Objective To analyze the effect of traditional Chinese medicine facial mask combined with cosmetic ffliform needle intensive acupuncture on skin condition of scar area in patients with early-stage, small-area facial hypertrophic scar. Methods A total of 68 patients with early-stage, small-area facial hypertrophic scar treated in Rugao Hospital of Traditional Chinese Medicine from January 2023 to May 2025 were selected as the research subjects. According to the lottery method, they were divided into the reference group and the study group, with 34 patients in each group. The reference group was treated with cosmetic ffliform needle intensive acupuncture alone, and the study group was treated with traditional Chinese medicine facial mask combined with cosmetic ffliform needle intensive acupuncture. The clinical efffcacy, scar severity and skin condition of scar area were compared between the two groups. Results The total effective rate of the study group (97.06%) was higher than that of the reference group (76.47%) (P<0.05). At 3 months after treatment, the scores of thickness, ffexibility, vascularity, color, pruritus and pain in the study group were lower than those in the reference group (P<0.05). At 3 months after treatment, the score of erythema in the study group was lower than that in the reference group, while the scores of moisture and elasticity were higher than those in the reference group (P<0.05). Conclusion The combined application of traditional Chinese medicine facial mask and cosmetic ffliform needle intensive acupuncture has a more definite effect in the treatment of early-stage, small-area facial hypertrophic scar. It can alleviate scar symptoms and effectively improve the skin condition of scar area.