In September 2019, I was very privileged to be one of the first few doctors in Singapore to travel to Milan, Italy to learn about Profhilo, so that I can help train doctors in the region on its usage. After working with Profhilo for two years, many of my patients have benefited from its skin boosting effects. The treatment has also gained considerable popularity here, resulting in many advertisements on the treatment – some misleading, leaving the public confused. As a result, there are many misconceptions about the treatment, which I hope to clarify here.
Profhilo – The Science
Some basics first – Profhilo is a bio-remodelling treatment made up of a unique hyaluronic acid molecule called the Hybrid Coorperative Complex (HCC).
It improves the skin through several effects. Once injected, it stimulates skin cells to collagen and elastin (1). It activates stem cells in the fat layer known as adipocytes to improve fat tissue renewal(2). It also promotes wound healing, and hydrates the skin(3).
Hyaluronic acid is natural compound which native to our skin. Because the Profhilo is only made up of hyaluronic acid, and it does not trigger an inflammatory response. Its breakdown products – H-HA and L-HA, are released slowed into the skin, making it very biocompatible and low in inflammation.
The treatment also the advantage of less injection points(4), and therefore less discomfort and downtime, compared to the traditional skinboosters.
(ONE)
Needleless Profhilo Does Not Work, and May Be Dangerous. Profhilo Needs to be Injected into the Skin
First and foremost, Profhilo has to be injected into the skin. It contains 32mg/ml of L-HA and 32mg/ml of H-HA, totaling 64mg in 2ml, the highest concentration of hyaluronic acid in a product. The product has some degree of viscosity (unlike water for instance), and therefore, is difficult to penetrate the skin layer though other methods.
A few days ago, I had a patient who is very keen on the treatment, but afraid of needles. She was advised by her friend to go to another clinic instead to have the treatment done, as that clinic claims to be able to deliver the treatment and give her the same beneficial skin effects using a revolutionary, proprietary machine, WITHOUT NEEDLES.
Needleless Profhilo, unfortunately, does not exist. This misconception is so widespread that the manufacturer IBSA Derma has release a statement to clarify that all benefits of Profhilo are only achievable by injections as demonstrated in multiple published clinical journals.Therefore, needleless Profhilo is nothing more than a fairy tale, and a dangerous, unethical marketing gimmick.
In fact, the U.S. Food and Drug Administration (FDA) has recently released a statement warning the public and health care professionals not to use needle-free devices for injection of hyaluronic acid products, as this can cause serious injuries and in some cases, permanent harm to the skin, lips, or eyes (5). Needle-free injectors are handheld devices or “pens” that use high pressure to force substances, such as fillers, into the body.
Needle-free injection devices for aesthetic purposes do not provide enough control over where the injected product is placed. Other risks, some of them permanent, may include:
- Bleeding or bruising
- Infection with bacteria, fungus, or virus from the filler or needle-free device
- Transmission of disease between people who use the same needle-free device
- Blockage of a blood vessel, leading to tissue death (necrosis), blindness, or stroke
- Scarring
- Damage to eyes from the pressure of the needle-free device
- Formation of lumps in the skin
- Discoloration of the skin
- Allergic reaction
(Source: U.S. FDA)
So Please, Stay Away from Clinics who Claim They can Perform Needleless Profhilo. At best, you are wasting your money. Worst case scenario – you may end up with permanent side effects.
(TWO)
PROFHILO Treatment Is Not Limited to the Cheeks, Lower Face, Neck
Profhilo is most often used to treat the cheeks, lower face and neck. We hear some much about the 5 point injections in these areas, that many people think that these are the only areas Profhilo can treat. However, it can also be used in many other areas on the body – for example the forehead, and hands, where it helps to hydrate and tighten the skin. It can be used practically anywhere on the body where there is skin laxity – most commonly the abdomen, knees and arms. In fact, there will soon be a new Profihlo product being introduced here – Profhilo Body, specially designed for treating areas off the face.
