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"  It&amp;#039;s the first day of London Fashion Week, but instead of darting about town reporting the latest beauty looks from backstage, I&amp;#039;m booked for an interview with legendary British facialist Amanda Lacey. &amp;quot;It&amp;#039;s a dreadful mess,&amp;quot; she says, gesturing to her immaculate Diptyque Figuier candle\u2013scented home clinic in the city&amp;#039;s posh Chelsea neighborhood. &amp;quot;Do you fancy some tea?&amp;quot; Scoring an appointment with Lacey is a highly coveted event: She tends to the luminous skin of Gwyneth Paltrow, Rosie Huntington-Whiteley, and Erin Wasson, among others. I should be thrilled, but instead I&amp;#039;m filled with anxiety: I&amp;#039;m fascinated by Lacey&amp;#039;s skin-care philosophy, yes, but also petrified of letting her touch my face. A few years ago, I had a bad facial. That kicked off a bout of acne, and I&amp;#039;ve been on a strict regimen of skin prescriptions ever since\u2014antibiotic Clindamycin wipes in the morning, antibiotic-and-retinoid hybrid Ziana gel in the evening, retinoid Atralin as needed, oral antibiotic Minocyline\u2026. I could go on. Thing is, I worship at an entirely different skin-care temple than that of Lacey&amp;#039;s followers: I believe in no-frills, high-octane dermatology. For me, at least, that&amp;#039;s what works. But it&amp;#039;s impossible to ignore my British peers&amp;#039; plush, springy skin. Even some of the smokers I&amp;#039;ve met in London look more fresh-faced than I do. &amp;quot;Who&amp;#039;s your dermatologist?&amp;quot; I ask an especially youthful-looking DJ friend over drinks\u2014a perfectly reasonable query on my side of the pond. &amp;quot;A dermatologist?&amp;quot; she says, sounding mildly offended. &amp;quot;Why would I need one? I have a facialist.&amp;quot; Brits and Americans are equally obsessed with the pursuit of an even, smooth, glowing complexion. In fact, it&amp;#039;s one thing that women everywhere can agree on\u2014we want perfect skin. But there&amp;#039;s an essential ideological difference between the two cultures: While Americans have been derm-dependent since the Botox boom of the late &amp;#039;90s, Brits have long subscribed to waiting-list-only, super-elite facialists. In the U.S., the big coup is getting an appointment with an MD such as Frederic Brandt, Dennis Gross, or Macrene Alexiades-Armenakas; in England, it&amp;#039;s getting a regular booking with a skin guru like Amanda Lacey, Sarah Chapman, Nichola Joss, or Eve Lom. It reflects something deeper about the two cultures and our views about beauty in general. British women don&amp;#039;t tend to diet like we do. They exercise for health and well-being, but they don&amp;#039;t kill themselves on the treadmill. They smoke less these days, but they don&amp;#039;t obsess over every cigarette; they don&amp;#039;t detox after every drink. And they think we&amp;#039;re insane to do all of that. It&amp;#039;s why Bridget Jones is such a quintessentially British bird. &amp;quot;In the UK, you go to a dermatologist when you have a problem, not preventatively,&amp;quot; says cosmetic dermatologist Marko Lens, MD, whose office is just off London&amp;#039;s renowned Harley Street. &amp;quot;British women want a couple of wrinkles to be seen.&amp;quot; Both aging and anti-aging are taken a shade less seriously. &amp;quot;I&amp;#039;m convinced if a woman is happy, with a regular sex life, then the skin looks much nicer,&amp;quot; Lens says with a suggestive brow raise, himself a glowing testament to this principle, having just returned from a skin-boosting weekend in Mykonos. Still, the Brits are coming around to our way of thinking about skin care, becoming more conversant with dermatologists such as Lens and signing up for lasers, fillers, and Botox\u2014while at the same time American cool girls are increasingly eschewing fillers for facials. Even U.S. dermatologists who have traditionally turned up their noses at facialists are beginning to appreciate their point of view. Many top stateside derms\u2014NYC-based David Colbert, MD, and Gervaise Gerstner, MD, among others\u2014now have aestheticians in their offices, and are incorporating a less invasive philosophy in some of their products and procedures, giving us the best of both worlds. &amp;quot;Facialists