Objective To explore the effect of compound glycyrrhizin combined with hydroxychloroquine sulfate tablets on skin improvement in patients with rosacea. Methods A total of 50 patients with rosacea who visited Tianquan County Hospital of Traditional Chinese Medicine from June 2024 to June 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 25 patients in each group. The control group was treated with hydroxychloroquine sulfate tablets, and the observation group was treated with compound glycyrrhizin combined with hydroxychloroquine sulfate tablets. The skin improvement, clinical symptoms, heme level and quality of life were compared between the two groups. Results After treatment, the depression value, protrusion value and roughness of the observation group were lower than those of the control group (P <0.05). After treatment, the scores of paroxysmal flushing, papules, persistent erythema and telangiectasia in the observation group were lower than those in the control group (P <0.05). After treatment, the heme level of the observation group was lower than that of the control group (P <0.05). After treatment,the scores of physiological function, general health, bodily pain and emotional function in the observation group were higher than those in the control group (P <0.05). Conclusion The application of compound glycyrrhizin combined with hydroxychloroquine sulfate in the treatment of rosacea can effectively improve patients' skin condition and clinical symptoms, reduce the heme level, and enhance the quality of life.