Objective To explore the application effect of modified Jianpi Xiaocuo decoction combined with herbal acne removing mask in the treatment of acne patients. Methods A total of 102 patients with acne admitted to our hospital from February 2020 to February 2022 were randomly divided into control group and observation group, with 51 cases in each group. Among them, the control group was treated with conventional western medicine, and the observation group was treated with herbal acne removing mask+Jianpi Xiaocuo decoction. The clinical efficacy, skin lesion severity, pain degree, adverse reactions and disease recurrence rate were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The severity of skin lesions, pain score and disease recurrence rate in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Herbal acne removing mask combined with Jianpi Xiaocuo decoction can improve the clinical efficacy, accelerate the recovery of skin lesions, reduce the pain of patients, and has good safety, which is worthy of clinical application.