Objective To explore the effect of Liangxue Wuhua decoction and conventional western medicine combined with delicate pulsed light in the treatment of rosacea. Methods A total of 110 patients with rosacea who were treated in our hospital from February 2021 to February 2024 were selected and randomly divided into control group and observation group, with 55 patients in each group. The control group was treated with conventional western medicine combined with delicate pulsed light, while the observation group was treated with Liangxue Wuhua decoction on the basis of the control group. The clinical efficacy, skin lesion degree, skin barrier function, quality of life and recurrence rate were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group (P <0.05). After treatment, the scores of skin lesions in the observation group were lower than those in the control group (P <0.05). After treatment, the skin barrier function indexes of the observation group were better than those of the control group (P <0.05). After treatment, the quality of life score of the observation group was lower than that of the control group (P <0.05). The recurrence rate of the observation group was lower than that of the control group (P <0.05). Conclusion Liangxue Wuhua decoction and conventional western medicine combined with delicate pulsed light are effective in the treatment of rosacea, which can improve skin lesions and skin barrier function, thereby improving the quality of life of patients. It is worthy of clinical application.