Acupuncture outperforms a popular topical medication for the treatment of melasma, . Researchers from Xiamen University Affiliated Hospital (Fujian, China) conclude that acupuncture is effective for the alleviation of melasma. In a randomized parallel study, the acupuncture treatment group achieved a total efficacy rate of 82.22% and the drug control group achieved an efficacy rate of 62.50%. Patients in the acupuncture treatment group received acupuncture needling on the Yangming meridians. Patients in the control group received oral administration of vitamin C and 3% hydroquinone topical cream. Hydroquinone is a cream used to lighten dark patches of skin. The researchers conclude that acupuncture significantly outperforms drug therapy for the treatment of melasma. The researchers highlight that “Acupoint selection at Yangming meridians for facial beauty enhancement has ancient historical roots, and acupuncture obtains satisfactory results for the treatment of melasma.” 
Melasma, also known as chloasma faciei, is a common skin problem that causes symmetric facial hyperpigmentation. Women are diagnosed more than men for melasma. The generally accepted female to male ratio of melasma is 9:1. 
Melasma is common during pregnancy and is exacerbated by sun exposure, which is why sunscreen is often recommended as a preventative measure. The National Institutes of Health estimates that 50–70 percent of pregnant women will have melasma.  Globally, melasma is responsible for a serious impact on patients’ appearance, causing psychosocial and emotional distress, and reducing quality of life.
A common treatment for melasma is hydroquinone, which works by lightning the skin when applied to the discolored skin patches.  While effective, the downside is that long-term use of the medication can cause chronic skin complications (e.g., ochronosis).  Acupuncture has an ancient and well documented history for the treatment of melasma that is both safe and effective. The study focuses on a comparison between drug and acupuncture treatments.
Researchers (Cao et al.) used the following study design. A total of 85 patients received acupuncture or drug treatments in this study. Patients were randomly assigned to a drug control group and an acupuncture treatment group respectively, with 40 and 45 patients in each group. The acupuncture treatment group was comprised of 3 males and 42 females, with an average age of 35.4 (±1.3) years and a melasma medical history of 36.7 (±1.9) months.The control group had 7 males and 33 females, with an average age of 34.9 (±2.1) years, and a melasma medical history of 35.1 (±2.4) months. The patients from both groups were comparable as there were no significant differences in terms of their gender, age, and medical histories when entering the study groups. Patients from the treatment group received acupuncture at the following primary acupoints:
A secondary set of acupuncture points was added dependent upon differential diagnostics in the Traditional Chinese Medicine (TCM) system. For qi and blood deficiency, the following acupoints were added with a reinforcing technique.