Objective To explore the clinical effect of red and blue light combined with doxycycline in the treatment of moderate and severe facial acne. Methods Sixty patients with moderate to severe facial acne admitted to the First People's Hospital of Qingzhen from March 2021 to December 2022 were selected and divided into control group and treatment group by random number table method, with 30 patients in each group. The control group was treated with doxycycline, and the treatment group was treated with red and blue light. The clinical effect, skin lesions and skin disease quality of life scores were compared between the two groups. Results The total effective rate of clinical treatment in the treatment group was 93.33%, which was higher than 73.33% in the control group (P<0.05). After treatment, the number and area of skin lesions in the treatment group were smaller than those in the control group (P<0.05). After treatment, the quality of life score of skin diseases in the treatment group was (3.07±0.87) scores, which was lower than (6.28±1.24) scores in the control group (P<0.05). Conclusion Red and blue light combined with doxycycline is effective in the treatment of moderate and severe facial acne, which can reduce the degree of skin lesions, help to improve the quality of life, and restore normal life as soon as possible.