Chloasma and vitiligo are refractory conditions of pigmentary skin disorders. Chloasma frequently occurs in adult females and the risk is higher during child bearing age. There are no ideal therapies available in biomedicine. However, the pathology of chloasma has been interpreted in Chinese medicine with effective treatment based on harmonizing qi, blood, yin and yang. Vitiligo is a skin disease which is easy to diagnose since it involves depigmentation. However, it is difficult to cure biomedically, as its mechanism is unclear and no effective treatments have been established. This text recounts the results of recent research in Chinese medicine that has detected an association of vitiligo with deficiency of liver and kidney, qi stagnation, and blood stasis. It details how practitioners have applied the principles of nourishing liver and kidney, invigorating blood to dispel stasis, and regulating qi and blood, to achieve positive therapeutic effects.