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Spanish auteur Pedro Almodóvar’s 18th feature – his first with one-time muse Antonio Banderas since 1990’s Tie Me Up! Tie Me Down! – explores the director’s oft-worked themes of sexual identity and desire while exhibiting his fondness for vivid colours, vibrant melodrama and zesty living spaces.

Yet in adapting Thierry Jonquet’s cold-to-burn novel Tarantula, Almodóvar has created his most outré outing to date: an arthouse rape-revenge/mad surgeon/ torture porn tale hinging on a fiendish reveal sure to reduce viewers to foetal balls.

Banderas plays Dr Robert Ledgard, a brilliant plastic surgeon obsessed with creating the perfect skin – smooth and fire-resistant, for reasons later revealed.

He has, locked upstairs, a beautiful guinea pig in the form of kidnappee Vera (Elena Anaya), though he’s never sure whether to operate on her, torment her, or fuck her, and she in turn flip-flops between cowering and seducing. It’s not, safe to say, a healthy relationship…

To tell more would be to straighten out the serpentine plotting and run risk of highlighting deep, dark plot twists. What can be said (because it will come as no surprise to Pedro’s fans) is that The Skin I Live In riffs playfully and artfully on plenty of other movies, with Frankenstein, Eyes Without A Face and Vertigo the primary inspirations for this mad, bad tale of obsession, grief, creation and science.

It’s all done with extraordinary finesse, and perhaps lacks the clinical horror that Cronenberg would bring or the soul-shaking dread of Lynch. But there is plenty of vigour in the visuals and the film pulsates with the anarchic brio of Almodóvar’s early, ‘enfant terrible’ movies.

OK, so there’s nothing here to upset quite like the graphic opening of 1986’s Matador, when Nacho Martinez masturbates over plasma-pumping Troma clips, but here it’s the ideas that slice into the fear cortex.

A reinvigorated Banderas is terrific as the slick, sick surgeon, while Anaya, re-teaming with Almodóvar after a small part in 2002’s Talk To Her, is an international star in the making. Initially a blank canvas for Ledgard (and viewers) to project fantasies onto, her Vera is then fleshed out in unexpected and challenging ways.

And if questions of desire and identity are ultimately skin-deep, the film at least emerges as another of Pedro’s passionate odes to women.

Jamie Graham is a freelance writer and former Editor-at-Large of Total Film magazine. You'll likely find them around these parts reviewing the biggest films on the planet and speaking to some of the biggest stars in the business – that's just what Jamie does. Jamie has also written for outlets like SFX and the Sunday Times Culture, and appeared on podcasts exploring the wondrous worlds of occult and horror.