Melasma is a common facial discoloration, mostly distributed symmetrically in the cheeks and cheekbones in the shape of a butterfly. Melasma has always troubled many women, including many men who have entered middle age, and is a major problem affecting facial appearance. Some of the stubborn melasma is still prone to recurrence and even aggravation after treatment by drugs, laser, Chinese medicine and other methods, is there any new method available for these intractable melasma? Why people don’t have spots when they are young? Why people don’t have spots when they are young, but with the aging of the skin, the spots on the face will become more and more? In fact, “spots” are also a manifestation of skin aging. Skin aging leads to lower cell regeneration ability, poor resistance, slowed metabolism, and easy deposition of melanin on the skin surface, which is an important mechanism of melasma! Therefore, if spot removal is the symptom, then anti-aging of skin is the root of the problem. Why melasma is highly prevalent in cheek face? The formation of pigmentation is actually the self-protection mechanism of the body. When the intensity of sunlight is high, the epidermis of the skin will produce a lot of melanin to form an isolation against UV rays. Our epidermis has two barriers, the first barrier is the stratum corneum and the second barrier is the basement membrane zone. The stratum corneum is located in the outermost layer of the skin and is the first barrier of human skin. The stratum corneum plays a role in making light diffuse against light exposure, reducing the intensity of light entering the dermis and protecting the whiteness of the skin. Therefore, it is important to do a good job of hydration and moisturization on a daily basis, and always apply sunscreen when going out to block UV rays, which is the outermost and most basic protection. The second barrier basement membrane is located between the epidermis and dermis, it is a layer of wavy semi-permeable membrane tissue, which can resist the passage of harmful substances from the external environment. Excessive cleaning, skin trauma, drug stimulation or natural aging can cause damage to the basement membrane zone. After the damage to the basement membrane zone, melanin particles in the epidermis will penetrate into the dermis through the broken basement membrane. For the dermis, the arrival of the black particles is intolerable, and the melanin-eating cells are deployed to gradually swallow the melanin, but this swallowing process is very long, taking about half a year or even several years. This swallowing process will leave stubborn pigmentation spots on the skin. Therefore, melasma is a product of abnormal self-protection mechanism, in order to resist UV attack, the body passively grows pigmentation to “strengthen” the barrier function of the skin. The skin of our cheek face is thin and close to the cheekbone, which is vulnerable to damage and stimulation, and has the most chances to be exposed to vertical sunlight, so melasma often occurs in this area. What is the value of RF in melasma treatment? Focused RF works by driving the water molecules in the skin tissue through high frequency alternating magnetic field with high speed oscillation and heating, without absorbing heat through the pigment target base, thus overcoming the problem of shallow penetration depth of laser and photon and epidermal pigment cell barrier, and avoiding aggravating the existing stubborn pigmentation. With the precise layered heating function of the circular bipolar treatment hand, the thermal action can be effectively concentrated on the basement membrane zone, promoting the continuous release of collagen from fibroblasts, replenishing the damaged collagen layer and helping to repair and rebuild the basement membrane zone. At the same time, it can improve the metabolic circulation of the treated area, accelerate the metabolism of melanin, and simultaneously inhibit the reoccurrence of melasma in the process of improving and resisting skin aging. Why is it easy to rebound and recur after melasma treatment? The traditional melasma combination treatment program includes oral medication + laser spot removal + topical medication, which requires long-term medication and multiple laser treatments, but still has little effect on those especially stubborn melasma. The root cause of difficult treatment and recurrence of melasma lies in the lack of effective functional repair of the damaged skin barrier, just like the theory of “removing evil and helping righteousness” in Chinese medicine, only when the body’s own normal protective ability is restored can long-term effects be obtained. In the author’s opinion, the rate of skin barrier damage caused by direct stimulation of physical and chemical factors is low, but more often, the skin barrier damage is caused by the combination of endocrine system or immune system disorders. Therefore, the combined melasma treatment program guided by the concept of skin anti-aging includes the new measure of “radiofrequency skin nourishment and spot suppression”, which can control melasma more effectively in clinical practice, inhibit the rebound and recurrence of melasma, and improve the efficacy and patient satisfaction. Even in patients who refuse to use any medication, they can obtain more satisfactory results. To sum up the three major advantages of the advanced treatment plan of [picosecond laser spot removal + RF skin care spot suppression] 1. safe and effective removal of melasma The strong pigment blasting energy and fast process of picosecond laser can effectively avoid excessive thermal damage to melanocytes while removing melasma and reduce the incidence of anti-blackening of pigmentation. 2. Repair and strengthen the basement membrane belt Focused RF can strengthen skin metabolism and promote melasma removal. At the same time, it stimulates the repair of basement membrane belt, strengthens the skin barrier function and effectively resists the adverse effects of skin aging for a long time. It helps to nourish the skin and suppress the spots, remove the evil and support the righteousness, and treat both the symptoms and the root cause. 3. Reshaping subcutaneous microenvironment High-energy focusing RF can act on subcutaneous fascia tissue layer, accelerate blood vessel and lymph flow, regulate the function of local nerve, blood vessel and lymphatic vessel system, reduce the immune regulating factors released from the body to stay in the local area, so that the recurrence and rebound rate of melasma can be reduced.