14 April 2020
Profhilo: The Insider’s Review to the Future of Injectable Skincare.
You’ve heard about oral skincare, printable skincare but what about injectable skincare? Injectable skincare isn’t exactly new- Skinboosters and Rejuran Healer are two very popular skin hydration and collagen building treatments in Singapore that are regarded as injectable moisturisers. Now you can add one more name to your vocabulary of injectable skincare: Profhilo.
For beauty insiders and readers who are clued in with European aesthetic trends, Profhilo might sound very familiar. It is THE skin hydration and anti-wrinkle treatment of the moment in Europe and has been reviewed by many beauty writers. Profhilo has even been called “The the anti-wrinkle treatment for 2019” by The Times, a British newspaper. The question that’s on everyone’s mind right now is: is Profhilo worth it? To answer this question, let’s first get down to the science and biochemistry of this bioremodelling injectable.
The breakthrough that sets Profhilo apart from the current realm of injectable skin hydrating treatments is its patented technology that remodels the skin for younger and healthier skin. Unique to Profhilo is its molecular structure that stimulates the formation of collagen, elastin and stem cells for healthier and younger skin1,2.
If injectable treatments like botox and dermal fillers worry you about overly filled and frozen faces, rest assured that you will not go down that route with this treatment. Technically speaking, Profhilo is much more than an injectable moisturiser. More correctly speaking, it is a bio-remodelling tissue stimulator that goes deeper into the skin to smoothen and tighten skin, while hydrating the skin from within3,4.
Excited to know more about the future of injectable moisturisers? Here’s the lowdown on all you need to know about this new bioremodelling treatment that looks set to be a game changer for injectable moisturisers.
Profhilo (逆時針) is an anti-aging injectable treatment that contains hyaluronic acid for skin rejuvenation, hydration and elasticity. The unique molecular structure of Profhilo stimulates the formation of 4 types of collagen, elastin and proliferate adipocytes (fat) stem cells causes bioremodelling of the skin while hydrating skin from within.
• Improved skin hydration
• Healthier and firmer skin
• Faster wound healing
• Lifting effect and tighter skin
• Smoother skin
• Reduced depth of depressed scars (e.g. from acne scars and chicken pox) can be made shallower
Profhilo contains a mixture of high and low molecular weight hyaluronic acid molecules. The concentration of hyaluronic acid in Profhilo is 64mg/2ml (or 32mg/ml)- higher than the concentration of hyaluronic acid in dermal fillers like Juvederm’s Voluma and Restylane’s Perlane (both contain 20mg/ml).
You might be familiar with hyaluronic acid- it is a familiar feature in dermal fillers and skincare for its hydrating prowess. In Profhilo, the low molecular weight hyaluronic acid allows for a slow and sustained release of hyaluronic acid which causes bioremodelling and reduced inflammation. The high molecular weight hyaluronic acid reinforces the framework and scaffolding of hyaluronic acid in the skin for the lifting (i.e. bioremodelling) effect3,4.
Just in case you’re a little confused about Profhilo treatments because of its similarities to Skinboosters and dermal fillers because all of them contain hyaluronic acid; that’s really where the similarities end. Profhilo is neither a dermal filler nor Skinbooster treatment. It is a bioremodelling skin treatment that rejuvenates collagen and elastin formation in the skin.
No BDDE or chemical cross links
Besides the high concentration and mixture of low and high molecular weight hyaluronic acid; Profhilo does not contain chemical cross links or BDDE (1,4-Butanediol Diglycidyl Ether). BDDE is a common feature in Skinboosters and dermal fillers for increased stability and biomechanics. BDDE has been linked to a slightly increased risk of inflammation and formation of lumps in the skin, however BDDE in general in dermal fillers and Skinboosters is very safe5.
Less inflammation and higher spreadability with Profhilo treatment
Although there are no chemical cross links or BDDE in Profhilo, the hyaluronic acid complexes are stabilised through thermal cross links. Profhilo’s patented NAHYCO® Technology binds the high and low molecular weight hyaluronic acid through thermal cross-linking to form Hybrid Cooperative Complex Hyaluronic Acid. This complex allows for lower inflammatory response, low viscosity and high spreadability6. This translates to better safety, lesser injection points and faster recovery for patients.
Collagen and elastin bioremodelling in the skin with Profhilo injections
This hybrid complex of hyaluronic acid also tightens, hydrates and rejuvenates skin by kickstarting collagen and elastin at different depths of the skin.
Profhilo treatment also recruits adipocyte stem cells and enhances renewal of cells1,2. The high molecular weight hyaluronic acid in Profhilo injections maintains optimal conditions for viability of the adipocyte stem cells for remodelling of the skin for better elasticity and support.
Profhilo also contains one of the highest concentrations of hyaluronic acid to up the ante for skin hydration.
These are some of the findings of the benefits that I find very useful, especially since of these benefits are not achieved with other anti-aging treatments.
There are 2 parts to this answer. The mixture of high and low molecular weight hyaluronic acid molecules hydrate the skin due to their hydrophillic nature, similar to Skinboosters.
