To investigate the effectiveness of acupuncture combined with auricular acupressure in chloasma treatment. Methods. A prospective, randomized controlled assessor-blind clinical trial was performed and 135 patients were assigned into acupuncture combined with auricular acupressure acupuncture and control groups, each with 45 patients. For groups A and B, body and facial acupuncture were applied for 2 months. For group A, auricular acupressure was applied concomitantly. For group C, vitamins C and E were prescribed for 3 months. Primary outcome measure was the therapeutic effects while secondary outcome measure was safety evaluation. Results. The total effective rate was 95.6%, 91.1%, and 75.6% for groups A, B, and C ( between groups A and C; between groups B and C). The posttreatment estradiol levels in groups A and B were significantly decreased while progesterone (P4) levels were significantly increased compared to pretreatment ( and , resp.). The differences were significant compared to group C ( and , resp.). No adverse events occurred. Conclusion. Acupuncture combined with auricular acupressure could significantly increase the therapeutic effect of chloasma treatment and could be better than vitamins C and E.