Melasma is a very distressing problem for many women, and even a nightmare. The originally fair skin is filled with melasma, and the skin instantly becomes dull and colorless, no longer rich in its former luster, so that beauty is in “crisis”. How to gently say goodbye to melasma, and identify those treatment of melasma foolishness? Let’s take a look! What is melasma? Melasma, also known as liver spot, is a common acquired hyperpigmentation skin disease occurring on the face, which is aggravated after sun exposure. It is common in young and middle-aged women. The course of the disease is chronic and there are no obvious conscious symptoms. The disease has a certain seasonality, heavy in summer and light in winter. Genetic susceptibility, ultraviolet radiation and changes in sex hormone level are the three important factors in the development of melasma, and vascular hyperplasia, skin inflammation and barrier function disorder may also be involved in the development of melasma: 1. Patients with family history are prone to treatment resistance and persistent treatment; 2. UV radiation in sunlight is considered to be the main factor causing the occurrence and aggravation of melasma, but it is not the only factor for the development of melasma; 3. Pregnancy, oral contraceptives and hormone replacement therapy are the most common triggering factors for melasma; 4. The number and volume of small blood vessels in the dermis of the pigmented area increase significantly, and the expression of local vascular endothelial growth factor (VEGF) increases significantly; 5. VEGF) expression is significantly increased; 5. The decrease of epidermal barrier function is related to the aging of skin caused by chronic ultraviolet radiation, the decrease of epidermal mucin content and fatty acid metabolism disorder; 6. The decrease of epidermal barrier function, which in turn weakens the pigment barrier function and disorders melanin metabolism, causing melanin particles to be deposited in the epidermis. Myths of melasma treatment 1, topical hormone drugs or cosmetics containing hormones to remove melasma There are many varieties of topical drugs containing corticosteroids, and they belong to OTC drugs, so people can buy them by themselves, so the misuse and abuse phenomenon is more serious. Hormones have non-specific anti-inflammatory effect and can inhibit melanocyte secretion in the early stage, so they can have certain effect when applied in the early stage. But after stopping the use, the color of pigmentation will come back again and even aggravate. Some people, due to long-term use, become dependent on hormones and form hormone-dependent dermatitis, resulting in new damages such as skin atrophy, thinning of stratum corneum or capillary dilation. Melasma is different from other pigmentation spots, its causes are very complicated, and treatment by laser and electrocautery alone may destroy skin sulfhydryl groups, deepen pigmentation, expand the scope of pigmentation, and even cause irreparable damage to the face. 3.Treatment of melasma with “peeling method” Our skin thickness is only 0.5 to 4 mm, and the epidermis is even thinner, not more than 0.2 mm. This thickness of less than 0.2mm includes more than ten layers of cells, and the underlying cells and the surface stratum corneum grow and shed on one side to maintain the ecological balance of the skin. The natural renewal cycle of facial skin is about 21 to 28 days, and the stratum corneum contains 10% to 20% water, all of which plays an important role in protecting and defending the skin from various factors by maintaining its moisturization. Frequent exfoliation of skin stratum corneum with some drugs or cosmetics containing keratin exfoliating agents will destroy the skin’s own resistance and weaken the sun protection effect greatly.