over a sagging jaw can still look older than you feel. That is the logic of combining — and the logic of not combining is simpler: if you have only one of the two problems, treat that one.
Profhilo is a hybrid complex of high- and low-molecular-weight hyaluronic acid. A 16-week open-label study of 64 women reported improvement in skin surface and a volume-loss scale, with minor temporary reactions in 23% (Sparavigna 2016). A small study of 25 subjects found improvement in neck roughness and laxity (Sparavigna 2022). A 2026 systematic review identified nine studies with 278 participants, all single-centre and mostly small, and the review was funded by the manufacturer (Sparavigna 2026).
Polynucleotides — the family that includes Rejuran and Nucleofill — were reviewed in 2025 across nine studies with 219 patients: side effects were mild and short-lived, and the authors noted limited consensus on optimal use (Lampridou 2025). An expert consensus exists for one polynucleotide product family (Cavallini 2021). Brand-specific controlled trials for Rejuran and Nucleofill are very limited.
Evidence for skin boosters is encouraging but limited: mostly small, uncontrolled and often industry-linked studies. Our comparisons of Profhilo vs Rejuran and Rejuran vs Nucleofill go into the differences.
The evidence is older, small, and does not all point the same way. An animal study found monopolar RF over soft-tissue fillers, including hyaluronic acid, did not increase burn risk or reduce filler persistence (England 2005). A 2023 human histology study found that radiofrequency applied on the same day as hyaluronic acid filler reduced the amount of hyaluronic acid in about 36% of participants, and concluded that RF may affect filler integrity, especially on the same day (Jurairattanaporn 2023).
No study has examined XERF with Profhilo, Rejuran or Nucleofill specifically. Until one does, the cautious approach is to separate them in time and to reduce energy over recently injected areas — which is also what dr. Jesslyn was taught in the advanced XERF programme (Seoul article).
When both are needed, XERF usually comes first and boosters follow at a later appointment rather than on the same day. The tightening is then not acting on freshly placed product, and the skin-quality treatment starts on settled tissue. If a patient has had boosters or filler recently, XERF is postponed or energy is reduced over those zones.
Some patients do boosters first — for example when crepey, dehydrated skin is the main complaint and laxity is minor. The order follows the main problem, not a fixed menu.
“The most common thing I do in these consultations is remove something from the plan, not add something. A combination should answer two problems the patient really has.” — dr. Jesslyn Amelia
XERF: implanted electrical devices and pregnancy are absolute contraindications; other precautions are listed on our XERF safety section. Boosters: active skin infection at the injection site, known allergy to the product, pregnancy or breastfeeding (generally avoided), and bleeding disorders or anticoagulant treatment (assessed individually).
Tightening, skin quality, or both?
Send a photo in natural light and dr. Jesslyn will tell you which of the two your skin actually needs — often it is one, not both.
Ask dr. Jesslyn on WhatsAppCompare the boosters: skin boosters at Elea
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Can I have XERF and Profhilo on the same day?
We generally separate them. One study found same-day radiofrequency reduced hyaluronic acid in about a third of participants (Jurairattanaporn 2023), and no study has tested XERF with Profhilo specifically.
Which should I do first, XERF or skin boosters?
Usually XERF first when laxity is the main issue, and boosters first when skin quality is. Your dermatologist should decide by your main concern.
Do skin boosters tighten skin?
They improve skin quality and firmness, but they are not a treatment for structural sagging.
Can I have XERF if I had Rejuran last month?
Often yes, with adjusted energy over treated areas. Tell the dermatologist exactly what was injected, where and when.
Medically reviewed by dr. Jesslyn Amelia, Sp.D.V.E — Dokter Spesialis Dermatologi, Venereologi dan Estetika. Registered with the Indonesian Ministry of Health, STR JT00000382760637. Verify registration. Last reviewed 23 September 2026. Individual results vary; this page is general information and not a substitute for consultation.