Objective To explore the effect of nursing intervention based on solution-focused approach on the psychological state of patients with facial depressed scar. Methods A total of 60 patients with facial depressed scar admitted to our hospital from January 2023 to December 2024 were selected as the research subjects, and they were divided into the conventional group (January-December 2023) and the solution-focused group (January-December 2024) according to the admission time, with 30 patients in each group. The conventional group received conventional health nursing intervention, and the solution-focused group received nursing intervention based on the solution-focused approach. The psychological state, coping style and self-body image acceptance were compared between the two groups. Results After intervention, the scores of HAMA and HAMD in the two groups were lower than those before intervention, and those in the solution-focused group were lower than those in the conventional group (P <0.05). After intervention, the score of confrontation in the two groups was higher than that before intervention, and that in the solution-focused group was higher than that in the conventional group (P<0.05). After intervention, the scores of avoidance and yielding in the two groups were lower than those before intervention, and those in the solution-focused group were lower than those in the conventional group (P <0.05). After intervention, the score of BIRS in the two groups was lower than that before intervention, and that in the solution-focused group was lower than that in the conventional group (P <0.05). Conclusion Nursing intervention based on the solution-focused approach can effectively alleviate anxiety and depression in patients with facial depressed scar, improve their self-body image acceptance, and promote patients to adopt more positive coping strategies.