Elisabeth Sparkle, a former big actor and now star of a popular TV aerobics show, is fired on her 50th birthday because she is too old. She receives an unexpected offer to try The Substance, a mysterious serum that when injected, creates a version of Elisabeth in her 20s.

There is an early scene where the camera focuses on a close up of Dennis Quaid’s producer character messily eating shell-on prawns. You will need a strong stomach to watch that but that is overshadowed by the body horror that follows.

Writer, director and co-producer, Coralie Fargeat delivers a truly audacious critique of the objectification of women in the entertainment industry, and, in the latter stages, of how society shuns anyone who is different. With echoes of Dr Jekyll and Mr Hyde, The Picture of Dorian Grey and The Elephant Man, the latter both thematically and visually, the ideas are not totally original and David Cronenberg’s influence is pretty self evident. But things are taken to new extremes.

Inventively shot by Fargeat and cinematographer Benjamin Kracun, a score by Raffertie that ramps up the horror, with a remarkably uninhibited performance from Demi Moore and a splendidly over the top one from Quaid, there is much to recommend.

It is far from perfect though. Margaret Qualley looks the part as Elisabeth’s new persona but it is hard to believe the actions she takes that seal her own fate and the more grotesque the central character becomes, the less scary it is. Also, Fargeat did not know when all the points had been made, and enough is enough, so the 141 minute run time is about 20 minutes too long.

Rating: 7.5 out of 10

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