Objective To explore the application of facial nursing combined with psychological nursing in acne patients with narrow-band red and blue light therapy and its effect on skin lesions and psychological state. Methods A total of 80 acne patients admitted to the Outpatient Department of Dermatology and Venereology, State Grid Corporation of China Beijing Electric Power Hospital from March 2023 to March 2024 were selected as the research subjects, and they were randomly divided into control group and observation group, with 40 patients in each group. Both groups were treated with narrow-band red and blue light, the control group was given conventional nursing, and the observation group was given facial nursing combined with psychological nursing. The nursing effect, skin lesions, psychological state, nursing satisfaction and adverse reactions were compared between the two groups. Results The total effective rate of nursing in the observation group (97.50%) was higher than that in the control group (75.00%) (P <0.05). The score of skin lesions in the two groups after nursing was lower than that before nursing, and that in the observation group was lower than that in the control group (P <0.05). The score of Symptom Checklist (SCL-90) in the two groups after nursing was lower than that before nursing, and that in the observation group was lower than that in the control group (P <0.05). The satisfaction scores and total score in the observation group were higher than those in the control group (P <0.05). The incidence of adverse reactions in the observation group (5.00%) was lower than that in the control group (27.50%) (P <0.05). Conclusion The application of facial nursing combined with psychological nursing in acne patients with narrow-band red and blue light therapy can effectively promote the enhancement of patient nursing effect, improve the skin lesions and psychological state of patients, and also reduce the incidence of adverse reactions, while patients’ satisfaction is high.