Objective To study the effect of adding and subtracting angelica peony soup combined with traditional Chinese medicine mask on the treatment of melasma. Methods: Taking 85 patients with melasma in Nanjing Jiayimei Medical Beauty Hospital from June 2023 to December 2025 as the research subjects, the control group (42 cases) was treated with simple traditional Chinese medicine mask; the observation group (43 cases) was combined with angelica peony soup on the basis of traditional Chinese medicine mask. ; Compare the syndrome changes before and after treatment of the two groups of patients, and test the skin barrier function of patients before and after treatment. Results After evaluation, there was no statistical difference between the groups in the pre-treatment syndrome evaluation of the two groups. The evaluation score of the post-treatment syndrome (male, skin lesions, sensitivity) of the patients in the observation group was lower than that of the control group, and the sebum content and cuticle water content were higher than those of the control group, and the percutaneous water loss was lower than that of the control group (P <0.05). Conclusion For patients with melasma, the treatment effect of combining traditional Chinese medicine mask combined with angelica peony broth is accurate, which significantly improves the performance of the syndrome and strengthens the skin barrier function, which is worth learning from.