What Is the XTherma Program? What It Treats, Explained by a Dermatologist — Monopolar RF + Cryogen Skin Tightening, Who It Suits, and How It Differs from Thermage and HIFU
XTherma is a non-surgical skin-tightening device that uses high-frequency monopolar radiofrequency (Monopolar Radiofrequency – RF) at 6.78 MHz, working together with a cooling system (Cryogen Cooling) to deliver heat that stimulates collagen production in the deeper layers of the skin while protecting the surface layer from burns. Its main aim is to help skin that has started to sag become firmer and tighter, without needles and with virtually no recovery time.
Fees and appointments
THB 12,900 – 45,900
200–900 shots, depending on the treatment area and the number of shots assessed by the doctor
Assessed by a dermatologist first every time • New treatment tip opened in front of you • 0% installments for up to 10 months
But what a dermatologist would like you to understand before deciding is that XTherma is a tool that helps tighten mild to moderate skin laxity. It is not a surgical facelift, and "sagging" has different causes in different people. Correctly assessing whether the problem comes from lax skin, drooping fat or volume loss is therefore more important than choosing by device name. This article explains how XTherma works, what it can realistically do, who it suits, and how it differs from Thermage and HIFU.
How does XTherma work?
XTherma works by using radiofrequency heat to stimulate the skin's own repair process:
Delivers heat energy into the dermis: RF energy builds up heat in the deeper skin layers to a level that causes existing collagen to contract immediately and stimulates the body to produce new collagen and elastin over the following weeks to months. As a result, the skin gradually becomes firmer and tighter.
Cooling system (Cryogen): While the deeper skin layers are heated, the system sprays cooling onto the surface layer (epidermis) to help reduce discomfort and lower the risk of burns.
Monopolar RF: The energy spreads deeply over a wide area, making it suitable for tightening skin across a region, unlike some devices that focus on specific deep points.
Put simply, XTherma does not mechanically "pull" the skin up; it stimulates the skin to build a new collagen framework. Results are therefore gradual and natural-looking, not an immediate change like surgery.
What can XTherma do?
XTherma is designed mainly for skin concerns related to laxity and wrinkles:
Tightens facial skin that has started to sag — reduces sagging cheeks and a double chin, and helps the jawline look more defined
Reduces fine, shallow wrinkles caused by loss of skin firmness
Makes the skin smoother and firmer through collagen stimulation
Tightens body skin in lax areas such as the upper arms, abdomen or thighs
From a medical standpoint, it is important to understand that RF skin tightening focuses on skin tightening through collagen remodeling. As for advertising claims of "fat melting", the effect of RF tightening on fat is limited and is not its main purpose. People with significant fat accumulation should consult a doctor to plan an approach suited to their actual concern, and should not expect fat reduction from a skin-tightening device alone.
Who is XTherma suitable for?
XTherma is suitable for people whom a doctor has assessed as having these characteristics:
Skin with mild to moderate laxity, especially of the cheeks, under the chin and along the jawline
Early wrinkles and loss of skin firmness with age, and a wish for preventive care (maintenance)
Wanting results without surgery, without needles and with minimal recovery time
Concerned about pain — thanks to the cooling system, it is easier to tolerate compared with some other heat-based procedures
On the other hand, people with severe sagging or a lot of excess skin may see limited results, and in some cases a surgical facelift may be a better fit. The doctor will assess whether your concern is suited to RF tightening, or whether another method or a combination of methods would be more appropriate.
Who should take precautions or inform the doctor before treatment
For your safety, please inform the doctor before treatment if you have any of the following:
Pregnancy or breastfeeding
Implanted electronic devices such as a pacemaker, or metal implants in the treatment area — an important precaution for radiofrequency treatments
Infection, inflamed rash or wounds in the treatment area — these should be treated and healed first
Recent filler injections or other procedures in the same area — allow an interval and consult the doctor, as heat may affect some types of fillers
Skin conditions or heat sensitivity — should be assessed individually by the doctor
The safety and results of RF depend on appropriate energy settings and the skill of the practitioner, so it is important to be treated by a doctor at an accredited medical facility.
Does XTherma hurt? How long is the recovery?
During treatment, patients usually feel pulses of warmth or heat alternating with coolness from the Cryogen system, which makes it easier to tolerate. The sensation depends on the area and the energy level used.
