The causes of chloasma are generally mental stress, endocrine disorders, gynecological diseases, liver and kidney diseases, tuberculosis, lack of vitamins, stimulation of local chemicals such as cosmetics, certain drugs such as birth control pills, sulfonamide, and certain drugs for treating high blood pressure and diabetes. Before treating melasma, try to remove the causes, such as stopping the use of oral contraceptives, etc., so that the treatment can be twice as effective. In order to treat melasma with acupuncture, we have to analyze the evidence, and the so-called “evidence” is a specific pathological state. Melasma has the following types of evidence: 1, liver qi stagnation. In Chinese medicine, the liver is in charge of regulating emotions and the operation of qi and blood. On the contrary, liver disease can also cause emotional disorders, which in Chinese medicine is called liver loss of drainage, liver loss of regulation, thus affecting the operation of qi and blood, resulting in the loss of qi and blood in the face, qi stagnation and blood stasis and morbidity. 2. Spleen and stomach disorders. Mainly refers to the malfunction of the digestive system, nutrients can not be absorbed normally, resulting in the Qi and blood can not moisten the face and the onset of disease. 3. Kidney deficiency and essence deficiency. Chinese medicine believes that the kidney is the root of the innate nature, the essence in the kidney is the driving force of life, is one of the sources of qi and blood, while the kidney is the master of water and fluid metabolism, separating the clear and turbid. If the kidney is damaged for some reasons, then on the one hand, the essence in the kidney cannot be honored and nourished on the face, and on the other hand, because the toxins in the body cannot be excreted properly, the turbidity can also lead to chloasma on the face. For these three types of melasma, acupuncture points can be used to treat melasma from the “root” by regulating the internal organs, meridians, qi and blood. In addition to the whole body adjustment with body points, acupuncture has some special methods to treat melasma as follows: 1. Local peri-prick. Using a short fine needle to stab directly in the center of the facial lesion, and stabbing multiple needles around the periphery of the lesion obliquely to the center, which can unblock the operation of local qi and blood. 2.Auricular acupuncture treatment. (1) Ear acupuncture pressure, can choose ear acupuncture endocrine, subcortical, liver, spleen, kidney, stomach, lung, middle ear, cheek, internal genitalia, sympathetic and other points. (2) Ear acupuncture point blood, can be in the ear tip, the back of the ear vein puncture bleeding a few drops can be. (3) Ear acupuncture point cutting treatment. The bleeding can be gently cut with a scalpel on the relevant ear point, and then applied with a special medicinal powder to play the dual role of needles and medicine. (3) Blood pricking and cupping. You can look for some special spots on the skin on both sides of the spine in the upper part of the back, prick them with a trigeminal needle or skin needle buckle until they bleed slightly locally, and then cupping with glass jar flash fire method for about 10 minutes. Besides acupuncture treatment for melasma, daily care is also very important. Firstly, we should keep our spirits happy, avoid bad emotions, and have a regular routine; secondly, we should have moderate exercise, aerobic exercise and sweating help metabolism and excretion of toxic substances in the body; thirdly, we should have a suitable diet, do not eat greasy and spicy food, quit smoking and drinking, and eat more fruits and vegetables rich in vitamin C; finally, we should avoid sunlight, and pay attention to shade when we go out on sunny days or apply sunscreen. Lastly, we should avoid sun exposure and pay attention to sunscreen and sunscreen when we go out on sunny days, but we should avoid using poor quality cosmetics and topical medications.