AsiaLIFE

Beauty is as beauty does, they say, but with rising disposable income in Cambodia, the demand for treatments to augment nature’s endowments are on the rise. However, due to a largely unregulated market those seeking beautification may get more than they bargained for. Words by Nora Lindstrom.

The Cambodian beauty industry is growing. Where services a decade ago were limited to small roadside barbers with basic equipment, today those with the cash to afford it can get anything from high-end hair cuts through botox injections to quality breast implants.

Dermatologist Dr. Em Sam Ol of Derma-Care Skin Clinic, attributes the changes in the industry to the effects of globalisation. “Before people would go abroad for these kinds of treatment,” he says. “But now we have real beauty here, and middle and high level people can enjoy these services in Cambodia.”

According to Sam there are essentially two kinds of service providers in the Cambodian beauty industry – cheap, local salons that mainly deal with hair and make-up but also offer some beauty treatments, and professionally run establishments with high quality and increasingly technology-based services.

“[The latter] is slowly growing,” he says. “It’s about real beauty and aesthetics where we use botox, laser and medicine for long-term impact and improvement of the skin. These are new ideas that have developed only in the last five years.”

Opened around a year ago, Sam’s clinic offers a wide range of high-tech services. “At the moment, botox, fillers and some medicine for the skin are popular,” he says. “Among foreigners, the first two are most popular, while among Cambodians it ranges from medicine for the skin, through botox and fillers, to laser treatments.”

Trained in part abroad, Sam notes that there are inherent dangers in the uncontrolled growth of the industry. “Only a few doctors have been trained abroad for using laser, and especially botox and fillers. You need special training for that,” he says. “We have many clients who come to us from another salon or clinic,” he adds, explaining how he often sees patients who have had botched chemical or synthetic implants. “In some cases we can solve the problem by removing the substances, but in others we cannot because the problem is very serious and we need to transfer the patient abroad.”

Sim Sovanratana (Ratana) of EL Skin & Wellness Centre has experienced similar situations. “Some people go for pigmentation treatments to salons that use too strong products, which harm the skin. The skin goes red and sometimes becomes inflamed,” she says. “Afterwards they come to me.”

She describes how the common desire for whiter skin leads Cambodian women to try out treatments that use steroids and hydrocortisone. Unless properly administered, these are often too strong for the skin, leading to complications.

Safety First?

Following three years of training in the U.S., Ratana has a Diploma in Clinical Skin Care from the Florida Career College. At EL, she provides over three hundred beauty treatments using Dermalogica products and new technologies for skin care, including light and heat energy, a third generation intensive therapy.

Unlike some in the industry, she is aware of her limits. “The first thing to consider is customer safety,” she says. “I would like to provide laser treatments to my customers as well, but in order to do that I would first have to return to the U.S. for further training.”

Lack of professional training is a pervasive problem in the industry. “Many people working within the beauty industry in Cambodia have had no formal training,” says Natalie Elverd, technical advisor at local NGO Friends International. With two decades of experience in the Australian beauty industry, Natalie is currently offering technical and training support in hair and beauty to the Mith Samlanh School’s vocational programme.

“Over the past couple of years I have seen some improvement in the quality of services offered,” she says. “But in many locally run businesses hygiene standards are still non-existent or very poor, due to lack of education and training.” Using dirty equipment can have any number of consequences, from irritating sensitive skin to spreading various infections and fungi.

Work in the beauty industry is in high demand among young Cambodians, especially girls. In Phnom Penh, a variety of beauty schools offer courses covering various aspects of beauty. Full courses generally cost between US$500 and US$1,000 – significantly more than most beauty therapist hopefuls are able to pay. Consequently, many learn the trade on the job. Given the lack of regulation of the schools, there is also no guarantee that graduates have learnt the appropriate skills.

When Japanese hairdresser Jun Kikuchi opened his top-end salon De Gran last year, he was astonished by the low skill level of those applying for jobs at his salon. “They have no basic skills,” he says. “They’ve just learnt by following someone else.” Who that someone else might be, and whether he or she is qualified, is a moot point.

Jun is not alone in his views. Diep Peseng (Thear), managing partner of popular Champei Spa, prefers to hire inexperienced staff and provide training in-house, to ensure his staff do not use unsafe techniques learnt elsewhere. “It’s better to get someone without any knowledge and teach them our way from the start,” he says. “It’s a lot faster and easier for us.”

Ratana also provides in-house training for her staff, commencing with looking at the basic ingredients of products. A knowledge of what each pot and tube contains is imperative in ensuring customers get the correct treatment, she maintains. Unfortunately, Cambodia is awash with counterfeit beauty products, so what’s written on the label does not necessarily reflect what’s in the pot. “It’s a big problem,” says Ratana. “You really need to go to the right place for real products, and look for certifications.”

