SKIN 
 

March 2021     Volume 5 Issue 2 
 

Copyright 2021 The National Society for Cutaneous Medicine 189 

COMPELLING COMMENT 
 

 

A Commentary on Colorism and Skin Bleaching in Asian and 
Asian American Patients 
 

Kezia I. Surjanto BS1, Michael B. Phan BS2, Laura Williams MD1 

 
1Tulane University School of Medicine, New Orleans LA 
2University of Texas Medical Branch, School of Medicine, Galveston TX  
 

 
 

The light-skinned Asian beauty standard that 
is prevalent today may have roots in colorism 
that extend far back into Asian history. 
Colorism is a bias according to a skin color 
hierarchy within ethnoracial groups that leads 
to systematic discrimination against 
individuals with darker skin tones.1,2 In Japan, 
light skin reflected nobility based on the 
implication that fair-skinned individuals were 
exempt from outdoor labor.1,2 In India, 
possessing darker skin implied that one was 
of a lower caste.2 Similar colorism trends were 
also present in China, Pakistan, Vietnam, 
Korea, the Philippines, Cambodia, Thailand, 
and Indonesia, ultimately associating fair skin 
with improved social privilege and beauty.1, 2 

 
These biases impact individuals whose skin 
tone does not conform to the culturally rooted 
standard that is perpetuated throughout 
generations. The discrimination seeps into 
their education and employment, rendering 
them vulnerable to skin tone specific 
microaggressions and potential internalized 
feelings of inferiority compared to their fair-
skinned counterparts.2 As a result, Asians and 
Asian Americans use skin bleaching products, 
despite their ingredients’ adverse effects 
which include, but are not limited to: 
exogenous ochronosis (hydroquinone), 
membranous nephropathy (mercury), and 
superficial mycoses (steroids).1,3 With this in 
mind, one can understand that the practice of 
skin bleaching is not only an attempt to attain 

beauty, but also a means to evade skin tone 
specific discrimination.2 
  
It is crucial for dermatologists— especially 
those serving a diverse patient demographic— 
to be aware of the origins of skin bleaching 
and approach patients suspected of this 
practice from a culturally sensitive 
perspective. Dermatologists have the 
opportunity for educating patients while 
remaining open to their needs, especially if 
they suffer from pigmentary disorders and are 
pursuing lightening outside of a purely 
cosmetic reason. This approach may produce 
better health outcomes in these patients and 
improve physician-patient relationships. 
 
Conflict of Interest Disclosures: None 
 
Funding: None 
 
Corresponding Author: 
Kezia Surjanto 
1430 Tulane Ave 
New Orleans, LA 70112 
Phone: 949-637-8614 
Email: ksurjanto@tulane.edu 

 
 

References: 
1. Gupta MA, Gupta AK. The color of skin: psychiatric 

ramifications. Clin Dermatol. 2019;37(5):437-446. 
2. Bettache K. A Call to Action: The Need for a Cultural 

Psychological Approach to Discrimination on the Basis 
of Skin Color in Asia. Perspect Psychol Sci. 
2020;15(4):1131-1139. 

3. Mahé A. The practice of skin-bleaching for a cosmetic 
purpose in immigrant communities. J Travel Med. 
2014;21(4):282-287.  

mailto:ksurjanto@tulane.edu