Despite decades of feminist progress, youth is still one of the most universal currencies for women. As we fight for equal pay, for a fair share of domestic labour, for representation and for respect, we are still expected to recoil at the sight of our emerging crow’s feet in the mirror, to battle the natural ageing process at all costs.

Indeed, if you ever find yourself on the beauty-focused side of TikTok, you’ll be greeted with an endless stream of videos in which women claim to have found the secret to eternal youth: face massaging, slugging, face taping and beyond. More young women, seemingly horrified by the thought of a single wrinkle, are trooping to their aestheticians seeking out “preventative Botox”. The fear of ageing has even reached girls, many of whom are reported to be shopping at Sephora and slathering retinol on their faces after school.

It is all, of course, unfair. The modern world is filled to the brim with messaging that tells us any sign of ageing is a fundamental flaw, that there is always something you could be doing to slow it down lest you become less visible and less valued.

It is this insidious cultural obsession with youth that Coralie Fargeat tackles in her horror spectacle, The Substance. An outrageous, gory extravaganza of body horror, the film pushes the idea to its most grotesque boundaries. Demi Moore stars as Elisabeth Sparkle, an ageing actress and fading star whose career has petered out into a hosting spot on a daytime jazz exercise TV show. When her boss Harvey, played by a grimy Dennis Quaid, unceremoniously tells her she is fired – “it stops after 50,” he says bluntly – she is left rudderless and distraught. Evidently, she has no friends, no family, no sense of value beyond her public persona. So, soon enough, she turns to “The Substance”, a black market drug that promises to split her in two with the new version becoming younger, more beautiful, more perfect. The only catch is that the two selves must split their time, each living for seven days before swapping over.

Sue, played by a glossy and slightly sinister Margaret Qualley, is born – or rather, she emerges, in a stomach-turning sequence through a crack in Elisabeth’s spine. Sue is beautiful, thin, giggly, coquettish – a Barbie doll come to life. When she walks into the room, you can practically see the dollar signs dinging in Harvey’s eyes. Sue takes over from Elisabeth, heading up a new, more youthful exercise show. Meanwhile, Elisabeth sinks deeper into her depression, spending her weeks devouring greasy food and mindlessly watching daytime TV. The arrangement, it turns out, doesn’t work particularly for either Elisabeth or Sue and things soon take a gory turn, leading to the creation of a nightmarish, contorted monster and a truly unhinged finale that is, quite literally, a sickening sea of blood, guts and gore. The point of all of this excess is simple: this is the ugliness that lies at the heart of our obsession with beauty.

We see a subtler (and more powerful) version of this grotesque display earlier in the film. During her first week awake after the split, Elisabeth half-heartedly tries to build a new life for herself. No, she doesn’t reach out to old friends or pull out a book or take an interest in the news or visit a museum or plan a trip. Her version of a life, it seems, must always involve the approving eyes of another: she calls Freddy, a simpering fan who gave her his number telling her she was “still the most beautiful woman in the world”.

She readies herself for the date, donning a little red dress and heels. She looks confident, powerful, gorgeous. But before she leaves, she catches a glimpse of Sue sleeping for the week on the bathroom floor. She looks back to the mirror. Suddenly, all she can see in her reflection are the lines, the dark spots and the jowls. In a painful sequence, we see the clock ticking away as Elisabeth piles more and more make-up onto her face, trying to hide every so-called flaw. But each time she looks at Sue’s sleeping form, her own reflection is more and more dissatisfying in comparison.

The Substance is not without flaws itself. It can feel clunky and has a tendency to over-explain its plot. It also doesn’t have much faith in its female characters to break out of the cycle and even consider what worth they may have beyond their physical selves – but that, I suppose, is the point of it all. Beyond its gory surface, it’s a film that confronts us: what do we truly value in ourselves? The name of the film may refer to the drug that Elisabeth uses, but it is also a snide reference to her own being. After a life spent obsessing about how she is perceived, there really is very little substance there. And it is not just Elisabeth that’s to blame.

Images: MUBI