To investigate the therapeutic effect of short-wave physiotherapy instrument combined with tranexamic acid extract in patients with chloasma. Methods Sixty patients with chloasma admitted to the Department of Dermatology and Cosmetology of Chongqing Hospital of Traditional Chinese Medicine from January to September 2022 were selected as the research objects. They were divided into treatment group and control group by random number table method, with 30 patients in each group. The control group was treated with conventional oral drugs, and the treatment group was treated with short-wave physiotherapy instrument to introduce the transamine acid extract on the basis of the control group. The skin lesions, clinical efficacy and adverse reactions were compared between the two groups. Results After treatment, the MASI score of the treatment group was (10.05±3.72) scores, which was lower than that of the control group (14.75±2.59) scores, and the difference was statistically significant (P <0.05). The total effective rate of the treatment group was 83.33%, which was higher than 56.67% of the control group, and the difference was statistically significant (P <0.05). There was only 1 patient with local skin slight redness in the treatment group, and the incidence of adverse reactions was 3.33%, but the patient was improved after symptomatic treatment, and no other adverse reactions were observed. Conclusion The short-wave physiotherapy instrument can effectively improve the pigmentation of patients with chloasma, with good clinical efficacy and higher safety, which is worthy of clinical application.