Objective: To explore the efficacy of glycolic acid peels combined with drugs in the treatment of moderate to severe acne in adolescents. Methods: From January 2022 to January 2025, 180 adolescent patients with moderate to severe acne were admitted to the dermatology department as the observation subjects. They were randomly grouped by the random number table method. 90 cases in the drug group were given drug treatment, and 90 cases in the observation group were given glycolic acid peelization combined with drug treatment. The short-term efficacy, adverse reactions and recurrence rate of the two groups were observed. Results: The total effective rate of one course of treatment in the observation group was higher than that in the drug group (P<0.05). After treatment, the score of the Vancouver Scar Scale (VSS) in the observation group was lower than that in the drug group (P<0.05). The aesthetic satisfaction of the observation group was higher than that of the drug group (P<0.05), and the incidence of adverse reactions was slightly lower than that of the drug group (P>0.05). After one month of medical follow-up, the recurrence rate of acne in the observation group was lower than that in the drug group (P<0.05). Conclusion: The short-term therapeutic effect of glycolic acid peels combined with drug treatment for moderate to severe acne in adolescents is remarkable. It reduces scar residue, improves skin aesthetics, has mild adverse reactions, and lowers the short-term recurrence rate of acne.