Objective To analyze the effect of adapalene gel+fusidic acid cream combined with alternating red and blue light irradiation in patients with acne vulgaris. Methods A total of 169 patients with acne vulgaris admitted to Yuncheng District People's Hospital of Yunfu City from January 2022 to March 2024 were selected, and they were divided into the control group (n=77) and the observation group (n =92) according to different treatment methods. The control group was treated with adapalene gel+fusidic acid cream, and the observation group was treated with adapalene gel+fusidic acid cream combined with alternating red and blue light irradiation. The acne lesion counts, acne severity, serum inflammatory factor levels and adverse reaction rate were compared between the two groups. Results After treatment, the numbers of comedones, papules and pustules in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). After 4 and 8 weeks of treatment, the GAGS scores in the two groups were lower those before treatment, and those in the observation group were lower than those in the control group (P<0.05). After treatment, the levels of IL-1αand IL-8 in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The application of adapalene gel+fusidic acid cream combined with alternating red and blue light irradiation has a definite effect in patients with acne vulgaris. It can effectively reduce acne-related lesions, alleviate the severity of acne and inflammatory response, and does not increase the risk of adverse reactions. Its treatment effect is superior to that of drug treatment alone.