Objective To analyze the effect of glycolic acid peel combined with red light therapy on the skin physiological indexes of patients with acne. Methods A total of 120 patients with acne admitted to People’s Hospital of Honghuagang District from January 2022 to December 2023 were selected as the research subjects. According to the random number table method, they were divided into the control group (n =60) and the observation group (n =60). The control group received red light therapy, and the observation group received red light therapy combined with glycolic acid peel. The clinical efficacy, skin physiological indexes, adverse reactions and recurrence rate were compared between the two groups. Results The total effective rate of clinical treatment in the observation group was 98.33%, which was higher than 88.33% in the control group (P <0.05). The skin elasticity in the observation group was higher than that in the control group, and the transepidermal water loss value and skin sebum value 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 5.00%, which was slightly lower than 8.33% in the control group, but the difference was not statistically significant (P >0.05). The recurrence rate in the observation group was 0, which was lower than 6.67% in the control group (P <0.05). Conclusion In the treatment of acne, glycolic acid peel combined with red light therapy can improve the clinical efficacy, optimize the skin physiological state indexes, with lower recurrence rate and higher application safety, which is worthy of clinical application.