Objective To explore the safety and efficacy of red and blue light therapeutic apparatus combined with acne facial removal surgery in the treatment of facial acne. Methods A total of 100 patients with facial acne admitted to our hospital from June 2023 to March 2024 were randomly divided into control group and observation group, with 50 patients in each group. The control group was treated with acne facial removal surgery, and the observation group was treated with red and blue light on the basis of the control group. The clinical efficacy, clinical symptom scores and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 94.00%, which was higher than 86.00% in the control group (P <0.05). After treatment, the scores of cyst, pruritus and tenderness in the observation group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 8.00%, which was lower than 20.00% in the control group (P <0.05). Conclusion The use of acne facial removal surgery combined with red and blue light therapeutic apparatus is effective in the treatment of facial acne, which can improve clinical symptoms and reduce the incidence of adverse reactions. It is worthy of clinical application.