Skin of Color pp 305-317 | Cite as

Cultural Considerations in Asian Patients



Asians have different cultural backgrounds and have a large range of skin types (from skin type II to VI). Certain skin diseases have different manifestations and prevalence among Asian patients. While in the West, it is common for physicians to approach diseases by assuming they are due to external factors, degeneration of the body part/organ, or a combination of both, Asians believe the body is a whole, and each part of it is thoroughly interconnected in its health and in a diseased state. People in Asia usually believe that diet plays an important role in disease, with some diets perceived to make the disease worse, while others would improve it. It is very common for Asians to ask for specific dietary restriction as a part of their treatments when they visit their physicians. Some Asian cultural practices can leave skin marks that may be misinterpreted by unfamiliar physicians as physical abuse. To understand the sociocultural traditions and health beliefs among Asians, it is important for all physicians to be familiar with these practices; this is especially important with the changing demographics of the population in Western countries, including the United States.


Atopic Dermatitis Herpes Zoster Allergic Contact Dermatitis Alopecia Areata Dermatology Life Quality Index 
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  1. 1.
    Culture of Asia. Accessed Aug 2009.
  2. 2.
    Taylor SC. Epidemiology of skin diseases in ethnic populations. Dermatol Clin. 2003;21:601–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Traditional Asian health beliefs and healing practices. Accessed Aug 2009.
  4. 4.
    Moy JA, McKinley-Grant L, Sanchez MR. Cultural aspects in the treatment of patients with skin disease. Dermatol Clin. 2003;21:733–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Sheehan MP, Atherton DJ. A controlled trial of traditional Chinese medicinal plants in widespread non-exudative atopic eczema. Br J Dermatol. 1992;126:179–84.PubMedCrossRefGoogle Scholar
  6. 6.
    Sheehan MP, Atherton DJ. One-year follow up of children treated with Chinese medicinal herbs for atopic eczema. Br J Dermatol. 1994;130:488–93.PubMedCrossRefGoogle Scholar
  7. 7.
    Hon KL, Leung TF, Wong Y, et al. A pentaherbs capsule as a treatment option for atopic dermatitis in children: an open-labeled case series. Am J Chin Med. 2004;32:941–50.PubMedCrossRefGoogle Scholar
  8. 8.
    Hon KL, Lee VW, Leung TF, et al. Corticosteroids are not present in a traditional Chinese medicine formulation for atopic dermatitis in children. Ann Acad Med Singapore. 2006;35: 759–63.PubMedGoogle Scholar
  9. 9.
    Hon KL, Leung TF, Ng PC, et al. Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo-controlled study. Br J Dermatol. 2007;157:357–63.PubMedCrossRefGoogle Scholar
  10. 10.
    Zhang GW. Treatment of psoriasis by photochemotherapy: a comparison between the photosensitizing capsule of Angelica dahurica and 8-MOP. Zhonghua Yi Xue Za Zhi. 1983;63: 16–9.PubMedGoogle Scholar
  11. 11.
    Koo J, Arain S. Traditional Chinese medicine in dermatology. Clin Dermatol. 1999;17:21–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Lim YL, Thirumoorthy T. Serious cutaneous adverse reactions to traditional Chinese medicines. Singapore Med J. 2005;46:714–7.PubMedGoogle Scholar
  13. 13.
    Kew J, Morris C, Aihie A, Fysh R, Jones S, Brooks D. Arsenic and mercury intoxication due to Indian ethnic remedies. BMJ. 1993;306:506–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Tay CH. Cutaneous manifestations of arsenic poisoning due to certain Chinese herbal medicine. Australas J Dermatol. 1974;15:121–31.PubMedCrossRefGoogle Scholar
  15. 15.
    Keane FM, Munn SE, du Vivier AW, Taylor NF, Higgins EM. Analysis of Chinese herbal creams prescribed for dermatological conditions. BMJ. 1999;318:563–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Graham-Brown RA, Bourke JF, Bumphrey G. Chinese herbal remedies may contain steroids. BMJ. 1994;308:473.PubMedCrossRefGoogle Scholar
  17. 17.
    Hughes JR, Higgins EM, Pembroke AC. Oral dexamethasone masquerading as a Chinese herbal remedy. Br J Dermatol. 1994;130:261.PubMedCrossRefGoogle Scholar
  18. 18.