(THREE)
PROFHILO Does not Give Volume like Fillers
Even though fillers and Profhilo are both made up of Hyaluronic Acid, they are meant to do different things. Facial Fillers, such as Restylane, Juvederm and Belotero, are designed to replace lost volume or fill up folds in the skin. Once faical fillers are injected, the gel stays in place and volumizes the area. To ensure they are firmer, and last longer, the HA molecules are modified by adding cross linking agents – the most common being 1,4-Butanediol diglycidyl ether (BDDE).
Profhilo, on the other hand, is used to improve skin quality, though hydration and the stimulation of collagen and elastin production in the epidermis, dermis and superficial fat compartments to restore aged tissue, without volumisation. Any plumping of the skin after Profhilo is through hydration.
(FOUR)
PROFHILO Has Some Similarities and Differences from SkinBoosters
Skinboosters is a popular treatment for skin quality improvement, especially in Asia. The treatment reintroduces lost hyaluronic acid in our skin to restore hydration and elasticity. The treatment involves tiny injections of a low viscosity hyaluronic acid filler, such as Restylane Vital or Vital Light, into the mid layers of the skin.
Although Profhilo hydrates the skin, but it is not a traditional “skinbooster”. Similar to Skinboosters, Profhilo improves skin hydration. However, it goes a step further to tighten and firm up skin through collagen and elastin stimulation.
The process in Profhilo is active, rather than passive like in other skinbooster treatments – it is a regenerative anti-aging treatment which reverses the aging process through bioremodelling of the skin.
Another difference is the way it is injected. Due to its extensive spreadability (of about 2cm radius), only 10 injection points are required for the cheeks and lower face, and a further 10 for the neck. This is in contrast to other skin boosting treatments which require up to 100 injections for the cheeks and lower face.
(FIVE)
The Five Point Injections are Not the Only Technique to Inject PROFHILO
The five injection points you hear so much, also referred to as the Bio-Aesthetic- Points (BAP), are a unique feature of Profhilo. It allows us to perform the treatment with minimal discomfort or downtime.
However, the BAPs are just a guide for your doctor. He or she may decide to vary the location and number of injections points depending on your skin. At the same time, the amount of Profhilo you need may vary, it may not always be a syringe per person. For example, if you have more textural abnormalities like acne scars, or also want to treat the forehead area, you will need more product. The way your treatment Is done will also be different from someone else’s.
(SIX)
PROHFILO Is Very Safe, But Can Have Side Effects
Finally, Profhilo is very safe, due to the reduced injection points, but it is not without side effects. The most common adverse event is bruising and swelling. These are temporary and resolve by themselves.
More serious adverse events – for example, injection into the artery causing skin death, can occur, just like with all other hyaluronic injectable treatments, although they are extremely rare. Therefore, you need to be aware of these risks before you undergo the treatment. Only get your Profhilo done with certified injectors.
With all these in mind, you can get the best out of your Profhilo treatment!
References:
- Stellavato A, Corsuto L, D’Agostino A, La Gatta A, Diana P, Bernini P, et al. Hyaluronan Hybrid Cooperative Complexes as a Novel Frontier for Cellular Bioprocesses Re-Activation. PLoS One 2016;11:e0163510.
- Hybrid Complexes of High and Low Molecular Weight Hyaluronans Highly Enhance HASCs Differentiation: Implication for Facial Bioremodelling A. Stellavato and M. La Noce et al. Cell Physiol Biochem 2017;44:1078-1092
- 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 Biology (2015) 16:19 DOI 10.1186/s12860-015-0064-6
- Efficacy, Safety, and Tolerance of a New Injection Technique for High- and Low-Molecular-Weight Hyaluronic Acid Hybrid Complexes Carmen Laurino, MSc, Beniamino Palmieri, MD, and Alessandro Coacci, MD
- Do Not Use Needle-Free Devices for Injection of Dermal Fillers – FDA Safety Communication