Secondly, this complex of stabilised hyaluronic acid is slowly released in the skin and acts on different layers of the skin to stimulate the fibroblasts, keratinocytes and adipocytes for healthier skin. This then effects the changes and benefits to the skin as mentioned above.
Profhilo is from Italy and it has been commercially available in Europe since 2015. The manufacturer of Profhilo is IBSA Farmaceutici Italia .
So far, Profhilo injection treatments have been shown to be safe3,4. Most patients report mild and temporary swelling related to the injections, rather than the ingredients of the product. Hyaluronic acid is safe to be injected in the skin and this has been confirmed by studies on Profhilo3,4.
There are some features in Profhilo treatment that improve the safety profile of the injections:
1. The absence of chemical cross links or BDDE for greater biocompatibility in human skin. This also lower the risk of inflammation and formation of lumps under the skin with Profhilo injections.
2. The injection points for Profhilo are less than Skinboosters and Rejuran; which means a lower risk of side effects and complications such as bruising and (very rarely) infections.
3. The injection points for Profhilo are also standardised- 5 injection points called Bio Aesthetic Points (BAP)3,4,7; which are far from major nerves and blood vessels; so risk of injury to these structures is much lower.
Profhilo is suitable for anyone who wants to improve skin hydration and correct mild to moderate signs of aging in the skin such as fine lines and mild sagging. This bioremodelling injectable can improve skin hydration, rejuvenation and tightening.
If you are looking for healthier and younger looking skin but you’re not keen for Botox or dermal fillers, a bioremodelling injectable like Profhilo would be a good recommendation to eradicate your fine lines, gently lift your skin and improve your skin texture.
Transepidermal water loss is also reduced with Profhilo injections. So if you have conditions such as eczema or dry skin due to increased transepidermal water loss, Profhilo treatment will be useful protecting your skin on top of your existing treatment(s).
Both male and female patients are suitable for Profhilo injections. This bioremodelling injectable does not change your facial features or shape so it will not make male patients feminine looking.
Treatment with Profhilo is generally safe. The side effects are related to the injections itself rather than the ingredients in Profhilo. A study that reviewed the safety of Profhilo injections showed that temporary swelling and bruising were the main issues of discomfort3,4. There were no reported major complications such as arterial occlusion3,4.
Downtime associated with Profhilo injections is negligible. There are small bumps/swelling immediately after Profhilo injections that will disappear within 1-2 hours. Very rare, this very mild swelling may persist. Bruising is very uncommon as major vessesls are avoided as the specific injection points for Profhilo.
Although Profhilo treatment is an excellent skin hydrating and skin tightening, there are a few limitations. Profhilo lasts for 6 months and you might need to repeat it if you would like to see the benefits again.
If you’re looking to get Profhilo injections, the recommended protocol is to begin with 2 treatment sessions one month apart followed by maintenance 6 months after. However, if you have very dry skin, conditions such as eczema or more severe signs of aging, you might require more sessions for more obvious results.
The other point that I have emphasised repeatedly- Profhilo is not a dermal filler is also particularly relevant here. Although both injectables contain hyaluronic acid as their main active ingredient; the biochemistry and injection techniques are very different. Correspondingly, the results of Profhilo vs dermal fillers are different. Profhilo is not capable of adding volume or sculpting the face the way dermal fillers can.
The skin tightening and gentle lifting effect of Profhilo also cannot be compared to a dedicated lifting treatment for sagging skin such as face threadlifts, dermalift or dermal filler (“Liquid Facelift”). Profhilo is also not an under eye filler for dark eye circle or under eye bags, which would require tear trough fillers. Although Profhilo can be injected close to the eyes for wrinkles; it is also does not remove crows’ feet wrinkles. Crows’ feet wrinkles at the outer corners of the eyes would require Botulinum toxin injections.
If you are looking to address these signs of aging- volume loss, sagging, skin laxity- you can consider combining Profhilo together with other treatments e.g. dermal fillers and threadlifts.
There is some discomfort with Profhilo injections; as with all injections. In my clinic in Singapore, I usually prepare the patient by getting their face numbed before starting. This helps to reduce discomfort.
One advantage of Profhilo injections is that only 5 injection points are required on each side of the face and/or neck; as opposed to the numerous injections required for Skinboosters.
The recommended treatment protocol based on the studies conducted is to begin with 2 sessions one month apart followed by maintenance injections 6 months afterwards.
As I have explained under “Are there limitations with Profhilo injections?”, if you have more severe signs of aging or dry skin like eczema, you may require a third or fourth session to achieve optimal results before moving onto maintenance treatment.
There isn’t a consensus about how long the results of Profhilo injections last so far. The recommended treatment protocol is to repeat Profhilo injections 6 months after the initial treatment.
As with any treatment- be it Skinboosters, Rejuran, Botox or dermal fillers- the longevity may differ from person to person.
You might be confused by the differences between Profhilo vs Rejuran Healer because they seem a little similar. Allow me to demystify some of the differences between Profhilo vs Rejuran Healer.
