Objective To analyze the effect of photorejuvenation on facial pigmentation and wrinkles in patients undergoing cosmetic dermatology treatment. Methods A total of 120 patients who underwent cosmetic dermatology treatment at Langfang I Beauty Plastic Surgery Medical Cosmetology Clinic from September 2022 to September 2024 were selected as the research subjects. According to different treatment methods, they were divided into the control group and the experimental group, with 60 patients in each group. The control group received microneedle therapy, and the experimental group received photorejuvenation therapy. The pigmentation, wrinkles, skin texture and complications were compared between the two groups. Results After treatment, the scores of pigmentation area and pigmentation color in the experimental group were lower than those in the control group (P <0.05). After treatment, the scores of wrinkle number and wrinkle depth in the experimental group were lower than those in the control group (P <0.05). After treatment, the scores of skin texture smoothness, pore size and skin elasticity in the experimental group were better than those in the control group (P <0.05). The incidence of complications in the experimental group was 1.67%, which was lower than 11.67% in the control group (P <0.05). Conclusion Photorejuvenation can effectively improve pigmentation and wrinkles in patients undergoing cosmetic dermatology treatment, optimize skin texture, and enhance facial skin condition, with a low incidence of complications. It is worthy of clinical application.