Objective To observe the therapeutic effect of levocetirizine hydrochloride tablets combined with medical wound care solution in the treatment of dermatitis and eczema, as well as its influence on skin barrier function and quality of life. Methods A total of 84 patients with dermatitis and eczema admitted to the Department of Dermatology of our hospital from March to June 2026 were selected, and they were divided into the control group and the observation group by the random number table method, with 42 patients in each group. The control group was treated with oral levocetirizine hydrochloride tablets, and the observation group was additionally treated with medical wound care solution. The clinical symptom scores, clinical efficacy, skin barrier function [transepidermal water loss (TEWL), stratum corneum hydration], quality of life (DLQI score), skin appearance satisfaction and adverse reaction rate were compared between the two groups. Results Compared with the control group, the total effective rate of the observation group was higher after 4 weeks of treatment, and the scores of erythema, papules, exudation and pruritus were lower (P <0.05). The TEWL level and DLQI score of the observation group were lower, the stratum corneum hydration and the satisfaction of skin appearance were higher (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Levocetirizine hydrochloride tablets combined with medical wound care solution in the treatment of dermatitis and eczema can rapidly relieve symptoms, effectively repair skin barrier, improve skin appearance and quality of life, with good safety.