Journal
Notes on Skin
Treatment guidance, ingredient breakdowns and the rituals we return to, written by Joanna and the team behind the spa.
Can You Combine XERF with Botox, Filler, or Lasers?
Yes, XERF may be incorporated into a treatment plan with Botox or other neuromodulators, dermal fillers, biostimulatory injectables, lasers and selected ultrasound procedures. XERF uses noninvasive radiofrequency energy to heat tissue and support skin tightening, while neuromodulators address expression lines, fillers restore volume, and lasers may target pigmentation or texture. However, these treatments are not automatically safe to perform together or on the same day. Radiofrequency heating may affect certain existing fillers, and sequencing depends on the product, treatment area, settings and medical history. At Joanna Vargas in New York City, medically guided consultations help determine whether XERF belongs in a personalized approach to skin rejuvenation.
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XERF vs. Thermage vs. Ultherapy: How They Compare
XERF and Thermage use monopolar radiofrequency energy to heat tissue and support collagen remodeling, while Ultherapy uses microfocused ultrasound with visualization to target selected tissue depths. XERF uses dual-frequency RF technology (6.78 MHz and 2 MHz), while Thermage FLX uses a single RF frequency of approximately 6.78 MHz. Ultherapy can target specific depths, including 1.5, 3.0 and 4.5 mm, depending on the treatment area and protocol. All three are non-surgical options for selected skin-laxity concerns, but they differ in energy delivery, comfort, clinical evidence and treatment planning. No device is universally best; the right choice depends on your anatomy, skin laxity, goals and medical evaluation.
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Serum or Moisturizer: Do You Really Need Both?
Yes, most people benefit from using both serum and moisturizer. Serum delivers targeted ingredients based on your skin's needs, while moisturizer helps support hydration and the skin barrier. Apply serum first, followed by moisturizer and SPF in the morning. Together, they create a simple routine that helps skin feel hydrated, comfortable, and balanced.
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The Four Products Joanna Uses Every Single Day
Joanna Vargas believes beautiful skin begins with consistency, not complexity. Her everyday routine centers on four essentials: cleansing, serum, moisturizer and daily sun protection. Rather than constantly changing products or chasing trends, Joanna focuses on a simple ritual that keeps hydration, nourishment and protection at the center of how she cares for her skin.
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What Happened When 40 Women Used Hyaluronic Acid Serum for 6 Weeks
A six-week clinical study of 40 women found measurable improvements in hydration and the appearance of smoothness, plumping and fine lines with consistent use of a hyaluronic acid serum. The findings reinforce something central to the Joanna Vargas philosophy: healthy-looking skin isn't built around quick fixes. It's built through consistent care. Daily Serum brings that philosophy home with Sodium Hyaluronate and complementary ingredients selected to leave skin looking hydrated, smooth, fresh and luminous.
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Why Hyaluronic Acid Serums Work Better Than You Think
Hyaluronic acid serum can help transform the appearance of thirsty, tired-looking skin by replenishing moisture and creating a smoother, plumper-looking complexion. In the Joanna Vargas Daily Serum, Sodium Hyaluronate is paired with Gluconolactone, a vitamin C derivative, chamomile and oat extracts for skin that looks fresh, soft and luminous. Because sometimes the difference between tired-looking skin and healthy-looking skin begins with hydration.
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Why the DEJ Holds the Secret to Younger Skin
The dermal-epidermal junction (DEJ) is the structural foundation where the epidermis meets the dermis, and its deterioration drives visible aging. Clinical biopsy data from a 63-year-old male patient treated with E-50 Skin Booster after microneedling showed a 17% increase in rete ridge density, 52% increase in epidermal thickness, and 61% increase in basal keratinocyte density, demonstrating that targeted exosome delivery can restore the DEJ architecture that gives skin its density and firmness.
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XERF Skin Tightening: The Dual-Frequency RF Treatment Everyone Is Asking About
XERF is a monopolar radiofrequency device that uses two frequencies, 6.78 MHz and 2 MHz, to deliver energy at multiple depths of the skin simultaneously for non-invasive skin tightening and rejuvenation. Unlike other RF devices that use one frequency and work on only one layer at a time, XERF's dual-frequency system allows deeper penetration through a single treatment tip, with energy exiting through a grounding pad placed elsewhere on the body.
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Why Mitochondrial Decline Is the Real Cause of Aging Skin
Aging skin, hair loss, and chronic inflammation share a root cause: mitochondrial decline. As we age, our cells produce less ATP, the energy currency required for repair and regeneration. Damaged mitochondria create more oxidative stress and slower healing. True skin regeneration requires restoring the cell's energy system, not just treating surface symptoms.
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Three Questions to Ask Before Choosing an Exosome Treatment
Before choosing an exosome treatment, evaluate three criteria: the source (species and cell type), purity (whether you're getting real exosomes or debris), and endogenous content (whether the vesicles contain growth factors, mRNA, and signaling molecules). Safety, compatibility, and regeneration depend on these factors.
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XERF vs. HIFU: Different Energy, Different Depth
XERF and HIFU are both non-invasive skin tightening technologies, but they use different energy types: XERF uses multifrequency monopolar radiofrequency while HIFU uses focused ultrasound. Provider materials often describe XERF as comfortable without topical anaesthetic, while HIFU protocols sometimes use numbing. Robust head-to-head data comparing pain, depth and outcomes remain limited, and device, protocol and patient factors all affect the experience and results.
