Coralie Fargeat’s satirical media skewering is a bundle of influences, so it’s no wonder they bubble and mash together by the film’s end. Kafka’s Metamorphosis, Stevenson’s Jekyll and Hyde, and Wilde’s Dorian Gray make their presence felt in the writer-director’s modern fable that’s done the rarest of things as a horror film: earned an Oscar nomination. The Substance isn’t about originality, too much of which could break its concept, but a confident swagger and commitment to grinding the body horror of its concept beyond the pale. On the way, it hands Demi Moore not-so-much a career-rejuvenating role as one made for her.

Moore’s Elizabeth Sparkle is in the long tail of her career. The derision of her boss (Dennis Quaid) and an Oscar win fading from view leaves the actress as cracked as her star on the Hollywood Walk of Fame. After surviving a car crash without a scratch, she finds she’s a perfect candidate for a life-changing new medication that allows her to unleash her better self, but is she her own worst enemy? 

‘You can’t escape from yourself’ after all… And is a bargain with a disembodied devil that comes with an impossible ask the right move? Elizabeth and her better, younger, more perfect self Sue (Margaret Qualley), are soon pitted against each other in a body that just isn’t big enough for the both of them. 

Once the titular substance is injected, the deal is sealed, and that goes for Elizabeth, Sue and the audience. It’s easy to see why the story needs to push itself, with scenes endlessly outdoing themselves on the way to a surreal, ultra-gory and Manga-infused conclusion. While the self-destructive end to Sparkle’s life and career is anticipated, it really is all about the journey. 

And in Moore and Qualley, there are excellent companions for that journey. We might not be able to root for either of them, even when the balance tips in favour of one, but Fargeat makes sure we understand their downward spirals of addiction. Moore is excellent, embodying a character who has to age, mutate, soundlessly scream, and more. There’s a pivotal scene when, at the point of no return and under mounds of make-up, her character still can’t give up the fame and success her other self has achieved.

The physical make-up that blisters and boils is spectacular. It pulsates against the striking set design and Benjamin Kračun’s sharp and colourful lighting. The Substance’s world is immaculately balanced to hold its sublime and ridiculous moments. That’s vital to add weight to the questions it poses to its audience, although it’s difficult to judge how broad that audience may be: this is no four-quadrant picture. 

The Substance will be too stylised for some tastes and too gross for others. While genre classics like Fritz Lang’s Metropolis and Stanley Kubrick’s The Shining make their stylish presence felt, dedicated horror fans may also take exception to The Substance’s genre appropriation. 

While The Substance serves up a lot for the male gaze, the grotesque body horror and hyper-realistic imagery aren’t erotic. Having piled on layers of disgust and disbelief for much of its runtime, as its protagonist cycles through evolutionary phases like Godzilla, deep into its third act, its focus sharpens on sexism and normalised abuse. As we meet the reality of man’s concept of an ideal woman, The Substance ends where it begins. It’s then Fargeat’s sparse script repeats itself, the early awkward dialogue becoming as sharp as a surgeon’s knife or a wonder drug syringe.