Objective To explore the effect of Shugan Huaban decoction combined with microneedle introduction of tranexamic acid on quality of life in patients with stable liver depression type chloasma. Methods A total of 72 patients with stable liver depression type chloasma admitted to our hospital from May 2022 to May 2024 were selected as the research subjects. They were divided into control group and observation group by the random number table method, with 36 patients in each group. The control group was treated with microneedle introduction of tranexamic acid, and the observation group was treated with Shugan Huaban decoction on the basis of the control group. The clinical efficacy, chloasma color score, Pigment Grading Assessment (PGA) score, Melasma Area and Severity Index (MASI) score, Dermatology Life Quality Index (DLQI) score and aesthetic satisfaction were compared between the two groups. Results The total effective rate of treatment in the observation group was 94.44%, which was higher than 86.11% in the control group (P<0.05). After treatment, the scores of chloasma color and PGA in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P <0.05). After treatment, the scores of MASI and DLQI in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P <0.05). The aesthetic satisfaction in the observation group was 97.22%, which was higher than 88.89% in the control group (P <0.05). Conclusion Shugan Huaban decoction combined with microneedle introduction of tranexamic acid for the treatment of stable liver depression type chloasma can improve the clinical efficacy, ameliorate the chloasma color and pigment residue, enhance the aesthetic satisfaction, improve the quality of life of patients, and alleviate the severity of chloasma, which is worthy of clinical application.