To analyze the clinical and skin imaging features of facial melasma. Methods A total of 75 patients with facial chloasma who underwent VISIA and dermoscopy in our hospital from May 2022 to September 2023 were selected as the research objects. The clinical data of the patients were collected and analyzed. Results Among the 75 patients with facial chloasma, there were more women than men. The inducing or aggravating factors were mainly the history of aggravation after clear sun exposure, and most of them were sensitive skin. 44 patients in advanced stage, 31 patients in stable stage; 32 patients were simple pigment type, 43 patients were pigment combined with vascular type. There were 67 patients (89.33%) with subclinical chloasma, including 38 patients in advanced stage and 29 patients in stable stage. The background color of chloasma lesions in patients with different clinical types was light brown to dark brown patches, and the distribution pattern of background patches was mainly capillary, vellus hair thickening and blackening, blue-gray patches/dots, and pseudo-pigmented mesh. Conclusion Facial chloasma patients are mostly female, and the characteristics of patients with different clinical types are different. Through non-invasive detection methods such as VISIA and dermoscopy, it can not only assist in the clinical classification of chloasma and evaluate the severity of skin lesions, but also guide the choice of treatment options and provide objective and accurate monitoring for the evaluation of patients' post-treatment effects.