Melasma is a common and frequent disease in dermatology, which affects patients’ appearance and causes great mental pressure to patients due to long course of the disease, and with the improvement of people’s economic living standard, more and more people require safe and effective treatment. Chloasma is also called “liver spot” and “stretch mark”. It is mostly found in young and middle-aged women, manifested as light brown spots or black spots on the face, with different shapes and sizes, ranging from broad bean to copper coin, with clear edges, smooth surface, no scaling, no inflammation, and no obvious conscious symptoms. The spots are usually found on the cheek, nose, forehead and around the mouth. It can spread to the whole body. The nose and its two lesions sometimes fuse with each other to form butterfly-like, so the folk have the common name of “butterfly spot”. The real cause of the disease is not yet clear, but the factors that are definitely related include: endocrine, sex hormone level (so there is also a pregnancy spot); free radicals, serum enzymes and trace elements; other factors such as genetic factors, drugs, sun exposure, imbalance of skin microecology, use of poor quality cosmetics and emotions have also been reported. Recently, it has been reported that the sensitivity of melanocytes to sex hormones and the alteration of sex hormone receptors in melanocytes are related to the formation of melasma. However, the overall pathogenesis of melasma is the increase of tyrosinase activity and melanin formation. TCM believes that melasma can reduce melanin synthesis by tyrosinase activity, and the use of drugs that inhibit tyrosinase activity and reduce melanin synthesis can improve the therapeutic effect of melasma. Chinese medicine believes that the cause of this disease is liver depression, spleen deficiency and kidney deficiency. Clinical treatment is based on regulating the liver, spleen and kidneys, so the treatment is often based on relieving liver depression, strengthening the spleen and dampness, warming the kidneys and nourishing Yin and tonifying the kidneys. Clinical treatment is often divided into 3 types. Liver depression and qi stagnation evidence: the color of facial spots is light brown or greenish-brown, often complaining of irritability, irritability; mood disorders, mental depression; irregular menstruation (menstruation is early or postponed for more than 7 days, and 3-4 months in a row), often accompanied by double breast swelling and pain before menstruation, dark red tongue, thin white or thin yellow tongue coating, thin string pulse. The treatment is mostly with Prosperity Pill plus or minus; kidney yin deficiency: dark spots, low menstrual flow, premenstruation, heat in the hands and feet, sleeplessness, astringent eyes and dryness, red tongue, thin pulse. The treatment mostly uses Liu Wei Di Huang Wan plus or minus; Kidney Yang deficiency type: dark brown, gray, dark menstrual blood, cold pain in the abdomen, lumbar spine pain, cold fear, cold limbs, frequent nocturnal urination, thin band, light tongue and sunken pulse. At present, Chinese medicine treatment for this type has no obvious effect. Western medicine systemic treatment of melasma is generally not a conventional treatment, but it is effective in treating dermal type and mixed type of melasma: vitamins and glutathione: VitC and VitE are commonly used alone or in combination, and the dosage should be large. Hemocyclic acid is an antifibrinolytic hemostatic drug, in vitro test has the effect of inhibiting melanin formation, some people reported that the combination of Hemocyclic acid, VitC, VitE 3 oral treatment of melasma, with 6-8 weeks, its lesions obviously subsided, the efficiency rate of 82.0%; tea extract (catechins or tea polyphenols) to remove oxygen free radicals stronger than it class, treatment of melasma 2 months for a course, the efficiency rate The effective rate is over 60%. There are many topical depigmentation agents for melasma, and the most effective ones are hydroquinone, retinoic acid, tretinoin, azelaic acid and sebaceous steroids. In most cases, topical depigmentation or depigmentation agents are the most effective way to treat the increase of melanin in epidermis. However, they can only control, not eradicate melasma. Nowadays, the safest and effective treatment method with little side effects is Chinese herbal medicine, which follows the principle of Chinese medicine to treat melasma from the inside out by taking Chinese herbal preparations with corresponding functions and applying Chinese herbal masks. There are many ways to remove spots, but the effect varies from person to person. What is certain is that this method is safe and reliable for treating melasma, treating the symptoms and the root cause, and not easy to rebound. Laser melasma removal is an effective and ideal treatment method for melasma that is emerging nowadays. Its principle is to use high intensity light beam with specific wavelength to be absorbed by pigments or tissues in the skin. The laser breaks down the pigment substances deposited in the skin in nanometer time to break them down, and promotes the circulation of the skin at the base to reduce the thermal damage effect of the treatment on the surrounding skin. As the pigment particles are gradually absorbed by the body, the color fades and finally disappears completely after several treatments. The effect of laser melasma removal is safe, less painful, no scarring and has a rejuvenating effect, which is the most ideal method to remove melasma at present. Liu Dongmei, Department of Dermatology, Jinhua Fifth Hospital The following points should be noted in the process of melasma treatment: (1) First of all, you should go to a regular hospital for examination, exclude the primary disease and actively treat the primary disease, once the disease is cured, the melasma will disappear; at the same time, you should also actively check the trace elements and sex hormone level to find the cause and actively treat the disease. (2) Prevent sunlight and use various cosmetics carefully. Sunlight exposure or excessive exposure to X-rays and ultraviolet rays can promote pigmentation and aggravate it. Even fluorescent lamps for indoor lighting can aggravate the pigmentation by stimulating ultraviolet rays, so patients should try to avoid prolonged sun exposure, especially in summer. (3) Prevent all kinds of ionizing radiation! Including all kinds of glass-cased display, all kinds of fluorescent lamps, X-ray machines, ultraviolet irradiators and so on. These undesirable stimuli can produce similar consequences as strong sunlight exposure, even greater than the damage of sunlight exposure, which results in the aggravation of pigmentation. (4) Pay attention to rest and ensure sufficient sleep. Insufficient sleep can easily lead to dark circles under the eyes, and the skin becomes gray and black. (5) Keep a good mood. Because of anxiety, irritability, insomnia, distraction. Depression, pain, overload and lack of necessary detoxification and effective diversion are the root causes of endocrine disorders and disorders that cause chloasma and pigmentation. You should learn to adjust yourself psychologically: look at problems positively and positively, relax, and keep a cheerful and optimistic attitude.