Objective To explore the application value of photorejuvenation combined with tranexamic acid gel patch in young and middle-aged female patients with chloasma. Methods A total of 130 young and middle-aged patients with chloasma admitted to Pingyi County Hospital of Traditional Chinese Medicine from February to December 2023 were randomly divided into photon group and gel group, with 65 patients in each group. The photon group was treated with photonrejuvenation, and the gel group was treated with photonrejuvenation combined with tranexamic acid gel patch. The MASI score, skin physiological parameters and incidence of adverse reactions were compared between the two groups. Results The MASI score of the gel group after treatment was (5.84±1.19) scores, which was lower than (7.66±1.56) scores of the photon group (P <0.05). After treatment, the skin oil content in the gel group was (96.84±12.81) μg/cm2, which was higher than (91.52±13.35) μg/cm2 in the photon group (P <0.05). There was no significant difference in transcutaneous water loss and stratum corneum water content between the two groups (P >0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Photonrejuvenation combined with tranexamic acid gel patch is effective in the treatment of young and middle-aged patients with chloasma, which can promote the repair of skin barrier, optimize various skin physiological parameters, and reduce the area of facial chloasma. It is safe and worthy of application.