Rejuran Healer is also used to treat conditions similar to Profhilo such as acne scars and signs of aging like wrinkles. To add to the confusion, some doctors and publications also refer to Rejuran Healer as an injectable moisturiser or skincare. Technically, that is not wrong as Rejuran Healer contains a small amount of hyaluronic acid that can hydrate the skin.
Unlike Profhilo where the active ingredients is a complex of high and low molecular weight hyaluronic acid, the main active ingredient in Rejuran Healer is polynucleotides (PN or PDRN) derived from salmon sperm.
Profhilo hydrates and bioremodels the skin by increasing the amounts of collagen and elastin in the skin. Stem cells in the skin are also activated by Profhilo. On the other hand, the polynucleotides in Rejuran Healer stimulate tissue repair, build collagen and reduce inflammation in the skin.
The injection techniques, treatment protocol and prices also differ for Profhilo vs Rejuran Healer. Profhilo is injected over 5 injection points on each side of the face and neck. Rejuran Healer is injected over more points over the face and neck; and it can be injected using an injector gun or manually with a needle. The recommended injection intervals are 1 month apart for the first 2 months for Profhilo followed by maintenance. For Rejuran Healer, the recommended injection intervals are one month apart for the first 3 months followed by maintenance.
My blogpost Profhilo vs Rejuran vs Skinboosters: Injectable Moisturisers Explained will discuss the differences in effects and treatment protocols in greater detail. If you are still in doubt about whether Profhilo vs Rejuran Healer is better for you; speak to your doctor about your concerns to know which is best for you.
Both injectables contain hyaluronic acid and hydrate the skin. Profhilo has the additional advantage of bioremodelling the skin i.e. form 4 types of collagen and elastin; and proliferate adipocytes (fat) stem cells.
Profhilo also acts on different layers of the skin- the epidermis, dermis and superficial fat layer to regenerate the skin. Skinbooster acts on a single depth.
Not really, Profhilo and Skinboosters have different strengths. The recommended treatment regime and cost of both treatments are also different.
Profhilo is most suitable for patients who want to treat skin dryness, mild skin laxity/ sagging and signs of aging like fine wrinkles. In my opinion, Skinboosters are best for patients who want to hydrate dry skin and achieve brighter and glowy skin and smaller pores.
Although the recommended treatment intervals and the number of injection points are less for Profhilo vs Skinboosters, Skinboosters seems to last longer than Profhilo. The cost of Profhilo vs Skinboosters is also different. With the total number of sessions taken into account, the price of Profhilo is still more than Skinboosters in Singapore.
Yes, it is safe to have these treatments combined. Profhilo injections alone are not able to completely eradicate wrinkles, lift the skin or replace volume loss. Hence, consider combining with other anti-aging treatments if you would like a more holistic approach to treating your skin.
My basic recommendation would be to combine Profhilo injections with Q-switched lasers to lighten pigmentation and brighten skin together! If you have specific concerns like wrinkles or volume loss, consider adding Botulinum toxin and dermal fillers!
• Body: chest and abdomen
So far the bio-aesthetic injection points have been standardised for the face and neck. The rest of the bio aesthetic injection points for the hands and bodies are being explored.
Avoid facials, massages or vigorous activity to the skin after injections. Please also avoid consuming alcohol, supplements that may worsen bruising such as gingko.
I hope that you found this insider’s guide to Profhilo. Profhilo is a welcome addition to the family of injectable skincare and bioremodelling treatments in Singapore. the This review of Profhilo will be updated with more details soon. Please feel free to leave a comment or share this post!
1. Hyaluronan Hybrid Cooperative Complexes as a Novel Frontier for Cellular Bioprocesses Re-Activation. Stellavato et al. PLoS One 2016;11:e0163510.
2.Hybrid Complexes of High and Low Molecular Weight Hyaluronans Highly Enhance HASCs Differentiation: Implication for Facial Bioremodelling. Stellavato et al. Cell Physiol Biochem 2017;44:1078-1092.
3. Efficacy and tolerance of an injectable medical device containing stable hybrid cooperative complexes of high- and low-molecular-weight hyaluronic acid: a monocentric 16 weeks open-label evaluation. Sparavigna and Tenconi. Clin Cosmet Investig Dermatol. 2016; 9: 297–305.
4. Efficacy, Safety, and Tolerance of a New Injection Technique for High- and Low-Molecular-Weight Hyaluronic Acid Hybrid Complexes. Laurino et al. Eplasty. 2015; 15: e46.
5. A Review of the Metabolism of 1,4-Butanediol Diglycidyl Ether–Crosslinked Hyaluronic Acid Dermal Fillers. De Boulle et al. Dermatol Surg. 2013 Dec; 39(12): 1758–1766.
6. In vitro analysis of the effects on wound healing of high- and low-molecular weight chains of hyaluronan and their hybrid H-HA/L-HA complexes. D’Agostino et al. BMC Cell Biol. 2015 Jul 11;16:19.
7. Hyaluronic acid hybrid cooperative complexes and the BAP (Bio Aesthetic Points) technique: the new edge in biorejuvenation. Beatiniet al. Aesthetic Medicine. 2016; 2(2); 45-51.