Objective To explore the effect of traditional Chinese medicine facial mask combined with Q-switched laser on skin lesions and Melasma Area and Severity Index score in patients with stable pigment-melasma. Methods A total of 60 patients with stable pigment-melasma admitted to our hospital from January to December 2022 were selected. According to the random number table method, they were divided into the control group and the observation group, with 30 patients in each group. The control group received laser treatment, and the observation group received the traditional Chinese medicine facial mask combined with Q-switched laser treatment. The clinical effect, skin lesions, recurrence and the Melasma Area and Severity Index (MASI) score were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.67%, which was higher than 73.33% in the control group (P <0.05). After treatment, the scores of lesion color and lesion volume in the observation group were lower than those in the control group (P <0.05). There was no significant difference in the recurrence rate between the two groups (P >0.05). The MASI score in the observation group was lower than that in the control group (P <0.05). Conclusion The application of traditional Chinese medicine facial mask combined with Q-switched laser in the treatment of pigment-melasma can reduce skin pigmentation, decrease the area of melasma, improve the overall treatment effect, and reduce the recurrence, which is worthy of clinical application.