    Wong SS, Tan KC, Goh CL. Cutaneous manifestations of chronic arsenicism: review of seventeen cases. J Am Acad Dermatol. 1998;38:179–85.PubMedCrossRefGoogle Scholar
  19. 19.
    Stevensen CJ. Aromatherapy in dermatology. Clin Dermatol. 1998;16:689–94.PubMedCrossRefGoogle Scholar
  20. 20.
    Ashour HM. Antibacterial, antifungal, and anticancer activities of volatile oils and extracts from stems, leaves, and flowers of Eucalyptus sideroxylon and Eucalyptus torquata. Cancer Biol Ther. 2008;7(3):399–403.PubMedCrossRefGoogle Scholar
  21. 21.
    Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust. 1990;153:455–8.PubMedGoogle Scholar
  22. 22.
    Tong MM, Altman PM, Barnetson RS. Tea tree oil in the treatment of tinea pedis. Australas J Dermatol. 1992;33:145–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Hay IC, Jamieson M, Ormerod AD. Randomized trial of aromatherapy. Successful treatment for alopecia areata. Arch Dermatol. 1998;134:1349–52.PubMedCrossRefGoogle Scholar
  24. 24.
    Boonchai W, Iamtharachai P, Sunthonpalin P. Occupational allergic contact dermatitis from essential oils in aromatherapists. Contact Dermatitis. 2007;56:181–2.PubMedCrossRefGoogle Scholar
  25. 25.
    Crawford GH, Katz KA, Ellis E, James WD. Use of aromatherapy products and increased risk of hand dermatitis in massage therapists. Arch Dermatol. 2004;140:991–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Kaddu S, Kerl H, Wolf P. Accidental bullous phototoxic reactions to bergamot aromatherapy oil. J Am Acad Dermatol. 2001;45:458–61.PubMedCrossRefGoogle Scholar
  27. 27.
    Trattner A, David M, Lazarov A. Occupational contact dermatitis due to essential oils. Contact Dermatitis. 2008;58:282–4.PubMedCrossRefGoogle Scholar
  28. 28.
    Cocks H, Wilson D. Dangers of the intake of psoralens and subsequent UV exposure producing significant burns. Burns. 1998;24:82.PubMedCrossRefGoogle Scholar
  29. 29.
    Chen CJ, Yu HS. Acupuncture, electrostimulation, and reflex therapy in dermatology. Dermatol Ther. 2003;16:87–92.PubMedCrossRefGoogle Scholar
  30. 30.
    Tan EK, Millington GW, Levell NJ. Acupuncture in dermatology: an historical perspective. Int J Dermatol. 2009;48:648–52.PubMedCrossRefGoogle Scholar
  31. 31.
    Iliev E. Acupuncture in dermatology. Clin Dermatol. 1998;16:659–88.PubMedCrossRefGoogle Scholar
  32. 32.
    Jerner B, Skogh M, Vahlquist A. A controlled trial of acupuncture in psoriasis: no convincing effect. Acta Derm Venereol. 1997;77:154–6.PubMedGoogle Scholar
  33. 33.
    Koizumi H, Tomoyori T, Kumakiri M, Ohkawara A. Acupuncture needle dermatitis. Contact Dermatitis. 1989;21:352.PubMedCrossRefGoogle Scholar
  34. 34.
    Ara M, de Santamaria CS, Zaballos P, Yus C, Lezcano MA. Mycobacterium chelonae infection with multiple cutaneous lesions after treatment with acupuncture. Int J Dermatol. 2003;42:642–4.PubMedCrossRefGoogle Scholar
  35. 35.
    Jeong KH, Lee MH. Two cases of factitial panniculitis induced by electroacupuncture. Clin Exp Dermatol. 2009;34:e170–3.PubMedCrossRefGoogle Scholar
  36. 36.
    Takeishi E, Hirose R, Hamasaki Y, Katayama I. Localized argyria 20-years after embedding of acupuncture needles. Eur J Dermatol. 2002;12:609–11.PubMedGoogle Scholar
  37. 37.
