Objective To explore the effect of intensive pulsed light combined with tranexamic acid in patients with chloasma and its effect on skin lesion area and skin lesion color. Methods A total of 70 patients with chloasma admitted to Xiamen Siming Wang Bingnan 99 Medical Beauty Clinic from July 2022 to July 2023 were selected as the research objects and divided into control group (n =35) and observation group (n =35) by random number table method. The control group was treated with tranexamic acid, and the observation group was treated with intensive pulsed light combined with tranexamic acid. The clinical efficacy, skin lesion area, skin lesion color, quality of life and treatment satisfaction were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.14%, which was higher than 82.86% in the control group (P <0.05). The skin lesion area score and skin lesion color score of the observation group were lower than those of the control group (P <0.05). The scores of SF-36 in the observation group were higher than those in the control group (P <0.05). The treatment satisfaction of the observation group was 97.14%, which was higher than 80.00% of the control group (P <0.05). Conclusion Intensive pulsed light combined with tranexamic acid is effective in the treatment of chloasma, which can reduce the area of chloasma lesions, dilute the color of skin lesions, improve the quality of life of patients, and improve treatment satisfaction.