Melasma is a common facial skin disease, commonly known as butterfly spot, which is a pigmentation spot on the face, symmetrically distributed, irregular in shape, variable in size and shade, mainly distributed around the eyes, cheeks, cheek area around the mouth, etc., affecting the beauty of the patient’s appearance, generally without self-conscious symptoms, but very difficult to treat. The causes of melasma: many factors can cause melasma, such as some women will appear after 3-5 months of pregnancy, and only gradually fade after delivery, called pregnancy melasma; some women will appear melasma after taking oral contraceptives for a period of time; some women suffering from female reproductive organ diseases will also accompany the development of melasma. It has been scientifically proven that chloasma is related to the stimulation of melanocytes by female hormones, which leads to pigmentation. However, not all chloasma is related to sex hormones. Some women may also develop chloasma when they are suffering from certain chronic diseases, such as tuberculosis, tumor and chronic liver disease. In addition, certain endocrine disorders, poor nutrition or unreasonable nutrition, such as lack of vitamin A, C, E, niacin and certain trace elements, or excessive exposure to ultraviolet rays can cause chloasma. Some scholars point out that psycho-neurological factors are also a cause of chloasma, such as irregular life and lack of sleep. In conclusion, there are many reasons for the occurrence of chloasma, and its exact cause is not yet completely clear. Judgment of chloasma: chloasma is also called butterfly spot, drug spot, liver spot, etc. It forms round irregular shape with unclear boundary, and is often symmetrically distributed on the face, around the cheekbones and around the lips. It is also common in people who suffer from chronic diseases, liver diseases, tuberculosis, tumor diseases and people who often take hormones and other drugs (such as tetracycline, sleeping pills, birth control pills, etc.). Melasma can be aggravated by sun exposure, mental depression, emotional instability, lack of sleep and endocrine disorders. Treatment of melasma: Western medicine mostly treats melasma with antioxidants such as vitamin E and vitamin C, but the effect is not significant and stable. In recent years, Chinese medicine and the combination of Chinese and Western medicine have received good results. The Department of Dermatology and Cosmetic Surgery summarizes the clinical experience of Chinese and Western medicine in treating chloasma for decades, and with reference to the treatment experience and reports at home and abroad, we have explored and summarized a set of methods for treating chloasma combining Chinese and Western medicine, internal and external treatment, dialectical treatment and spot removal and conditioning.