Objective To explore the application effect of oral administration of traditional Chinese medicine decoction combined with external application of fusidic acid cream in the treatment of acne vulgaris. Methods From May 2021 to February 2023, 60 patients with acne vulgaris admitted to the hospital were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 30 patients in each group. The control group was treated with fusidic acid cream, and the observation group was treated with oral administration of traditional Chinese medicine decoction combined with external application of fusidic acid cream. The TCM symptom score, psychological state, comfort and clinical efficacy were compared between the two groups. Results After treatment, the scores of facial flushing, itching, swelling and pain, and thermal desquamation in the observation group were lower than those in the control group, and the differences were statistically significant (P