Objective To observe the clinical effect of Xiaofeng decoction combined with western medicine in the treatment of senile eczema dermatitis. Methods A total of 94 elderly patients with eczema and dermatitis in our hospital from March 2022 to March 2023 were selected as the research objects. According to different treatment methods, they were divided into routine group and combined group, with 47 patients in each group. The routine group was treated with western medicine compound flumetasone ointment, while the combined group was treated with Xiaofeng decoction on the basis of the routine group. The clinical efficacy, skin lesion area, pruritus symptom score, inflammatory factor level and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the combined group was 97.87%, which was higher than 78.72% in the routine group (P0.05). Conclusion Xiaofeng decoction combined with western medicine has a good effect in the treatment of senile eczema dermatitis, which can reduce the area of skin lesions, relieve skin itching symptoms, inhibit inflammatory reaction, and will not increase the risk of adverse reactions, with higher application safety