Objective To analyze the effect of red and blue light combined with fusidic acid cream on skin lesion symptom score in acne patients. Methods A total of 80 acne patients admitted to the Department of Dermatology, Chifeng Songshan Hospital from June 2024 to June 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 received fusidic acid cream treatment, and the observation group received red and blue light combined with fusidic acid cream treatment. The skin lesion symptom score, clinical efffcacy, skin lesion number, recurrence and adverse reaction rate were compared between the two groups. Results The skin lesion symptom score of the observation group after treatment was lower than that of the control group (P<0.05). The total effective rate of the observation group (97.50%) was higher than that of the control group (77.50%) (P<0.05). The number of skin lesions in the observation group after treatment was lower than that in the control group (P<0.05). The recurrence rate of the observation group was lower than that of 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 synergistic therapy of red and blue light combined with fusidic acid cream for acne patients can effectively improve the treatment effect. It not only promotes skin lesion repair and reduces the risk of disease recurrence, but also shows good treatment safety.