>>436832
I've noticed this, too. I think it has something to do with the fact that Japanese people seem to get horrified by the outlandishly absurd, while us in the West tend to find it comedic. The longer his works go on, the more absurd things get.
There was LOTS of things in Uzumaki that were pretty terrifying, a lot of it psychological. Like the woman who drilled out her own ears and went blind and deaf and lost her sense of balance all at once. She spent her last days screaming in agony because she was constantly feeling vertigo which she interpreted as falling down a spiral: her worst fear.
But then there was shit like the girl with the possessed monster-hair. And the motherfucking corpse with a spring embedded inside it that BOUNCED AFTER the protagonists; I laughed myself silly that whole chapter. And the teenage gang members who harnessed tornadoes and flew around on them (Ito's got a thing for people flying around; as you mentioned he did the same thing in Hellstar Remina). The people-turning-into-snails bit wasn't frightening until it started happening to the protag's little brother, because that's when it became a psychological horror again.
What I think a lot of people don't understand (including Ito or his publishers/editors at times) is that creepy disgusting things like body horror AREN'T really what's scary. It's extremely unnerving and disturbing to people, but not scary by itself. It should be used to define the mood that then builds upon the psychological horror, not used in lieu of it. The great thing about HP Lovecraft is that he put ideas and concepts of horrifying infinity into our minds; he didn't write entire stories filling with graphic descriptions of horrible things.
My favorite of his works that I've read so far is Hellstar Remina. It's very Lovecraftian in the "eldritch horror from the great beyond" sense, and I feel that's the main point of what makes it terrifying. It's a giant creature that is going to eat Earth, and there is NOTHING YOU CAN DO ABOUT IT! The fact that it has eyes and a giant tongue and its surface is fractal madness that melts and possesses people adds to the horror, but it isn't the horror, itself. It just makes it more disturbing.
In much the same way, I feel the ending third that focused on the chase after the girl Remina was rather unimportant. She was used as a vehicle for the reader to follow, to show the rising madness gripping humanity at a micro-scale, but in the grand scale of things (complete human extinction) she wasn't at all important. There was nothing particularly valuable or compelling about her person that made you want her to survive. This meant that the bittersweet ending was just odd; why should I care if some girl I know nothing about survived the apocalypse and will now starve out in space in a few years?
A better ending would be: the hellstar ATE THE FUCKING EARTH... and yet... the rest of the Universe didn't even notice.