“I have worked with - and deeply studied the physics of - radiofrequency for more than 15 year and I never had to make treatment painful for it to be effective. Properly applied, safe radiofrequency should be a painless - even comfortable - procedure and should never require the use of anaesthetic (numbing) cream. NEVER. In fact, numbing cream-requiring RF treatments are known for their adverse reactions - and still no better results than safe, strong, painless radiofrequency so we do not offer those. If someone says that you will need numbing cream to mask the pain of radiofrequency treatment then you are at the wrong place. Can’t say it clearer than that.”
Should RF skin tightening hurt to be effective?
Should radiofrequency treatment be painful to be effective for cellulite removal / skin tightening?
Pain and “destructive” radiofrequency
Most people think radio frequency has to be painful to be effective
Why do most people think radio frequency treatment is painful?
Does RF microneedling hurt? Pain with fractional microneedling radiofrequency.
Pain with HIFU (High-intensity focused ultrasound)
Pain with bipolar radiofrequency
Pain with ignorant application
No pain, no gain?
The fact is that properly applied radiofrequency treatment does not have to be painful
How should a proper radiofrequency treatment feel?
When is radiofrequency painful?
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Should radiofrequency treatment be painful to be effective for cellulite removal / skin tightening?
High-power, deep-acting radiofrequency treatment is now the indisputable technology for skin tightening (especially body skin tightening) and one of the two best technologies for cellulite.
But should it be painful to be effective? Absolutely not.
Properly applied, safe radiofrequency should be a painless - even comfortable - procedure and should never require the use of anaesthetic (numbing) cream. Never. In fact, numbing cream requiring RF treatments are known for their adverse reactions - and no better results than strong but painless radiofrequency.
Unfortunately radiofrequency treatment is known in the public’s imagination to be painful and/or dangerous, due to its erroneous application by doctors in the first few years of its use for aesthetic purposes, i.e. a quarter of a century ago in the early 2000s.
It’s unbelievable that such technology is still used today when it is proven to have too many adverse reactions and cause too much pain for the results it offers.
Pain and “destructive” radiofrequency
This type of extremely high-intensity, stationary RF technique application, requiring the use of numbing cream/topical anaesthetic, calls for literally BURNING the inside of the skin at 60-90ºC. This is then euphemistically called “coagulation”, when it is actually good old deep skin burning.
The flawed theory is that this burning TRAUMA will consequently create INFLAMMATION and SCAR TISSUE. This is then euphemistically called ‘neocollagenesis’, when it is actually good old scar tissue and the end results is then baptised ‘skin tightening’, when in fact it is skin hardening.
(In fact, the same principle is also used in RF microneedling, hence all the adverse reactions.)
Oh well…
Another problem with such procedures is that sometimes the skin does not even respond with the building of scar tissue to replace the burned tissue, so you are left with paper thin skin. This is because your existing collagen gets damaged by the procedure and not enough new scar tissue collagen is created.
Sadly this kind of application (creating scar tissue with intense heat) still continues today amongst many practitioners, especially doctors, for non-surgical as well as for surgical procedures (such as vaser, cellulaze, smart lipo etc).
The latest iterations of this internal skin burning technique are:
Extreme intensity HIFU (high intensity focused ultrasound)
Radiofrequency microneedling
The popularity of the “burn > inflammation > scar tissue > skin tightening” theory is due to the widespread ignorant notion, even among doctors and surgeons, that hardened, inelastic, scar tissue collagen is the same as real, healthy, elastic, functional collagen. To those I say, well, open a book and find out that it isn’t.
In fact, we all know from different scars that we have in our bodies, this is clearly not the case.
On this article I explain:
What types of radio frequency treatment are painful
Why those treatments are not as effective as the safe, non-painful forms of RF and can be even be dangerous
Why good radiofrequency need never be painful
Most people think radio frequency has to be painful to be effective
Most new clients I meet at the clinic think that radio frequency treatment is painful, and some are actually really scared.
It takes some time to explain to them:
How RF works
That pain does not equal better results
That the treatment is generally comfortable
That some people find it so relaxing, they even almost fall asleep
Of course, 10-20 minutes into the treatment they relax and they realise that even a strong RF treatment does not need to be painful at all to be effective. Most find it relaxing and many find it soothing.
There is a small minority of clients (less than 5%) that find it uncomfortable.
And there is a very small minority (around 1%) that find it painful. Of course, to adhere to our health and safety protocol, we do not provide the treatment to those who find it painful.
But the vast majority of clients find the treatment comfortable and even relaxing, despite the high intensity used with only occasional, split-second feeling on burning from time to time.
This is due to us using the best equipment in the world, combined with advanced protocols and our 14,000+ treatment experience, at the time of updating this article (November 2025).
