If the spots appear on the lower eyelids, if they are grayish-blue or brownish-blue spots, which are present at birth, it is more likely to consider nevus of Ota. Nevus of Ota is mainly distributed along the trigeminal nerve of the face and manifests as brown, greenish-gray, or blue-black patches. The etiology is not clear, and treatment can be done with Q-switched or violet emerald laser. If a female patient has a yellowish-brown spot on the lower eyelid area, chloasma is more likely to be considered. Chloasma may be related to sun exposure, pregnancy, hormone level disorder, endocrine system disease, liver disease or oral contraceptive pills, etc. Sometimes tension, anxiety and low emotion also easily lead to the appearance of chloasma.