Facing the Truth

Lying on a heated bed, Kim Su-yoen, 22, is covered up to her neck in a thin blanket. She is about to have her face peeled off. But don't worry － she'll be out the door and back to work within half an hour. It's not some kind of medieval torture, just the latest beauty fad to hit Korea.

Her face, stripped of makeup, reveals acne on her cheeks and chin and a general redness. In walks Kim Jae-won, dermatologist and head of Yein Skin Clinic, Samseong-dong in southern Seoul. He applies a thin layer of clear solution over Ms. Kim's face with a cotton swab, avoiding the delicate areas around the nose, eyes and mouth. "This is left on for about 6 or 7 minutes," says Dr. Kim, "washed off, followed by a calming pack and a laser treatment, and she can resume her daily routine."

Officially, it is called "facial scaling," but it is perhaps more popularly known as a "lunchtime peel" because the procedure takes about an hour and a half, allowing the patient to pop in around noon, have it done and then head back to the office. This is possible because, unlike other types of chemical peels, facial scaling uses alpha hydroxy acid, which affects only the superficial lining of the skin.

Alpha hydroxy is a group of naturally occurring substances often called "fruit acids." When applied to the skin, the acid destroys the "glue" that holds dead cells to the surface of the skin － or that's the theory. This allows the dead cells to slough off, leaving behind a smoother skin surface. Although different combinations of acids can be used, the most commonly employed is a highly concentrated glycolic acid derived from sugar cane, which is used to remove the upper layer of the skin, called epidermis, exposing the lower layer of undamaged skin.

Deeper peels, such as trichloroacetic acid peel, destroy deeper layers of the skin to permit the underlying new skin to surface, hence making them more effective for fixing deeper damage. However, they produce redness, flaking and peeling that can last for several days, keeping the patient confined to the house. The lighter skin scaling, on the other hand, allows the patients to resume their daily routine after they leave the doctor's office.

The alpha hydroxy peel is an efficient treatment for patients like Ms. Kim who have acne, mild acne scars and enlarged pores, according to Dr. Kim. "Such conditions do not warrant deep peeling and can be sufficiently addressed with the light peel that will give almost instant results," he said. However, because it affects only the superficial lining, a series of peels, usually 5 to 10, over one-week intervals, may be necessary to obtain best results.

Ms. Kim, undergoing her third procedure primarily to eliminate acne, feels a definite improvement. Although her friends have yet to notice any difference, she says, "There is definitely less oil on my skin." Suffering from acne since grade school, she has tried skincare at beauty salons, which proved to be futile. "Once, I paid 2 million won ($1560) for 10 acne-care sessions at a beauty salon, but saw no change," she says.

Best of all, defying the notion of "no pain, no gain," the procedure is virtually pain-free. "There is a slight smarting sensation for a few minutes when the acid solution is applied, but there is no pain afterward," Ms. Kim explains. At 100,000 won per peel, she finds the cost reasonable and the results satisfactory, better than her previous attempts at beauty salons.

Another form of instant gratification to be indulged in at the dermatologist's office is the crystal peel, a form of micro-dermabrasion. The non-surgical procedure uses a precisely controlled jet of aluminum oxide micro-crystals, a sterile fine stand. A handheld wand with adjustable air and vacuum control is passed over the treatment area creating superficial wounds from 10 microns to 100 microns in depth (a sheet of paper is 80 microns thick). The result is the removal of the top layer of skin, stimulating the growth of new skin for improved skin tone and texture.

"For enlarged pores, this is more effective than light peels," Dr. Kim says, adding that the changes are also more dramatic even after just one session, although several sessions, spaced one week apart, are necessary for optimal results. The slight discomfort during the procedure is easy to tolerate and does not require topical anesthesia. Because this procedure allows the patient to wash his or her face and wear makeup immediately afterward, female workers in their 30s and 40s often opt for a crystal peel to smooth away fine lines and brown spots that begin to show around that age. "As with the light peel, the treatment is effective for six to eight months and most patients return after six months," says Dr. Kim. Each session costs around 200,000 to 250,000 won at dermatologist's clinic.

For those willing to lay it all on the line for beauty, poison is another fashion choice.

Botox (short for Botulinum toxin Type A, a purified toxin) can be injected in the face to temporarily "erase" wrinkles. This toxin works by paralyzing muscles. In large doses, usually from eating contaminated canned foods, it causes botulism. Used in purified form, in tiny amounts, and in specific muscles, Botox injections temporarily paralyze specific muscles. "Botox relaxes the muscles in which it is injected," Mr. Kim explains, "thus making lines on the face, in the forehead or mouth, and crow's feet become less deep."

While these quick fixes appear convenient, there are some potential complications. Chemical peels can cause contact dermatitis. And as for Botox, a misplaced injection can cause the wrong muscle to freeze up or freeze up too much, causing unsightly sagging in the face. Fortunately, this problem is only temporary.

Hmmm. Sounds like a beauty fad and a medieval torture.

by Kim Hoo-ran