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XERF vs. Morpheus8: Two Radiofrequency Devices Explained
XERF and Morpheus8 both use radiofrequency energy to treat skin, but they deliver it differently. Morpheus8 uses microneedles and is commonly considered for texture, scarring and laxity together. XERF uses a non-invasive surface applicator and is marketed for patients who prefer to avoid needles and want lower downtime. The better choice depends on the concern, your risk profile, and a qualified provider's assessment.
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How Many XERF Sessions Do You Actually Need?
The number of XERF sessions needed varies based on published studies and provider protocols. A recent small prospective study used two sessions four weeks apart, while other protocols may differ. The optimal number and interval are still being established, and a provider should customize any treatment course to the patient, the treatment area, and the available evidence.
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XERF vs. RF Microneedling: Which Treatment Is Right for You?
XERF delivers radiofrequency skin tightening without the microneedling component found in devices like Morpheus8 and Secret RF. The monopolar RF approach typically involves less discomfort, shorter recovery time, and no visible redness or flaking, though results last several months rather than being permanent. The choice depends on pain tolerance, downtime availability, and how aggressive a treatment you want.
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Exosome Treatments vs. Traditional Facials: What to Know
Exosome treatments use lab-derived vesicles containing signaling molecules to support cellular communication and skin renewal, while traditional facials rely on topical ingredients, manual techniques, and technologies like microdermabrasion or LED. The main difference lies in the technology: exosomes work at a deeper cellular level, while conventional facials focus on cleansing, exfoliation, hydration, and surface-level rejuvenation. Both have value depending on your skin goals, timeline, and investment level.
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How to Use Retinol Without Thinning Your Skin
Retinol regulates cell turnover by eliminating dead, dark skin cells and bringing fresh cells to the surface, which helps reduce wrinkles and dark spots. However, it penetrates so deeply that it can cause redness, flakiness, dryness, sensitivity, and skin thinning, which may create a shiny, tight, robotic appearance. To use retinol safely, choose products that include soothing agents like fatty acids, chamomile, aloe, or green tea extract alongside the retinol to buffer the penetration and reduce irritation.
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What Is an Exosome Facial? Benefits, Results & How It Works
An exosome facial combines an exosome-containing topical formulation with a professional treatment such as microchanneling or microneedling. The Joanna Vargas Exosome Facial Facelift uses E50 exosome technology with controlled microchanneling across the face and neck. Early human studies report promising improvements in hydration, elasticity, wrinkles, pores, pigmentation and overall skin appearance, although research is still developing and results vary by product and protocol.
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Epidermal Growth Factors: The Nobel Prize-Winning Ingredient
Epidermal growth factor (EGF) is a signaling protein involved in cellular growth and communication. Swiss apple fruit cell culture, typically listed as Malus Domestica Fruit Cell Culture Extract, is a different skincare technology and should not be confused with EGF. Joanna Vargas uses Swiss apple fruit cell culture extract in several formulas, including Eden Niacinamide Calming Serum, Eden Hydrating Pro Moisturizer, Eden Instant Lift Mask, and Supernova Retinol Serum.
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Why You Should Never Do Extractions at Home
You should never do extractions at home, especially with metal tools. At-home extractions can cause scarring, discoloration, capillary damage, or drive bacteria deeper into the skin, leading to infection and inflammation. Instead, visit a trained aesthetician who knows how to perform extractions hygienically and properly, or maintain clear pores at home through consistent washing, exfoliating at least twice a week, and steaming to loosen blackheads before gentle exfoliation.
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The Four-Step Routine Joanna Uses Every Single Day
Joanna Vargas uses four products every single day: a cleanser, a serum, a moisturizer, and sunscreen. She cleanses at night, applies serum morning and night, uses moisturizer twice daily, and finishes each morning with sunscreen. A short routine you actually do beats an elaborate one you skip.
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Why Darker Skin Tones Are More Sensitive Than You Think
Melanin-rich skin tones are often more sensitive than lighter complexions, despite common assumptions. While darker skin may not wrinkle as prominently or quickly because dermal cells are packed more tightly, African-American, Hispanic, Asian, and Mediterranean skin is actually more prone to irritation, breakouts, and conditions like rosacea. Thickness does not equal resilience, and understanding this allows for better, more personalized care.
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How to Tell If You Have Sensitive Skin (Hint: 85% of Us Do)
To test if you have sensitive skin, press firmly on your cheek in a few spots and lift your finger. If redness appears where you pressed, you have sensitive skin. You can also check the crease of your nose next to the nostrils or your upper cheeks for small broken capillaries under the surface. Sensitivity often shows up as breakouts, redness, rosacea, or dry, flaky patches, and Joanna Vargas estimates that roughly 85% of her clients have sensitive skin, even if they don't realize it.
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What Really Happens to Your Skin Between Age 30 and 80
Between age 30 and 80, the skin undergoes significant changes: the dermis loses 20 to 80 percent of its thickness, collagen and elastin production slows and degrades, hyaluronic acid decreases starting in the 40s leading to dehydration, fatty acids in the stratum corneum lose their ability to bind water, and skin cell turnover declines by 30 to 50 percent. These changes result in wrinkles, dullness, rough texture, and loss of fullness, but can be slowed with the right skincare habits, including consistent cleansing, targeted serums, hydration, and professional treatments.
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Is Sunscreen Enough to Protect Your Skin in Summer?
Sunscreen is the single most important step you can take. On its own, though, it is doing less than half the job. Here is what to add.
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