Helter Skelter, josei mangaka Kyoko Okazaki's English-language debut, is a hard book to read. It is the sort of book that you seriously consider putting down at least half a dozen times as the heroine's life spins out of control in disasters of her own making, as we watch her do worse and worse things to unsuspecting people, and then turn on the television and realize that we are the ones who enabled her creation in the first place. Yes, Helter Skelter is difficult to get through. But that is all the more reason why we should finish the book.

Helter Skelter follows fashion icon and general idol Liliko. Liliko is the perfect woman on the outside – her proportions are ideal, her skin is gorgeous, her beauty unstoppable. The only problem is that Liliko was not born a perfect beauty – she was created through plastic surgery and dangerous drug therapies. As a teenager, Liliko was “discovered” by an aging model turned manager known to us as “Mama,” who saw the bones of perfection underneath Liliko's flawed surface. Convincing Liliko that she could be famous, Mama subjected the girl to massive and experimental medical procedures, creating a Frankenstein's monster in reverse: Liliko is human on the outside, but monstrous underneath. Not only do the medications have side effects the likes of which don't get advertised on television, Liliko herself is all too aware of the fact that all things have an expiration date, and that should she not keep up with the treatments (or even if she does), hers will quickly be upon her. Just what the true results are we don't fully know, but over the course of the volume we watch Liliko spiral into madness as her delicate flesh bruises and her hair begins to fall. She is a monster of human creation, and with each passing day, that monster comes closer and closer to the surface.

What is so difficult, and yet important, about the book is the way the audience's participation in Liliko's downfall is implied. Okazaki is too accomplished a mangaka to come right out and tell us that we are all implicit in the creation of Lilikos with our craving for unattainable beauty in the media, but the implications are unmissable. Scenes of everyday people chatting about the latest idol, gushing about surface beauty, and cattily taking shots at anything less than perfection are interspersed throughout the book, giving us brief but meaningful glimpses of the world that allowed Liliko to be born. This is driven home in the volume's ending, reinforcing the superficiality of celebrity culture and leaving an empty feeling that slowly fills with discomfort as the implications set in.

Liliko's slide into depravity is what really earns this volume its mature rating, and those disturbed by deliberate acts of cruelty both physical and sexual will have a difficult time reading the middle portions of the book. As Liliko's life spirals out of control (although we certainly have to question whether she was ever really in control in the first place), she resorts to a vicious cruelty, destroying the lives of those around her as her own is crumbling. Those who bear the brunt of her attacks are her manager Hada and Hada's boyfriend. Liliko sets out to destroy them emotionally by using sex and manipulation, and the resulting carnage is not only depraved but disturbing. Okazaki gets more mileage out of implied scenes and verbal descriptions than she would have by explicit sex scenes (although we see plenty of Liliko's fully drawn naked body), and the result is distinctly uncomfortable. At times this seems more done for the shock value than other parts of the story, but there is no denying that Okazaki's depiction of Liliko's inner monster gets the job done.

Okazaki's artwork falls into the josei category of “raw,” and will be familiar to those who read Tokyo Pop's releases of Erika Sakurazawa's work. This is an art style that we don't often see in English-language releases, and while it may take some getting used to, it helps to emphasize the horrors of the story while still being capable of beauty when it needs to be. Vertical has included color pages in the front of the book that run the gamut from beautiful to disturbing, with the final glossy page reminding us that, “a laugh and a scream are very similar.” In many ways, that sums up the entire book.

Helter Skelter is both the story of a descendant of Mary Shelley's monster and a biting commentary on the cult of beauty that pervades popular culture. It is not an easy read, but it is an important one. Though places over do the point and the “epilogue” goes on a bit too long, Okazaki's story takes an uncomfortable look at the beauty industry and leaves us wondering about the harm that we as consumers can do simply by looking at a face in a magazine and saying, “I wish I was that pretty.”