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By Valerie Monroe
If you’re interested in feeling happier about your appearance—especially as you age—you might like reading what she has to say about it. For more of her philosophical and practical advice, subscribe for free to How Not to F*ck Up Your Face at valeriemonroe.substack.com.
Can’t get enough Valerie Monroe? There’s more at https://valeriemonroe.substack.com.
A DEAR FRIEND recently mentioned a new skin miracle she’d heard about, ubiquitous in Europe but not FDA approved in the US. Someone she’d met swore by it, so my friend was curious. My friend is slightly younger than I am. She has porcelain skin without any noticeable wrinkles or sun damage; in other words, she’s mistress of an enviable complexion. The woman who introduced my friend to this new skin miracle she doesn’t need said she was injected with it at some spa or medi-spa or other venue that’s not a doctor’s office—because, you know, illegal.
What is the stuff? Profhilo, a liquid form of hyaluronic acid, which hydrates skin cells in a layer deeper than what can be reached by topical moisturizers. It’s different from hyaluronic acid fillers, in case you’re wondering, which are cross-linked to (basically) bind together different-size molecules to create volume. Profhilo, on the other hand, is thin and disperses throughout the dermis, providing hydration without volume.
If results are visible—that depends on the condition of your skin—two or three repeat treatments (averaging $325/treatment according to RealSelf) are recommended. The results last around a month. One happy recipient (in the UK) gushed that it made her skin look like she drank 10 glasses of water a day. I actually drink around 10 glasses of water a day. I wonder if you could guess how well-hydrated I am by looking at my face? Definitely not as easily as if I told you how much time I spend in the bathroom.
Anyway, I checked out the place where it seemed Profhilo injections were being administered. At least on the website, there’s no specific mention of it. Still, I hope my friend is as cautious as I begged her to be. Not long after her text, I received a reader email about another form of hyaluronic acid touted as a skin miracle. Will wonders never cease? Not in the beauty world, evidently.
Q: Val, every podcast I listen to seems to offer some fancy new supplement that will cure all my skin woes. I’m skeptical by nature (verging on cynical at times), so I view all the “clinical results show . . . ” with more than a touch of side-eye. And yet. . . . The latest is Ritual’s hyaluronic acid supplement, which promises to restore my skin from the inside out. Is there merit to any of it? Should I stick to the topicals?
Thanks for all you do. I’ve saved myself a fortune reading your sage advice (and put some of it towards a HNTFUYF subscription).
A: Attention HNTFUYF-ers: This reader is a role model! How impressive is her indisputably practical thinking!
On the supplement front, I, too, verge on cynical. But I take calcium/magnesium, vitamin D, and zinc, so I’m not completely free of the supplement spell. If there were reputable studies showing hyaluronic acid pills work and how they work, I might consider adding them to my small cache. So I asked HNTFUYF DermDiva Heidi Waldorf, MD, what she thought.
Importantly, “Most supplements aimed at improving skin health with peptides and antioxidants are safe,” said Waldorf, “and there are small studies on individual actives [including hyaluronic acid] showing some benefit. What hasn’t been studied is long-term improvement or how they stand up against standard topical therapy.”
To illustrate the power of topical therapy, Waldorf shared how even a little care could go a long way. “A year ago, a 70-something, low-maintenance guy in my gym asked what he could do for lower eyelid wrinkles,” she said. “He zoned out when I mentioned devices and injectables. Then, I asked what he did regularly for his under-eye area. The answer? ‘Nothing.’ So I recommended he add a basic daily moisturizer. He still tells me how many compliments he gets—including from his dermatologist. Now, all his 70+ guy friends are using a Eucerin cream.”
Waldorf guesses that most of you thinking about taking a supplement are already using a moisturizer and more. So who might benefit from oral hyaluronic acid? Someone not getting hyaluronic acid from a nutritious diet (unlikely) or someone for whom a regular skincare regimen isn’t sufficient, said Waldorf. I bet you’re aware, as am I, of the spongy meanings behind “regular” and “sufficient,” which could suggest anything from applying a moisturizer weekly to having daily hydrafacials (don’t). But Waldorf hits the bull’s-eye:
“Realistic expectations are key. From a long-term and cost-benefit perspective, a gentle non-soap cleanser, moisturizer, prescription retinoid, and sunscreen, with or without an over-the-counter, science-based anti-aging topical cosmeceutical (for example, peptides or antioxidants), will do more for you than a supplement and for less money.”
Still unconvinced? I haven’t yet mentioned that it’s hard to know what you’re getting in that supplement bottle. According to a recent story in The Washington Post:
In the United States, companies sell an estimated 90,000 dietary supplements, representing a roughly $50 billion industry. As a result, some experts say, consumers who buy supplements can’t always be sure that they are getting what they paid for. Studies of melatonin, fish oil, probiotics, ginkgo biloba, and other supplements have found that the doses and compounds listed on their labels are often not what are found in their bottles.
- In one study in the journal Pediatric Research, researchers tested 16 probiotic supplements and found that only one of them contained the specific bacterial strains listed on its label.
- In another study, researchers tested 30 dietary supplements that claimed to strengthen immune health and found that 17 of the products were “misbranded.” These supplements either lacked key ingredients listed on their labels—such as vitamin B12, garlic extract, ginger root and folate—or they contained a variety of unlisted ingredients.
For more information about supplements,* check out this comprehensive report by Jen Gunter, MD, in The Vagenda. By the way, this is my current favorite supplement. I use it after applying moisturizer/sunscreen in the morning and whenever I need to reapply sunscreen while out and about. Only positive side effects!
*Also see Mary Carpenter’s Well-Being column from last week.
