Objective To explore the effect of 308 nm excimer light combined with paeonol ointment on skin lesion severity in female patients with neurodermatitis. Methods A total of 200 female patients with neurodermatitis admitted to Hangzhou Linping District Integrated Traditional Chinese and Western Medicine Hospital from January 2021 to January 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the combined group, with 100 patients in each group. The control group was treated with 308 nm excimer light irradiation, and the combined group was treated with external application of paeonol ointment on the basis of the control group. The skin lesion severity, pruritus degree, Dermatology Life Quality Index (DLQI) score and adverse reaction rate were compared between the two groups. Results The EASI score of the combined group after treatment was lower than that of the control group (P<0.05). The NRS score of the combined group after treatment was lower than that of the control group (P<0.05). The DLQI score of the combined group after treatment was lower than that of the control group (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion 308 nm excimer light combined with paeonol ointment has a good clinical effect and high safety in the treatment of female patients with neurodermatitis. It can effectively reduce the severity of skin lesions, relieve pruritus symptoms, and help to improve patients' quality of life.