Can Profhilo (hyaluronic acid) be used as an alternative to Botox (botulinum toxin) for reducing the appearance of facial pores in a patient who has already tried Botox?

Profhilo for Facial Pores: Not a Substitute for Botox

Profhilo is not an appropriate alternative to Botox for reducing facial pores because these treatments work through completely different mechanisms—Botox reduces pore appearance by decreasing sebum production through muscle relaxation, while Profhilo is a bioremodeling agent that improves skin quality through tissue hydration and remodeling but does not directly target pore size. 1

Understanding the Mechanism Difference

Botox (Microbotox) for Pores

• Microbotox specifically targets pore reduction through intradermal injection of diluted botulinum toxin into the upper dermis, which decreases sebaceous gland activity and reduces pore size 1
• A single microbotox session achieved 87.2% average improvement in pore size (3.7 on a 0-4 scale) with sustained results for 1 year 1
• Dermoscopic evaluation confirmed actual reduction in both the size and number of pores, along with improved skin texture and decreased oiliness 1

Profhilo's Actual Mechanism

• Profhilo is a hybrid hyaluronic acid complex designed for tissue bioremodeling and adipose tissue restoration, not pore reduction 2, 3
• It works through diffusion of high and low molecular weight HA to improve skin hydration, elasticity, and overall tissue quality 2
• The product has high biocompatibility and low viscosity that favors tissue-level diffusion for facial contour remodeling 2

What Profhilo Actually Treats

Profhilo demonstrates efficacy for:

• Skin texture and elasticity improvement through dermal remodeling 4
• Facial volume restoration in adipose tissue compartments, particularly the superficial medial and lateral-temporal cheek fat compartments 3
• Overall skin quality enhancement including moisture, firmness, and wrinkle reduction 4

However, significant pore reduction was NOT observed as a primary outcome in any Profhilo studies reviewed 4, 2, 3

Evidence-Based Alternatives for Pore Reduction

If Botox Has Failed or Is Undesirable

Consider PRP/PRF-based treatments combined with microneedling, which showed statistically significant pore reduction:

• Combined therapy with microneedling demonstrated significant pore reduction observable at 1 week and sustained improvement at 8 weeks 4
• PRF treatment showed statistically significant improvement in pores (p < 0.01) at 12 weeks follow-up 4

Combination Approach for Comprehensive Skin Quality

If the goal extends beyond pores to overall skin rejuvenation:

• Combining PRP with non-crosslinked HA (50:50 mix) produced highly significant improvement in facial appearance compared to either treatment alone, with 20-24% increase in FACE-Q scores 5
• This combination also significantly improved skin elasticity and texture 5
• This is NOT the same as Profhilo, which uses a proprietary hybrid HA complex rather than a simple PRP/HA mixture 2

Critical Clinical Pitfall

Do not promise patients that Profhilo will reduce pore size—this sets unrealistic expectations. While Profhilo improves overall skin quality, hydration, and texture 2, 3, there is no evidence it specifically targets or reduces pore diameter like microbotox does 1. The patient satisfaction with Profhilo relates to bioremodeling effects, not pore reduction 6.

Safety Considerations

• Profhilo has an excellent safety profile with only 12 adverse events reported in over 40,000 patients over 3 years, none serious 2
• Most reactions were early-onset injection site reactions (swelling, edema, redness) that resolved without complications 2
• Microbotox for pores also showed no serious or long-term side effects 1

Recommended Treatment Algorithm

1. If pore reduction is the primary goal: Continue or optimize microbotox technique with proper intradermal placement 1
2. If overall skin quality plus modest pore improvement is desired: Consider PRP/PRF with microneedling, which addresses both pores and texture 4
3. If facial volume loss and skin laxity are concerns: Profhilo targets these issues effectively but should not be positioned as a pore treatment 3
4. For comprehensive rejuvenation: Combine PRP with non-crosslinked HA (50:50) for synergistic effects on multiple skin parameters 5