Objective To analyze the changes in psychological symptoms and quality of life of patients with moderate to severe acne after implementing point-to-point whole-course tracking facial nursing combined with physical and mental system nursing. Methods A total of 82 patients with moderate to severe acne (grade Ⅱ, grade Ⅲ, grade Ⅳ) admitted to Guigang City People's Hospital from April 2023 to October 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 41 patients in each group. The control group received conventional nursing, and the observation group received point-to-point whole-course tracking facial nursing combined with physical and mental system nursing. The psychological symptoms, quality of life, self-care ability, treatment compliance and satisfaction were compared between the two groups. Results After intervention, the scores of various dimensions of SCL-90 in the observation group were lower than those in the control group (P<0.05). After intervention, the score of DLQI in the observation group was lower than that in the control group (P<0.05). After intervention, the scores of various dimensions of ESCA in the observation group were higher than those in the control group (P<0.05). After intervention, the score of MMSA-8 in the observation group was higher than that in the control group (P <0.05). The satisfaction in the observation group (97.56%) was higher than that in the control group (82.93%) (P <0.05). Conclusion The application of point-to-point whole-course tracking facial nursing combined with physical and mental system nursing for patients with moderate to severe acne can improve their emotional state, and then enhance their treatment compliance and self-care ability, and reduce the impact of the disease on the quality of life. It is worthy of application.