Aesthetics investigates the efficacy of IBSA Pharmaceutical’s (Farmaceutici Italia) new hyaluronic acid injectable that aims to treat skin laxity without the use of BDDE
“Profhilo is not a mesotherapy product, neither is it a dermal filler,” says aesthetic dental practitioner Dr Emma Ravichandran, who was one of the first practitioners in the UK to use the product, having incorporated it into her clinic in February 2016. “Profhilo is a stabilised hyaluronic acid (HA) but without any chemical cross-linking agents – the first injectable of its kind,” she explains.
Profhilo, distributed by HA Derma, is indicated for the treatment of skin laxity and is free of 1,4-butanediol diglycidyl ether (BDDE) – a viscous liquid, hygroscopic in nature, which links the HA chains to prevent them being broken down by the body.1 Although cross-linking chemicals, such as BDDE, in small doses in dermal filler has been indicated to be safe,2 the BDDE-free concept could be appealing to consumers who are wary of synthetic chemicals being used in products.3
According to IBSA, the HA is stabilised by a patented thermal process whereby the natural bonds found in high molecular weight (H-HA) break, and new hydrogen bonds are formed between the H-HA and low molecular weight (L-HA). This allows for 32mg of L-HA (80 – 100 kDa) to be combined with 32mg of H-HA (1100 – 1400 kDa), to form stable hybrid complexes (64mg in 2ml). In practice, the L-HA aims to hydrate and stimulate skin, while the H-HA acts as a dermal scaffold in the skin.4
As with any injectable treatment there are minor risks, including bruising and swelling, as well as infection, allergic reaction, vascular compromise and nerve damage; although IBSA claims these are rare.
Both the company and practitioners who have experience using Profhilo claim there is no real downtime, due to minimal injection points. “From a safety perspective, Profhilo is highly biocompatible, owing to the fact that it is made from natural hyaluronic acid and stabilised without the addition of chemical cross-linking agents,” says Dr Ravichandran, adding, “But it’s still important as an aesthetic injector to have the protocols to deal with any complications in case they occur.”
Dr Ravichandran says, “After four weeks, my patients have experienced improvement in lines and tightness of their skin. After eight weeks there is a definite lifting and tightening of the skin – it is more hydrated and appears more youthful and in better health.” Some of her patients have reported an immediate improvement after treatment. She continues, “I have now completed 20 patients’ preliminary two-step treatments and am delighted with the results I have achieved (Figure 2). Overall, patients can expect increased firmness, elasticity and an overall improved quality of skin, with the effects lasting up to six months.”
Dr Ravichandran concludes, “Profhilo does not create the volumetric lift or volume replacement associated with cross-linked dermal fillers, however, it creates volume in the tissue where it is needed due to its high spreadability. Owing to this characteristic, it is an ideal treatment for challenging areas as well, such as the neck, perioral area, and hands and arms, where we do not see the significant volume loss, but skin has lost elasticity. I often see patients with artificially enhanced cheeks, which is a result of overfilling because the wrinkle ‘just doesn’t go away’. But, in my experience, Profhilo has been very effective in correcting this concern.”