Objective To observe the clinical effect and safety of Yurong powder Chinese medicine fumigation+Taohong Siwu decoction in the treatment of chloasma of qi stagnation and blood stasis type. Methods A total of 80 patients with chloasma of qi stagnation and blood stasis type admitted to our hospital from January 2023 to January 2024 were selected as the research objects. They were divided into control group and observation group by random number table method, with 40 patients in each group. The control group was treated with Taohong Siwu decoction, and the observation group was treated with Yurong powder Chinese medicine fumigation+Taohong Siwu decoction. The clinical efficacy, skin lesion color and area, sex hormone level, chloasma severity index and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.50%, which was higher than 77.50% in the control group (P <0.05). The scores of skin lesion color and area in the observation group were lower than those in the control group after intervention (P <0.05). After intervention, the levels of estradiol and follicle stimulating hormone in the two groups were lower than those before intervention, and those in the observation group were lower than those in the control group (P <0.05). The chloasma severity index of the two groups after intervention was lower than that before intervention, and that of the observation group was lower than that of the control group (P <0.05). The incidence of adverse reactions in the observation group was slightly lower than that in the control group, but the difference was not statistically significant (P >0.05). Conclusion Yurong powder Chinese medicine fumigation+Taohong Siwu decoction is effective in treating chloasma of qi stagnation and blood stasis type, which can effectively improve the color and area of skin lesions, reduce the severity index of chloasma and sex hormone levels, and will not increase the incidence of adverse reactions.