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Che Qilei, Fu Meng, Li Chengxin. Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi′an 710032, China Corresponding author: Li Chengxin, Email: chengxinderm@163.com ��Abstract�� Melasma is a pigmentary skin disorder characterized by light or dark brownish black patches on the face. Recent studies have shown that multiple factors are involved in the pathogenesis of melasma, including structural damage to basilar membrane, increased vascularity, oxidative stress, etc. Moreover, expressions of lipid metabolism-associated genes and the noncoding RNA H19 gene have been found to be down-regulated in melasma lesions. Molecular biology researches have revealed that multiple signal transduction pathways such as Wnt signaling pathway, inducible nitric oxide synthase ��iNOS�� and AKT/nuclear factor-κB signaling pathway play critical roles in the occurrence of melasma. In addition, neuroregulation is implicated in the pathophysiology of melasma.