To explore the clinical effect of red and blue light combined with salicylic acid in patients with facial acne. Methods A total of 80 patients with facial acne admitted to the Department of Dermatology of our hospital from January to June 2023 were selected as the research objects. They were divided into control group and study group by random number table method, with 40 patients in each group. The control group was treated with simple red and blue light, and the study group was treated with red and blue light combined with salicylic acid. The acne symptom scores, clinical efficacy, adverse reactions, psychological status and treatment satisfaction were compared between the two groups. Results After 4 weeks of treatment, the GAGS score of acne in the study group was better than that in the control group (P <0.05). The total effective rate of treatment in the study group was 95.00%, which was higher than 70.00% in the control group (P <0.05). The incidence of adverse reactions in the study group was 7.50%, which was lower than 20.00% in the control group (P <0.05). After treatment, the SAS score and SDS score of the study group were lower than those of the control group (P <0.05). The treatment satisfaction of the study group was 92.50%, which was higher than 72.50% of the control group (P <0.05). Conclusion The clinical effect of red and blue light combined with salicylic acid in the treatment of facial acne patients is good, which can effectively improve the acne symptoms of patients, help to reduce their bad mood, and the incidence of adverse reactions is lower, and the patient satisfaction is higher.