The Physical Toll of Hollywood’s Most Demanding Role
Actors often go to great lengths to bring their characters to life, but few have faced the kind of physical challenges that Margaret Qualley endured while filming The Substance. The critically acclaimed horror film, directed by French filmmaker Coralie Fargeat, required Qualley to wear extensive prosthetics that left her skin in severe condition. According to the actress, it took nearly a full year for her face to fully recover from the damage caused by the effects.
Qualley, who plays Sue—a younger version of Demi Moore’s character in the film—described the process as grueling. “At the end, when they’re shooting up my skirt in the beginning credits, when it’s like the palm trees all around and they have all these long lenses from the bottom, that’s just because my face was so fked up by that time,” she revealed on the podcast Happy Sad Confused. The prosthetics not only altered her appearance but also led to persistent acne, which continued to affect her even while filming her next project, Kinds of Kindness.
A Challenging Transformation

The film’s premise centers on Elisabeth Sparkle, a celebrated actress and fitness guru played by Demi Moore, who is fired on her 50th birthday. She discovers a black-market drug called the Substance, which promises to give her a younger version of herself named Sue. This transformation leads to a disturbing body-horror narrative where Sue emerges from a slit in Elisabeth’s spine, and their relationship becomes increasingly destructive as both characters’ bodies decay.
Qualley described the prosthetic suit she wore in the final act as “a torture chamber.” She told the Los Angeles Times that the experience was so intense that she would often have panic attacks during filming. “We would just go until I had a panic attack,” she said. “And the tempting thing is you want to peel it off, but of course you can’t do that, because you’ll bring your skin with you.”
The Cost of Practical Effects

The prosthetics used in The Substance were not only physically taxing but also time-consuming. According to Demi Moore, the application process could take anywhere from six to nine and a half hours, and removing them took at least an hour and a half. The use of practical effects over CGI added to the authenticity of the film, but it came at a steep cost for the actors involved.
Despite the challenges, the film has been a critical and commercial success. It has entered the cultural zeitgeist, with both Moore and Qualley receiving significant awards buzz. Moore won a Golden Globe for her performance, and the film itself has been praised for its bold storytelling and visual effects.
A New Era of Body-Horror
The Substance represents a new era in body-horror cinema, blending psychological tension with visceral imagery. The film explores themes of aging, identity, and the dangers of chasing eternal youth. As Sue and Elisabeth’s relationship deteriorates, their physical transformations become a metaphor for the emotional and moral decay that comes with obsession.
The final act of the film is particularly intense, with the story culminating in a blood-soaked climax that redefines the term “bloodbath.” This level of commitment from the cast and crew has contributed to the film’s reputation as one of the most daring and unforgettable horror movies in recent years.
The Aftermath of a Transformative Role
For Qualley, the experience of playing Sue was more than just a professional challenge—it was a physical and emotional journey. The acne she developed from the prosthetics became part of her performance, as she used it to enhance the realism of her character. “I was like, ‘Oh this is actually kind of perfect. I’m playing all these different characters. For one of them, we’ll use all my crazy prosthetic acne,’” she said.
It took Qualley about a year to fully recover from the effects of the prosthetics, highlighting the toll that such roles can take on an actor’s health. Despite the difficulties, she remains proud of her work on The Substance, which has solidified her place in the industry as a versatile and dedicated performer.
A Growing Trend in Hollywood
The use of extensive prosthetics in The Substance reflects a growing trend in Hollywood, where filmmakers are increasingly relying on practical effects to create more immersive and believable experiences. While CGI has become the go-to solution for many productions, there is a renewed appreciation for the artistry and craftsmanship involved in traditional makeup and prosthetics.
This trend is not without its challenges, as seen in Qualley’s experience. However, it also allows for a deeper connection between the audience and the characters, as the physical transformations become a key part of the storytelling. As more filmmakers embrace this approach, the demand for skilled makeup artists and special effects technicians continues to grow.
The Future of Body-Horror
With The Substance setting a new standard for body-horror, the genre is poised for a resurgence. Filmmakers are pushing boundaries, exploring darker themes, and using innovative techniques to create more impactful narratives. The success of the film has sparked interest in similar projects, with audiences eager to see more stories that challenge conventional ideas about beauty, aging, and identity.
As the industry evolves, the balance between practical effects and digital technology will continue to be a topic of discussion. However, the legacy of The Substance serves as a reminder of the power of physical transformation in storytelling—and the dedication required to bring such visions to life.