Sam too considers limited regulation of products a key issue affecting the industry. “The quality of medicine is most important,” he says. “Is it proper? Where is it from? Is it FDA approved?” Sellers in the markets, who are often the first stop for locals seeking treatment for skin conditions, seldom have the answers to these questions.

Sculpt Me Pretty

In addition to seeking out conventional beauty treatments, Cambodians are also increasingly looking into more drastic measures.

During his decade of working in the country, American plastic surgeon Dr. Reid Sheftall of The Breast Clinic has seen an almost complete change in his clientele.

“There’s been a huge increase in Cambodian patients lately,” he says. “When I first arrived 10 years ago there used to be no Cambodians, there was no middle class. Now, almost three quarters of his patients are locals, including actresses, singers and models.

Through surgery, many are looking to attain more western, or Caucasian, features.

“The reason for that is that the western world dominates the fashion industry,” says Reid. “Most of the famous magazines have more Caucasian than Asian women in them. They see that, and they like the high nose, the bigger eyes...”

The quest for more beautiful and youthful looks through surgery has its pitfalls. Given limited regulation, some establishments offer services they are not qualified to perform. Like Sam and Ratana in the field of dermatology, Reid says many of his patients come to him after someone else has “mangled” them.

“There are people here doing it that are not plastic surgeons, they’re just doctors who want to make some money,” he says. “They even caught a dentist here doing it a couple of years ago, and people are doing it in beauty salons.”

By “it” Reid is referring to a variety of surgeries, from liposuction through tummy tucks and nose jobs, to eyelid surgery to creating a double crease. “Beauty salons should not be doing operations on people,” he adds, calling for stricter regulation of the industry. He suspects many of his patients who come for corrections are either too scared of going back to their original doctor, or have gone back only to be told that there is “no problem”.

Nose jobs and breast augmentations are some of his most common procedures. According to Reid, these are in theory very simple, but demand skill and a meticulousness eye.

“Plastic surgery is easier in some ways than general surgery, but the standards of precision are much higher,” he says. “In plastic surgery, if you’re off half a millimetre on the eyelid, the patient is going to be very unhappy because they came to you wanting to look better, and instead they look worse.”

Not everything can be improved by the knife. Reid turns away at least half of the people that come to him. “I tell them I don’t want to do it because I don’t think it will make them look better,” he says. “I can make money from surgery and I love doing it, but I tell them ‘I don’t want to do that on you’ because I don’t want them to have a bad result.” Unfortunately, that still leaves the customers the option of seeking out another surgeon.

Reid believes plastic surgery is here to stay. “It will increase as the middle class increases and people also become more aware of the world,” he says. “People are going to want to correct things they are unhappy about.” He also argues there is very little stigma attached to plastic surgery in Cambodia. “The singers aren’t embarrassed at all,” he says. “They all come in and take their tops off and ask me if they should be doing it. A lot of them have really rich husbands.”

Beauty Tourism?

Though health tourism is yet to hit Cambodia, Reid is already getting patients flying in from other parts of the world. Predominantly, these are Americans of the Khmer diaspora, though he does get patients from Thailand, Singapore, Australia and France. With breast augmentations priced at US$2,500, it is easy to see the draw.

At Derma-Care, most foreign clients are expats, happy to have someone local to go to for reliable beauty treatments. Sam thinks it will take some time before Cambodia reaches the same level of health or beauty tourism as in Thailand and Singapore. “Maybe ten years or so. We need to increase the quality first, we need capacity building,” he says.

He also notes that while labour costs in Cambodia are significantly lower than in the West, customers still need to pay for quality products. “Because we buy high quality medicine, we need to have a high price,” he says. At his clinic, botox injections start from US$12 per unit.

Though it serves to be wary when seeking out beauty treatments in Cambodia, Natalie says using common sense and doing your research will take you far.

“One of the many pleasures when living in or visiting Cambodia is the vast selection of affordable beauty treatments available,” she says. “Ask for a friend’s recommendation. Some of the popular and well-known businesses here do offer a high level of service.”

Sam says stricter control of the industry is needed, but also notes that patients’ experiences through trial and error are likely to help improve the industry. “Step by step people will begin to understand and seek the right place for beauty services,” he says. “Because of side effects and complications from those who don’t practice well, people will become increasingly aware.”


Box:
Hints and Tips by Natalie Elverd

Manicures and Pedicures
Look for clean equipment and towels, especially cuticle cutters and nail filing tools as skin infection and fungus can be easily spread from one person to another.

Hair Removal
Ask if the wax used in the business is new. Some businesses will recycle wax. Not a nice thought when someone might have had a bikini wax the day before your waxing service.

Facial Skin Scrubs and Masks
Some products are not what they claim and may be too harsh to use on the face, they are often bought at the local market. Ask questions about the products being used or ask friends for recommendations.

Please be careful if you are considering facial injections, chemical peels or laser treatments, Cambodia is not regulated and the experience of the technician may be minimal.