Melasma is a pigmentation spot that commonly occurs on the face. It is mainly caused by endocrine disorders, mental stress, pregnancy, oral contraceptives, menstrual disorders, various diseases (liver and kidney insufficiency, gynecological diseases, diabetes), as well as the lack of vitamins in the body and the stimulation of topical chemical drugs. At present, there are many different kinds of treatment methods for melasma, with many different names and different quality, which makes it difficult for patients to identify and choose. I will talk about my personal opinion on the common problems of patients. Can melasma be cured? The answer is yes, although the cause of melasma is very complicated, most of it is caused by endocrine disorder, and it can be greatly improved by comprehensive treatment to achieve good results. There are many patients who come to me for melasma treatment, and so far there are no cases of no effect, although the degree of improvement and treatment time vary from person to person. Generally, oral Chinese medicine and simple topical medication can achieve good results and greatly improve the appearance of the face. In other words, the quality of life can be significantly improved by simple medication. Can melasma be completely cured? My opinion is that it is almost impossible. Some of my patients are basically cured, but rarely, and some of them will recur as time progresses. This is because the physical condition of human body keeps developing and changing with time, and the endocrine changes are generally developing according to the condition of the whole body, which is an irreversible law. Moreover, people have to face sunlight, mental stress, diseases, drugs, diet and other problems every day, all of which will have an impact on the condition of melasma. So the treatment of melasma should be understood more as a dynamic adjustment. Can laser completely treat melasma? With the development of laser hormone in recent years, various lasers and intense light instruments for melasma treatment have emerged, and their strong advertisement makes patients rush to them. We should look at the role and positioning of laser in the treatment of melasma objectively. Laser is effective, but the recurrence rate is higher because laser treatment belongs to external treatment and does not fundamentally solve the problem of melasma’s etiology. My opinion is: melasma can be combined with laser treatment because laser can accelerate the speed of treatment, but it should be positioned on the basis of drug-based comprehensive treatment with laser-assisted treatment, so as to ensure the long-term effect. Commonly used laser treatment instruments include C3, C6, C8, color light, black face doll, non-ablative fractional laser and so on. It should be emphasized here that some of these instruments may aggravate melasma, which is not uncommon in clinical practice, so this treatment must be carried out in an experienced specialist hospital. In my personal opinion, fractional laser is relatively safe and effective at present. How to choose a product for melasma removal? The reason why I want to emphasize this point is that there are so many problems caused by blemish removal products, and it is already a serious social problem. Around the 1990s, some beauty salons and cosmetic manufacturers took advantage of the unsound social regulation and patients’ lack of knowledge in this area, and widely used hormones, heavy metals of lead and mercury, retinoic acid, fruit acids, azelaic acid and other ingredients in blemish removal products, and this problem still exists in beauty stores and domestic cosmetics. The result is the creation of many problematic skin, such as hormone dependent dermatitis, sensitive skin and a large number of patients. At the beginning of the drug, patients can feel the temporary pigmentation reduction and crystal clear skin, but the next problem is like a nightmare, which can be manifested as facial sensitivity, epidermal atrophy and thinning, itching, burning, red blood, increased coarse hair, increased pigmentation and so on. So how do we choose in the face of a wide range of spot whitening products? To be exact, I can’t tell the authenticity either, because cosmetics never announce their real ingredients. But the general principle is: European and American products are relatively safe; domestic, Korean, Taiwanese and Southeast Asian products should be used with caution; beauty store products should be used with caution; and various “three to five products” should be resolutely resisted. This is not regional discrimination, but the national quality of different countries and legal norms vary greatly, to protect themselves must face the reality. If you finally ask me to recommend a good product for removing spots, my advice is: try not to use non-medical products for removing spots, and it is better to go to a famous hospital in China to remove spots. How to face melasma correctly? To patients, the biggest problem of melasma is that it affects their appearance, while to doctors, melasma is the skin manifestation of various factors in patients’ bodies. Both doctors and patients should face it correctly. Melasma is a natural manifestation of the skin during a certain period of the human body’s life, and to call it a disease is actually an overstatement, most melasma is not a sign of internal disease, nor does it affect health and life expectancy. Therefore, I prefer to position the treatment of melasma in terms of improving the appearance and highlighting the concept of harmless and green treatment. Faced with the demand of melasma patients to get rid of their spots, all social strata will regard it as a huge market to make money, and cosmetic companies, pharmaceutical companies, medical equipment companies and medical institutions will provide various products and services. So how should you choose as a melasma patient? Perhaps this view will be more rational: large domestic hospitals are generally at the forefront of academics, and they often have the most scientific treatment concepts and plans, so it is relatively safe to leave the facial problems to them. It is the wisest choice to let professional doctors make treatment plans for you!