Why do most people think radio frequency treatment is painful?
Most people have only heard of what we call ‘destructive RF’, which I mentioned above.
This is the “one-session miracle” gimmick radiofrequency treatment which promises to provide results in one extortionately expensive (£2,000-£4,500 per session), very painful session, based on burning the hypodermis and dermis and creating scar tissue.
That treatment requires numbing cream to be applied, can be extremely painful and can cause burns and scar tissue bumps.
Does RF microneedling hurt? Pain with fractional microneedling radiofrequency.
Others hear of the pain, swelling, irritation, inflammation and hyperpigmentation that can be caused by fractional radiofrequency, a type of destructive RF used for superficial facial skin tightening and facial skin resurfacing (also used with topical anaesthesia).
Lately, this painful/destructive type of treatment is seeing a resurgence with fractional RF microneedling for face and body - with needles going as deep as 7mm or more for “cellulite reduction”.
Those treatments are advertised as “you only need one” (very expensive) session. But real life experience has shown that with these “one-off” treatments you never need just one. You need 6 or more for good results - which is what is required for normal, safe, painless RF. However, in contrast to safe RF which can be safely repeated for dozens of sessions, having repeated “destructive” treatments increases the risk of damage exponentially.
So, for whoever is having hyped up gimmicks such as RF microneedling, all I have to say is “good luck with that”, both in terms of poor results and adverse reactions.
Pain with extreme intensity HIFU (High-intensity focused ultrasound)
Extreme intensity HIIFU works in the same way.
It aims to focus powerful soundwaves inside the skin with the aim to burn it and cause scar tissue, which is the baptised as skin tightening.
HIFU is sound, not radiofrequency, so I will not analyse it on this post but suffice to say that it is equally stupid.
Low intensities are safe but provide poor results
High intensities are very painful and dangerous
Medium intensities are usually safe but still painful and ineffective, requiring multiple sessions, not the promised “you only need one” session - you need 6+. With normal, safe RF you get better results in 6 sessions and no pain.
Pain with bipolar radiofrequency
Some have heard of bipolar radiofrequency, which is very superficial and which consequently can be very painful and cause burns, if used at very high intensity by overzealous therapists.
The problem with bipolar RF is that it makes the epidermis (top skin layer) very hot while the dermis and hypodermis (where skin tightening / cellulite reduction occur) does not get hot at all. So what do some therapists do? Crank up the volume to properly heat the hypodermis - and as a result burn the epidermis.
I know. It’s stupid, isn’t it?
Pain with ignorant application
I even met a client a few weeks ago who was a victim of an ignorant and irresponsible therapist who actually needed an assistant to keep applying cream during treatment in order to stop the client from feeling burned.
This is so wrong on so many levels, I have no words to describe it.
No manufacturer suggests such a practice, so I assume the therapist believed that the more you burn the client, the better the results, as long as you temporarily cool them down with a cream.
Unbelievable…
(Needless to say that in the end the client predictably did get burned.)
No pain, no gain?
Some people perhaps imagine that it is all about “no pain, no gain”, as in laser hair removal, surgery, cosmetic injections etc, so “radiofrequency must hurt to be effective', right“?
Wrong. Just wrong. For radiofrequency to work, you don’t need pain.
The fact is that properly applied radiofrequency treatment does not have to be painful
Radiofrequency has been safely and effectively used for decades in physiotherapy before being adapted for use in aesthetic treatments, based on the principle of ‘never crossing the pain threshold’.
The ‘no pain’ principle still remains the pillar of properly applied radio frequency today, both in beauty and physiotherapy.
Working with several modestly priced sessions just below the pain threshold with ‘stimulative radiofrequency’ (i.e. with the aim to stimulate collagen synthesis and contraction, as well as fat release - as opposed to burning the sh*t out of everything inside the skin) can provide up to 99.5% safety and better results than with one very expensive, very dangerous, “you only need one, darling” destructive radiofrequency session.
Unfortunately, the down to earth, 6-12 session, stimulative approach does not generate 5x or 10x times more income for the clinic that provides it and it is not based on promising miracle/instant results (which don’t exist in real life, anyway), so many clinics opt for the destructive option. But it is the best option for the client.
In fact, if your radio frequency treatment is consistently painful, either you belong to 1% of the population who are overly sensitive or your therapist does something - or a lot of things - wrong. Even worse, if numbing cream needs to be used, you are really having the wrong type of radiofrequency.
According to both studies and practical experience, painful, ‘destructive radiofrequency’ has less benefits than ‘stimulative radiofrequency’ and lots more chances of side effects (pain, scar tissue, burns etc).
How should a proper radiofrequency treatment feel?