After treatment:
There may be slight redness or warmth at first, which usually settles on its own within a few hours
In general, you can return to daily activities immediately; it is considered a procedure with virtually no downtime
You should moisturize and apply sunscreen as advised by the doctor, to support good results and care for the skin after heat exposure
When does XTherma show results, and how long do they last?
Immediately after treatment: Many people feel their skin is slightly tighter as existing collagen contracts
1–3 months: Results become more noticeable as new collagen gradually forms; the skin is firmer and the jawline looks more defined
Duration: Results typically last around 8–12 months or more, and longer for some people. However, because the skin continues to age, periodic repeat treatments are usually needed to maintain results
To be honest, XTherma helps "slow down and improve" skin laxity; it does not permanently stop skin aging. Skincare, sun protection and repeat treatments according to the doctor's plan are therefore part of the long-term result.
How is XTherma different from Thermage and HIFU?
This is the most frequently asked question, and the short answer is "they work by different mechanisms at different depths":
XTherma and Thermage / Oligio (Monopolar RF group) — use radiofrequency to spread heat widely through the dermis, focusing on skin tightening and collagen remodeling in this layer. Suitable for mild to moderate laxity and for firming the skin.
HIFU (e.g., Ulthera / Ultraformer) — uses focused high-intensity ultrasound to deliver energy deep to the SMAS layer, the layer surgeons lift during a facelift, so it focuses on "lifting" the deeper structure.
Neither group is "better" across the board, because they work on different layers and address different concerns. Some people suit RF, others suit HIFU, and many get better results when they are combined according to a plan designed by the doctor. The most suitable device therefore comes from assessing your type of laxity, not from trends.
How much does XTherma cost?
Fees depend on the treatment area and the number of shots assessed by the dermatologist after examination. The table below shows the fee per session.
Number of shots | Fee (THB) |
200 shots | 12,900 |
300 shots | 17,900 |
600 shots | 33,900 |
900 shots | 45,900 |
Payment and booking
0% installments by credit card for up to 10 months
THB 1,000 booking deposit, deducted from the fee on the day of treatment
Full deposit refund if you consult the doctor and decide not to proceed
Appointments can be rescheduled up to 2 times with at least 1 day's notice
Verify the genuine device yourself
New treatment tip box opened in front of you
Check the shot counter on the screen during treatment
Supervising physician: Dr. Patara Voravutinon, Dermatologist, Medical License No. 54323
Frequently asked questions about XTherma
What is XTherma?
XTherma is a non-surgical skin-tightening device that uses high-frequency monopolar radiofrequency (Monopolar RF 6.78 MHz) together with a cooling system to deliver heat that stimulates collagen in the deeper skin layers, helping sagging skin become firmer and tighter.
What can XTherma do?
It helps tighten facial skin that has started to sag, reduces sagging cheeks and double chin, makes the jawline more defined, reduces fine wrinkles, and tightens skin on some areas of the body. It focuses on skin tightening through collagen remodeling, not direct fat reduction.
Who is XTherma suitable for?
It suits people with mild to moderate skin laxity and early age-related wrinkles who want skin tightening without surgery and with minimal recovery time. People with severe sagging should have a doctor assess which method is most appropriate.
Does XTherma hurt? How long is the recovery?
During treatment you feel warmth alternating with coolness from the Cryogen system, which most people can tolerate. Afterwards there may be slight redness that settles on its own within a few hours, and you can return to daily activities immediately, with virtually no downtime.
How long does XTherma last?
Results become more noticeable over about 1–3 months and typically last around 8–12 months or more. Because the skin continues to age, periodic repeat treatments are usually needed to maintain results.
How is XTherma different from Thermage and HIFU?
XTherma and Thermage are radiofrequency (RF) devices that heat the dermis over a wide area, focusing on skin tightening, while HIFU is focused ultrasound that reaches down to the SMAS layer, focusing on lifting the deeper structure. Each suits a different type of laxity, so a doctor should assess you before choosing.
Article by Dr. Patara Voravutinon (Dr. Pat), MD, Dermatologist (Medical License No. 54323) · Last reviewed 31 July 2026
The information in this article is for general understanding only and does not replace examination, assessment and treatment planning by a doctor. Results of radiofrequency skin tightening depend on skin characteristics and vary by individual. Please consult a dermatologist for an assessment before treatment.
Results vary by individual · Siam Dermatology Specialist Skin Clinic, clinic license no. 11102000969 · Advertising approval ฆสพ.สป. 138/2569
Comments