Objective To investigate the effect of olopatadine hydrochloride tablets combined with compound glycyrrhizin tablets and mometasone furoate cream on skin appearance in patients with chronic urticaria. Methods A total of 80 patients with chronic urticaria admitted to Longjiang County First People’s Hospital from June 2024 to February 2026 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was treated with olopatadine hydrochloride tablets, and the observation group was treated with compound glycyrrhizin tablets and mometasone furoate cream on the basis of the control group. The clinical efficacy, clinical symptom improvement, skin appearance and quality of life were compared between the two groups. Results The total effective rate of the observation group (92.50%) was higher than that of the control group (72.50%) (P<0.05). After treatment, the scores of pruritus severity and wheal quantity in the observation group were lower than those in the control group (P<0.05). After treatment, the scores of skin color, skin ffatness and residual improvement of skin lesions in the observation group were higher than those in the control group (P<0.05). After treatment, the DLQI score of the observation group was lower than that of the control group (P<0.05). Conclusion Olopatadine hydrochloride tablets combined with compound glycyrrhizin tablets and mometasone furoate cream achieves favorable efffcacy in the treatment of chronic urticaria. It can effectively improve patients’ skin appearance, relieve clinical symptoms and help to elevate their quality of life.