Objective To explore the clinical efcacy of 420 nm intensive pulsed light combined with Xiaocuo No.1 prescription in the treatment of acne. Methods A total of 87 patients who received acne treatment in the Affiliated Hospital of Jiangnan University from February 2021 to February 2023 were selected and divided into control group (n=43, treated with 420 nm intensive pulsed light) and study group (n=44, treated with 420 nm intensive pulsed light combined with Xiaocuo No.1 prescription) by random number table method. The clinical efcacy, TCM syndrome score and symptom recovery time of the two groups were compared. Results The total e?ective rate of treatment in the study group was 90.91%, which was higher than 74.42% in the control group (P<0.05). After treatment, the scores of TCM syndromes in the study group were lower than those in the control group (P<0.05). The in?ammation regression time and acne red print recovery time of the study group were shorter than those of the control group (P<0.05). Conclusion 420 nm intensive pulsed light combined with Xiaocuo No.1 prescription is e?ective in the treatment of acne, which can reduce the symptoms of traditional Chinese medicine and shorten the time of symptom improvement.