With the development of society, people’s pursuit of beauty has also been increasing. Acne is also getting more and more attention from beauty lovers because of its impact on facial appearance, and it has become a common disease in dermatology. Sometimes serious facial acne, because of recurrent attacks and complex etiology, can also become a difficult problem for dermatologists and seriously affect the patient’s psychology. In the treatment of acne in Western medicine, the application of antibiotics, vitamins and retinoids has its own curative side, but its side effects are also more obvious and often not ideal when it comes to severe acne, but Chinese medicine also has its own unique side in the treatment of acne. The following is a discussion of the unique understanding of Chinese dermatology in the etiology and treatment of acne. In terms of etiology, TCM believes that acne is caused by people’s uncontrolled diet, addiction to spicy, fried and cold foods, damage to the spleen and stomach, internal dampness and heat, exuberant lung fire; liver qi stagnation, qi and blood stasis, condensation of the skin; external wind and dampness evil, resulting in acne due to heat and toxicity of qi and blood in the skin. In terms of treatment, TCM identifies three main types of acne and uses a combination of internal herbal medicine, external herbal masks and acupuncture to treat it. The following is the treatment method and main clinical manifestations of internal Chinese herbal medicine in TCM: Lung meridian contains heat: the main manifestations are acne at the beginning, redness, swelling and pain, itching of the face, dry mouth, yellow urine, dry stool, and red tongue with yellow coating. Treatment is based on clearing and cooling the lung and blood, commonly used as loquat and lung clearing drink, with herbs such as loquat leaf, mulberry bark, Zhi Mu, Huang Cen, Yin Hua, red peony, raw earth, raw gypsum and raw licorice. Acne in young men and women is mostly of this type. It is important to eat less fried, barbecued and other foods that are easily inflamed. Phlegm and phlegm stasis: This type of acne is mainly characterized by acne over time, hard texture that is difficult to eliminate, painful to the touch, or a bumpy face like an orange peel. This type is mostly seen in long-term chronic patients. The main ingredients are: rhubarb, stinging insect, leech, white flower and snake’s tongue, peach kernel, safflower, motherwort, Chen Pi, atractylodes, raw licorice, etc. Qi stagnation and blood stasis type: This type is mostly found in middle-aged people. The rash is distributed on the face and chest and back, accompanied by chest congestion, swelling and pain in the ribs, and boredom, with increased skin lesions in the front of the menstrual period and breast swelling and pain in women. It is recommended to soothe the liver and regulate qi. The medicine used is forsythia, Xia Gu Cao, Chai Hu, Scutellaria, Sheng Di, Mudan Pi, etc. These are the three main types of acne, but we also need to combine the characteristics of the current lifestyle and the patient’s physical constitution to identify and reduce the symptoms in order to receive good results. For example, people nowadays like to drink cold drinks, which can easily lead to spleen deficiency and dampness, so treatment should be given to strengthen the spleen and resolve dampness by adding Radix et Rhizoma Ginseng, Atractylodes Macrocephalae and Coix Coix Seeds to the medicine. In terms of external treatment, a mask made of Chinese herbs to clear heat and dampness can be applied to the face once a day, together with internal Chinese herbal treatment. In general, acne can basically see more obvious results in about a week. In the case of cystic nodular acne, a powdery tumor will often form. At this time, it is more difficult to eliminate internal Chinese and Western medicine and external facial masks, and the use of surgical treatment is difficult for many patients to accept. In summary, Chinese medicine in the treatment of acne, using the control of the patient’s diet, evidence-based treatment to regulate the patient’s physique, the use of internal and external treatment of acupuncture combined with a comprehensive treatment method, in the treatment of acne is very own unique side.