Objective To explore the effect of red and blue light combined with skin management assisted by conventional pharmacotherapy on skin barrier function in acne patients. Methods A total of 98 acne patients who received treatment in the Department of Medical Cosmetology, the Third People's Hospital of Huizhou from January 2024 to May 2025 were selected, and they were divided into the control group and the study group by the random number table method, with 49 patients in each group. The control group was given conventional pharmacotherapy, and the study group was given red and blue light combined with skin management assisted by conventional pharmacotherapy. The clinical efficacy, GAGS score, skin barrier function and adverse reaction rate were compared between the two groups. Results The total effective rate of treatment in the study group (95.92%) was higher than that in the control group (81.63%) (P <0.05). The GAGS score of the study group after treatment was lower than that of the control group (P <0.05). After treatment, the pH and transepidermal water loss rate of the study group were lower than those of the control group, and the stratum corneum hydration was higher than that of the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Red and blue light combined with skin management assisted by conventional pharmacotherapy in the treatment of acne can further improve the clinical efficacy, reduce the GAGS score, improve the skin barrier function, and has good safety.