Abstract： Objective： To observe the clinical effect of HU's Xiaocuo Decoction combined with fire needle in treating acne of lung-stomach damp-heat type． Methods： A total of 80 acne patients treated in the dermatology outpatient clinic of Yuyao Hospital of Traditional Chinese Medicine from January to December 2024 were selected and randomly divided into the observation group and the control group by a simple randomized ordering method ， with 40 cases in each group．The observation group was treated with HU's Xiaocuo Decoction combined with fire needle， while the control group received Doxycycline Hydrochloride Enteric-Coated Capsules combined with fire needle．After four weeks of treatment， the clinical effects， incidence of adverse reactions， as well as traditional Chinese medicine （TCM） syndrome scores， skin lesion scores， and Dermatology Life Quality Index （DLQI） before and after treatment were compared between the two groups．Results：After treatment，the total effective rate was 90.00% （36/ 40） in the observation group and 70.00% （28/40） in the control group， the difference being significant （P＜0.05）． After treatment， the TCM syndrome scores in both groups were decreased when compared with those before treatment （P＜0.05），and the scores in the observation group were lower than those in the control group （P＜0.05）． The skin lesion scores and DLQI scores in both groups were decreased compared with those before treatment （P＜0.05）， and the scores in the observation group were lower than those in the control group （P＜0.05）． During treatment，the incidence of adverse reactions was 5.00%（ 2/40） in the observation group and 2.50%（ 1/40） in the control group，there being no significant difference （P＞0.05）． Conclusion： HU's Xiaocuo Decoction combined with fire needle shows definite effect in treating acne of lung-stomach damp-heat type．It can effectively alleviate TCM syndromes，promote the repair of skin lesions，and improve the quality of life of patients.