Objective To observe the efficacy and cosmetic effect of acupuncture combined with minocycline in the treatment of acne. Methods 80 acne patients admitted in our hospital from January 2024 to December 2024 were divided into the reference group of 40 cases (minocycline) and the intervention group (supplemented by TCM acupuncture), and the total efficacy, hormone level, acne and improved quality of life of the two groups were observed. Results The total efficacy (95.00%) was higher than the reference group (80.00%), P <0.05; no difference, P> 0.05; serum testosterone (T) and serum estradiol (E2) levels were lower than the treatment group, P <0.0.5 (GAGS) score and dermatology quality of life index score (DLQI) before treatment, P> 0.05; the intervention group was lower than the reference group, P <0.05. Conclusion Acupuncture combined with minocycline has a remarkable effect on acne, not only strengthening the clinical effect, but also improving the hormone level and quality of life of patients, which is worthy of clinical promotion and application.