are great for helping a person read and understand their skin type,&amp;quot; Gross says, and they&amp;#039;re also able to spend more time with the patient than the doctor can. The British facialist experience revolves around dual obsessions with cleansing and massage\u2014the two elements of skin care that I&amp;#039;m downright lax about. &amp;quot;Cleanser is the most important thing,&amp;quot; says Lacey, who favors her own gentle oil-based pomade over the type of foaming face washes generally beloved by dermatologists. She warms the balmy blend in her hands so that it will spread easily, then, working up from the d\u00E9collet\u00E9, massages the face in a clockwise motion, stimulating circulation and lymphatic drainage, a technique that visibly reduces puffiness. UK facialist and blogger Caroline Hirons swears by a three-cleanser regimen. &amp;quot;In an ideal world, everyone should have a natural balm cleanser, a non-foaming milk or gel cleanser, and either a pre-cleanse oil or an eye makeup remover if you wear waterproof eye makeup,&amp;quot; she says. &amp;quot;The lighter milk or gel is perfect for a quick cleanse in the morning, and the balm is for evening use and massage.&amp;quot; To American ears it sounds extreme: Why waste money on cleansers that just get washed away? &amp;quot;Renoir didn&amp;#039;t paint on the sidewalk,&amp;quot; Hirons says. &amp;quot;An expensive moisturizer is not going to penetrate your skin if your face is not thoroughly cleansed and prepared.&amp;quot; Plus, Hirons&amp;#039; approach gets skin clean, but not too clean, unlike a super-sudsy sulfate-based face soap that might disrupt the skin&amp;#039;s protective barrier. For someone like me who torches her face twice daily with potent Rx bombs, a gentle approach could be just what the doctor ordered. In New York City, dermatologist Dennis Gross, MD, is also taking grime-blasting seriously. The latest addition to his product line is an at-home device lifted straight from facialist 101: Steamer Solutions, designed for ultradeep cleaning. &amp;quot;It&amp;#039;s brilliant for unblocking pores and it&amp;#039;s incredible for hydration and plumping. People find steam calming, and the relaxation to the facial muscles really makes you look younger,&amp;quot; says Gross, who promises that the just-warm-enough mist released by his steamer won&amp;#039;t cause any of the damage (irritation, dryness, broken capillaries) of the overheated steamers of the past. &amp;quot;The beautiful thing is that the benefits are all done essentially with water. And when you can use something natural like that, it doesn&amp;#039;t get better.&amp;quot; Gross recommends a 20-minute treatment once or twice a week, but of course, he&amp;#039;s not suggesting steam is a substitute for in-office ministrations: &amp;quot;It&amp;#039;s best to steam before a chemical peel because the steam will loosen dead skin cells and enhance a chemical peel&amp;#039;s exfoliation,&amp;quot; he says. Back home, when clusters of tiny bumps appear on my forehead and cheeks\u2014the result, perhaps, of spooning my Delta Air Lines blanket a bit too closely\u2014I put off my monthly derm visit in favor of a facial with famed Manhattan-based French aesthetician Isabelle Bellis, renowned for her deep face massage technique and, in true facialist form, attention to cleansing. Bellis handles the visage of megamodel Anja Rubik, among other supes. During my session, Bellis talks me through each step, making easy suggestions: Perhaps I might give my skin a rest by applying my beloved retinols every other day? Why don&amp;#039;t I try a thermal water mist after washing with New York City tap water? Nothing extreme. Despite her request that I not rinse my skin after her treatment, ever facial-phobic I slip into the bathroom and frantically splash with water. But the oils she&amp;#039;s used don&amp;#039;t budge and, even better, the glow remains. Maybe it&amp;#039;s the dreamy lighting, but I swear Bellis&amp;#039; windmill-like fingertips have visibly lifted my cheeks and brows\u2014and my jet-lagged under-eyes appear less puffy. Though I&amp;#039;m unlikely ever to completely forsake my trusted derms, I float out onto the New York City street ready for dual citizenship. "^^<http://www.w3.org/2001/XMLSchema#string>
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