At the clinic we have been using deep-acting, high-power radiofrequency and in the last 14 years - and over thousands of sessions - it has been consistently pain-free and side effect-free (99.5% of the time), despite the high power used.
Most people find it comfortable and some actually doze off for a few minutes, if they are too tired
A small minority find it uncomfortable but not painful
Whenever occasionally there is some pain/burning feeling that is only for a a split of a second and afterwards the therapist makes sure treatment becomes comfortable / painless again, by lowering the intensity, moving away from that specific spot or changing other settings
So radiofrequency is safe, if focused on the right skin layer (dermis, hypodermis) and when provided with high yet controlled intensity and the appropriate contact creams/gels/oils.
Of course, there is the opposite end of the spectrum: very comfortable treatment merely due to very low intensity, which is a sheer waste of money and time. But thats a story for another article.
When is radiofrequency painful?
If stationary treatment is used (i.e. when the handpiece does not move during treatment), radiofrequency is bound to be painful and ineffective. A lot of high-tech solutions have been developed to - largely unsuccessfully - solve the problem of overheating with static RF provision, when the simple solution is to keep moving the handpiece (it’s more tiring for the therapist, but safer and more effective for the client). Furthermore, studies and practical experience have shown that treatment with continuous movement actually provides better results than stationary treatment.
RF microneedling: painful, dangerous, expensive, largely ineffective and promoted with fake “before and after” pictures. What to like about it?
If bipolar radio frequency is used at very high intensities, treatment can be painful and skin can be burned
The same applies to other high intensity superficial types of radiofrequency, such as fractional radiofrequency or some types of capacitive radiofrequency
If cooling is not applied, with certain types of RF
If the wrong cream/gel/oil is used (this can make a huge difference)
If intensity is simply excessive in order to produce “faster results” for the client. The body has its limits so excessive intensity is bound to be painful. Painful application may increase results by 10-20% but it also increases the chance of irritation by 200-300%. Clearly not worth it.
Have a treatment in London with the cellulite experts
At LipoTherapeia we have specialised 100% in skin tightening and cellulite reduction for more than two decades and 20,000+ sessions.
This is all we study and practise every day and have researched and tried hands-on all the important skin tightening equipment and their manufacturers.
As strong, deep acting radiofrequency and deep-acting, high-power ultrasound cavitation are the technologies of choice for skin tightening and cellulite reduction, we have invested in the best RF/ultrasound technologies in the world.
(Of course, we keep looking for new technologies every day and if/when a better technology materialises we will be the first to provide it. However, we will never follow the latest ineffective gimmick, just because it’s good marketing to offer the latest hyped up - yet ineffective and/or unsafe treatment.)
Furthermore, over the last two decades we have developed advanced RF and cavitation treatment protocols in order to make the most of our technologies, for maximum results, naturally and safely.
And for even better, faster results, we now combine our RF/ultrasound treatments with high-power red/infrared light LED treatment.
Our radiofrequency/ultrasound/LED treatments are comfortable, pain-free, downtime-free, injection-free, 99.5%+ safe and always non-invasive.
(No unsafe and ineffective RF microneedling or HIFU and no safe but ineffective acoustic wave therapy, superficial RF (bipolar/tripolar/multipolar etc), low power RF/cavitation, electrical muscle stimulation, lymphatic massage, cupping, dry brushing and no ridiculous bum bum creams.)
Our focus is on honest, realistic, science-based treatment, combined with caring, professional service, with a smile.
We will be pleased to see you, assess your cellulite, skin laxity or fibrosis, listen to your story, discuss your case and offer you the best possible treatment.
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Why train with The Cellulite School™?
We all know that training in cellulite reduction and skin tightening is as basic as it gets. It is typically a 4-6 hour training, involving only basic instruction from the manufacturer on how operators can use the machine; lots of myths, erroneous information and misconceptions; and some basic health and safety on how to use the machine.
There is no proper, real training in the science or cellulite, skin tightening, radiofrequency, ultrasound and all related technologies is non-existent - worldwide.
Do you want to deeply understand radiofrequency, ultrasound cavitation, LED phototherapy, cellulite and skin tightening?
Get proper training based on 24-year theory and practical application of cellulite reduction and valuable insights from 23,000+ sessions and 4,100+ clients.
Now you can get instant access to our expertise and save yourself literally thousands of pounds, dollars or euros of expensive mistakes and thousands of hours of study, research and practical application by attending one of our half-day, 1-day, 2-day or 3-day professional consultancy / training courses.
Understand deeply - and get properly trained in - the science of radiofrequency, ultrasound cavitation, LED phototherapy, cellulite and skin tightening and confidently offer your clients the safest, strongest and most effective treatment possible.
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