Objective To explore the effect of Qingdou Paidu prescription on TCM syndrome score in female patients with mild to moderate acne vulgaris. Methods A total of 86 female patients with mild to moderate acne vulgaris admitted to the outpatient clinic of Department of Endocrinology, Changzhou Hospital of Traditional Chinese Medicine from March 2023 to September 2025 were selected as the research subjects, and they were divided into group A and group B by the random number table method, with 43 patients in each group. Group A was treated with external clindamycin phosphate gel, and group B was treated with Qingdou Paidu prescription on the basis of group A. The lesion count, TCM syndrome score, clinical efffcacy, quality of life and adverse reaction rate were compared between the two groups. Results The lesion count in group B at 4 weeks after treatment was lower than that in group A (P<0.05). The TCM syndrome score in group B at 4 weeks after treatment was lower than that in group A (P<0.05). The total effective rate of group B (95.35%) was higher than that of group A (81.40%) (P<0.05). The scores of all dimensions of quality of life in group B at 4 weeks after treatment were lower than those in group A (P<0.05). There was no signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Qingdou Paidu prescription has a good efffcacy in the treatment of female patients with mild to moderate acne vulgaris, which can effectively promote the regression of skin lesions, improve TCM syndromes and quality of life, with good safety.