The clinical efficacy of modified xiaoyaosan in the treatment of liver Qi stagnation-type chloasma from the starting point of liver

Chloasma (melasma) is a common pigmentary disorder characterized by hyperpigmented facial macules with a high recurrence rate. In Traditional Chinese Medicine, liver qi stagnation is considered a key pathogenesis. This study aimed to evaluate the clinical efficacy and safety of Modified Xiaoyaosan, a classical liver-soothing herbal formula, as an adjunct to conventional therapy in patients with liver qi stagnation-type chloasma. A retrospective analysis was conducted on 78 female patients diagnosed with liver qi stagnation-type chloasma who received treatment at our hospital. Based on their treatment regimens, patients were categorized into a control group (treated with vitamin C, vitamin E, and topical tranexamic acid) and a study group (treated with the same regimen plus Modified Xiaoyaosan) for a duration of 12 weeks. Clinical efficacy, skin lesion scores, VISIA skin imaging parameters, quality of life (assessed using the Dermatology Life Quality Index), serum oxidative stress markers (including superoxide dismutase and malondialdehyde), recurrence rate, and adverse events were retrospectively evaluated and compared between the 2 groups. The study group showed significantly higher total clinical efficacy (94.87% vs 79.49%, P < .05), greater improvement in skin lesion scores and VISIA parameters (P < .001), and lower Dermatology Life Quality Index scores at 4 and 12 weeks (P < .001). Serum superoxide dismutase levels increased while malondialdehyde levels decreased more significantly in the study group (P < .001). Recurrence rate was lower in the study group (2.56% vs 17.95%, P < .05), with no significant difference in adverse event rates. Modified Xiaoyaosan combined with conventional Western treatment effectively improves clinical symptoms, reduces oxidative stress, enhances skin quality and quality of life, and lowers recurrence in liver qi stagnation-type chloasma, with good safety and tolerability.