Objective To explore the efficacy of Traditional Chinese Medicine Facial Masks combined with Chai Xiong Spot-Removing Decoction and Vitamin C in the treatment of Liver Qi Stagnation and Blood Stasis Pattern Melasma and its influence on the MASI Scores；Methods Seventy female patients with melasma due to liver qi stagnation and blood stasis who visited the dermatology outpatient clinic at Jiangsu Provincial Hospital of Traditional Chinese Medicine between February 2024 and October 2025 were enrolled and randomly divided into a control group and an observation group, each comprising 35 patients. Both groups of patients received oral administration of Tried and Chai Xiong Spot-Removing Decoction and vitamin C tablets. The observation group additionally applied traditional chinese medicine facial masks topically, in addition to the regimen used in the control group. After 8 weeks of treatment, compare the MASI scores, Traditional Chinese Medicine syndrome scores, overall clinical response rates, DLQI scores, and incidence of adverse reactions between the two groups of patients. Results After treatment, MASI scores decreased significantly in both groups compared with pre-treatment levels (P<0.05), with the observation group showing lower scores than the control group (P<0.05). The clinical total effective rate in the observation group was 91.43%, higher than the 71.43% in the control group (P<0.05). Both groups showed significant reductions in both TCM syndrome scores and DLQI scores compared to pre-treatment levels, with the observation group exhibiting a greater decrease than the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion The combination of traditional chinese medicine facial masks, Chai xiong spot-removing decoction, and vitamin C treatment significantly improves the lesion area, pigmentation intensity, and uniformity in patients with liver-qi stagnation and blood stasis-type melasma. It enhances clinical efficacy and quality of life while demonstrating good safety.