Objective To explore the effect of traditional Chinese medicine mask combined with Chaixiong Quban decoction and vitamin C on TCM syndrome score in patients with melasma of liver stagnation and blood stasis type. Methods A total of 70 female patients with melasma of liver stagnation and blood stasis type who visited the Dermatology Outpatient Department of Jiangsu Province Hospital of Chinese Medicine from February 2024 to October 2025 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 35 patients in each group. The control group was treated with Chaixiong Quban decoction and vitamin C tablets, and the observation group was treated with external application of traditional Chinese medicine mask on the basis of the control group. The clinical efffcacy, Melasma Area and Severity Index (MASI) score, TCM syndrome score, quality of life and adverse reaction rate were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group (P<0.05). The MASI score of the observation group after treatment was lower than that of the control group (P<0.05). The TCM syndrome score of the observation group after treatment was lower than that of the control group (P<0.05). The DLQI score of the observation groupafter treatment was lower than that of the control group (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Traditional Chinese medicine mask combined with Chaixiong Quban decoction and vitamin C in the treatment of melasma of liver stagnation and blood stasis type can effectively improve the skin lesion area and pigmentation degree of patients, reduce the TCM syndrome score of liver stagnation and blood stasis, thereby enhancing clinical efffcacy and patients' quality of life, with good safety during treatment.