Objective To investigate the clinical efcacy of red and blue light combined with adapalene gel in the treatment of acne. Methods A total of 114 acne patients admitted to Qingyang Hospital of Traditional Chinese Medicine from May 2020 to June 2021 were randomly divided into control group and observation group, with 57 patients in each group. The control group was treated with adapalene gel, and the observation group was treated with red and blue light irradiation on the basis of the control group. The clinical efcacy, symptom score, psychological state, skin lesions and adverse reactions were compared between the two groups. Results The total e?ective rate of treatment in the observation group was 96.49%, which was higher than 71.93% in the control group (P<0.05). After treatment, the symptom scores of the observation group were lower than those of the control group (P<0.05). After treatment, the scores of SAS and SDS in the observation group were lower than those in the control group (P<0.05). After treatment, the number of skin lesions in the observation group was lower than that in the control group (P<0.05). The incidence of adverse reactions in the observation group was 1.75%, which was lower than 14.04% in the control group (P<0.05). Conclusion Red and blue light combined with adapalene gel can improve the clinical symptoms and psychological state of acne patients, relieve skin lesions, obtain better clinical efcacy, and the incidence of adverse reactions is low.