    Teo LH, Tang MB, Tan AW, Tan HH, Ng SK. Ulcers related to acupuncture and traditional Chinese medicine: a case series and review of the literature. Arch Dermatol. 2009;145: 490–2.PubMedCrossRefGoogle Scholar
  38. 38.
    Coining method. Accessed Aug 2009.
  39. 39.
    Gua Sha. Accessed Aug 2009.
  40. 40.
    Amshel CE, Caruso DM. Vietnamese “coining”: a burn case report and literature review. J Burn Care Rehabil. 2000;21:112–4.PubMedCrossRefGoogle Scholar
  41. 41.
    Yoo SS, Tausk F. Cupping: East meets West. Int J Dermatol. 2004;43:664–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Chen D, Jiang N, Cong X. 47 cases of acne treated by prick-bloodletting plus cupping. J Tradit Chin Med. 1993;13:185–6.PubMedGoogle Scholar
  43. 43.
    Ding LN. 50 cases of acne treated by puncturing acupoint dazhui in combination with cupping. J Tradit Chin Med. 1985;5:128.PubMedGoogle Scholar
  44. 44.
    Kouskoukis CE, Cupping LM. The art and the value. Am J Dermatopathol. 1983;5:235–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Lee CS, Lim HW. Cutaneous diseases in Asians. Dermatol Clin. 2003;21:669–77.PubMedCrossRefGoogle Scholar
  46. 46.
    Wang D. Indirect moxibustion with herb cake for treatment of atopic dermatitis: dermatitis: 20 cases (in chinese). China Acupunct. 2000;20:612.Google Scholar
  47. 47.
    Ghorpade A. Tattoo inoculation lupus vulgaris in two Indian ladies. J Eur Acad Dermatol Venereol. 2006;20:476–7.PubMedCrossRefGoogle Scholar
  48. 48.
    Kluger N, Muller C, Gral N. Atypical mycobacteria infection following tattooing: review of an outbreak in 8 patients in a French tattoo parlor. Arch Dermatol. 2008;144:941–2.PubMedCrossRefGoogle Scholar
  49. 49.
    Ko YC, Ho MS, Chiang TA, Chang SJ, Chang PY. Tattooing as a risk of hepatitis C virus infection. J Med Virol. 1992;38:288–91.PubMedCrossRefGoogle Scholar
  50. 50.
    Preda VA, Maley M, Sullivan JR. Mycobacterium chelonae infection in a tattoo site. Med J Aust. 2009;190:278–9.PubMedGoogle Scholar
  51. 51.
    Pasricha JS, Gupta R, Panjwani S. Contact dermatitis to henna (Lawsonia). Contact Dermatitis. 1980;6:288–9.PubMedCrossRefGoogle Scholar
  52. 52.
    Wolf R, Wolf D, Matz H, Orion E. Cutaneous reactions to temporary tattoos. Dermatol Online J. 2003;9:3.Google Scholar
  53. 53.
    Kang IJ, Lee MH. Quantification of para-phenylenediamine and heavy metals in henna dye. Contact Dermatitis. 2006;55:26–9.PubMedCrossRefGoogle Scholar
  54. 54.
    Jasim ZF, Darling JR, Handley JM. Severe allergic contact dermatitis to paraphenylene diamine in hair dye following sensitization to black henna tattoos. Contact Dermatitis. 2005;52:116–7.PubMedCrossRefGoogle Scholar
  55. 55.
    Gulen F, Zeyrek D, Altinoz S, Peker E, Demir E, Tanac R. Urticaria and angioneurotic edema due to the temporary henna tattoo. Minerva Pediatr. 2006;58:583–5.PubMedGoogle Scholar
  56. 56.
    Jovanovic DL, Slavkovic-Jovanovic MR. Allergic contact dermatitis from temporary henna tattoo. J Dermatol. 2009;36:63–5.PubMedCrossRefGoogle Scholar
  57. 57.
    Sidwell RU, Francis ND, Basarab T, Morar N. Vesicular erythema multiforme-like reaction to para-phenylenediamine in a henna tattoo. Pediatr Dermatol. 2008;25:201–4.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of DermatologyFaculty of Medicine Siriraj HospitalBangkokThailand
  2. 2.Department of DermatologyHenry Ford Medical Center, New Center OneDetroitUSA

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