Objective To analyze the effect of Q-switched laser combined with phototherapy platform on skin physiological parameters in patients with post-acne hyperpigmentation. Methods A total of 80 patients with post-acne hyperpigmentation admitted to Fogang People's Hospital from February 2024 to February 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was treated with Q-switched laser, and the observation group was treated with Q-switched laser combined with phototherapy platform. The skin physiological parameters, clinical efficacy, hyperpigmentation status and adverse reaction rate were compared between the two groups. Results After treatment, the skin moisture content of the observation group was higher than that of the control group, and the sebum secretion rate was lower than that of the control group (P <0.05). The total effective rate of the observation group (95.00%) was higher than that of the control group (75.00%) (P <0.05). After treatment, the scores of pigmentation degree and pigmentation number in the observation group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the observation group (5.00%) was lower than that in the control group (20.00%) (P <0.05). Conclusion The application of Q-switched laser combined with phototherapy platform in the treatment of patients with post-acne hyperpigmentation shows good efficacy.It can effectively improve skin physiological parameters, help to reduce hyperpigmentation, and has a low incidence of adverse reactions during treatment, with high application safety.