Discussing Colorism and Pigmentary Disorders, With Seemal Desai, MD, and Pearl Grimes, MD

In a recent episode of the Skin of Color Savvy podcast, hosted by Skin of Color Society (SOCS) leaders and produced by HCPLive, Seemal R. Desai, MD, sat down with internationally recognized pigmentary disorders expert Pearl Grimes, MD, for a wide-ranging discussion on colorism, pigmentary disease, and the ethical complexities dermatologists face when treating patients seeking skin lightening.1

Desai opened the conversation by emphasizing the growing importance of understanding the intersection between pigmentary disorders and cultural perceptions of skin tone, noting that issues surrounding skin bleaching, fairness, and hyperpigmentation remain deeply intertwined in many societies. Grimes, founder of the Vitiligo and Pigmentation Institute of Southern California and the Pearl Melasma Research and Treatment Institute, reflected on more than 45 years of experience in pigmentation research, describing the field as both her professional passion and a core part of her identity.

Throughout the discussion, Grimes highlighted the global nature of colorism, explaining that preference for lighter skin extends across numerous cultures and geographic regions, including the US, Europe, Africa, the Middle East, and Asia. She noted that the roots of colorism are multifactorial, shaped in some regions by colonialism and enslavement, while in others influenced more heavily by class structures and social hierarchy. According to Grimes, lighter skin has historically been associated with economic opportunity, professional advancement, marriage prospects, and social status in many cultures.
Desai added personal perspective by referencing the longstanding caste system in India, where lighter skin historically carried social advantages tied to education, employment, and marriage. He noted that these attitudes have persisted across generations and remain influential today despite evolving societal norms.

The conversation then shifted toward the clinical realities dermatologists encounter when managing disorders such as melasma, post-inflammatory hyperpigmentation, and lichen planus pigmentosus. Both physicians acknowledged that the distinction between medically treating uneven pigmentation and addressing culturally driven desires for lighter skin can become blurred in practice.

Grimes explained that many patients initially present seeking treatment for a specific pigmentary condition, but underlying concerns related to colorism may emerge during the clinical encounter. She described how some individuals hope treatment of hyperpigmentation will also lead to an overall lighter complexion, whether consciously or subconsciously motivated by societal pressures.

Both speakers emphasized the responsibility of dermatologists to navigate these conversations thoughtfully and ethically. Grimes stressed the importance of helping patients achieve healthy, even skin tone while also reinforcing positive self-image and discouraging aggressive skin-lightening practices that may carry long-term risks. She noted that clinicians must balance medical management with emotional and psychological support, encouraging patients to focus on becoming “the best version” of themselves rather than pursuing unrealistic or potentially harmful standards tied to colorism.

Editor’s note: This description was summarized with the help of AI tools.

References

1. Desai S, Grimes P. Skin of Color Savvy: Tackling Colorism in Dermatology, With Seemal Desai, MD, and Pearl Grimes, MD. HCPLive. March 24, 2026. Accessed May 12, 2026. https://www.hcplive.com/view/skin-of-color-savvy-tackling-colorism-dermatology-seemal-desai-md-pearl-grimes-md.