Objective To explore the efficacy and safety of intense pulsed light combined with laser therapy in facial skin cosmetology. Methods A total of 100 patients who underwent facial skin cosmetology in Department of Skin Cosmetology, Wuhan Wuzhou Plastic Surgery Hospital from January 2024 to January 2025 were selected, and they were divided into the reference group and the study group according to different treatment methods, with 50 patients in each group. The reference group was treated with single ultra-pulsed CO2 fractional laser, and the study group was treated with intense pulsed light combined with ultra-pulsed CO2 fractional laser. The treatment effect, skin barrier function indexes, skin structure indexes and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the study group (100.00%) was higher than that in the reference group (84.00%) (P <0.05). The TEWL and stratum corneum hydration of the study group after treatment were better than those of the reference group (P <0.05). The dermal thickness and collagen fiber density of the study group after treatment were better than those of the reference group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion The application of intense pulsed light combined with laser therapy in facial skin cosmetology can improve the total effective rate of treatment, effectively enhance skin barrier function and skin structure, without increasing the risk of adverse reactions, showing good efficacy and safety.