Objective To explore the effect of modiffed Liangxue Wuhua decoction combined with intense pulsed light (IPL) on skin condition improvement in patients with rosacea of excessive heat-toxicity syndrome. Methods A total of 102 patients with rosacea of excessive heat-toxicity syndrome admitted to our hospital from February 2023 to October 2025 were selected, and they were divided into the control group (n=51) and the study group (n=51) by the random number table method. The control group was treated with IPL, and the study group was treated with modified Liangxue Wuhua decoction combined with IPL. The rosacea severity, skin condition improvement, TCM syndrome scores and quality of life were compared between the two groups. Results After treatment, the GAGS score of the study group was (15.11±1.66)points, which was lower than (18.43±2.66)points of the control group (P<0.05). The TEWL in the study group was lower than that in the control group, and the SCH was higher than that in the control group (P<0.05). The scores of facial ffushing, burning and stinging, telangiectasia, papules and pustules in the study group were all lower than those in the control group (P<0.05). The scores of all dimensions of DLQI in the study group were lower than those in the control group (P<0.05). Conclusion Modiffed Liangxue Wuhua decoction combined with IPL can effectively improve the skin health status in patients with excessive heat-toxicity syndrome, relieve TCM symptoms, reduce the severity of rosacea, and minimize the adverse impact of the disease on quality of life.