Abstract： Objective： To observe the clinical effect of Qingre Jiedu Decoction combined with fire needling for acne of damp-heat accumulation type， and to analyze its effect on skin barrier function. Methods：A total of 118 cases of patients with acne were selected and divided into the observation group and the control group according to the random number table method，with 59 cases in each group. The control group was treated with routine western medicine， and the observation group was additionally treated with Qingre Jiedu Decoction and fire needling based on the treatment of the control group. Both groups were treated for four weeks. The changes in main symptom scores， skin lesion scores， dermatopathological features，and skin barrier function in the two groups were compared before and after treatment，and the clinical effects in the two groups were evaluated. Both groups were followed up for six months，and the recurrence rates were recorded at the third and sixth months. Results：After treatment， the main symptom scores and skin lesion scores in the two groups were decreased when compared with those before treatment (P＜0.05)，and the main symptom score and skin lesion score in the observation group were lower than those in the control group (P＜0.05). After treatment， the scores of red area， porphyrin，and brown spots of skin in the two groups were decreased when compared with those before treatment (P＜0.05)；the scores of red area，porphyrin，and brown spots of skin in the observation group were lower than those in the control group (P＜0.05). After treatment，the percutaneous water loss and skin mucin contents were decreased when compared with those before treatment， and the stratum corneum hydration in the two groups was increased when compared with that before treatment (P＜0.05)； the percutaneous water loss and skin mucin content in the observation group were lower than those in the control group，and the stratum corneum hydration in the observation group was higher than that in the control group (P＜0.05). The total effective rate was 96.61% in the observation group，higher than that of 86.44% in the control group (P＜0.05). The recurrence rates at the third and sixth months in the observation group were lower than those in the control group (P＜0.05). Conclusion：Qingre Jiedu Decoction combined with fire needling for acne of damp- heat accumulation type can relieve clinical symptoms， improve dermatopathological features，enhance skin barrier function and clinical effect，and reduce recurrence rate.