Objective To analyze the effect of skin cosmetic nursing combined with supportive psychological nursing on female patients with moderate to severe acne. Methods A total of 84 female patients with moderate to severe acne admitted to our hospital from February 2021 to February 2023 were selected as the research objects. They were divided into control group and experimental group by random number table method, with 42 patients in each group. The control group was given skin cosmetic nursing, and the experimental group was given skin cosmetic nursing combined with supportive psychological nursing. The negative emotion, body image disorder, survival ability and nursing satisfaction of the two groups were compared. Results After intervention, the scores of anxiety and depression in the experimental group were lower than those in the control group (P<0.05). After intervention, the scores of body image disorder and viability in the experimental group were lower than those in the control group (P<0.05). The nursing satisfaction of the experimental group was 95.24%, which was higher than 78.57% of the control group (P<0.05). Conclusion Skin cosmetic nursing combined with supportive psychological nursing has a good application effect in female patients with moderate to severe acne, which is beneficial to reduce the negative emotions of patients, improve the body image disorder, improve the survival ability, and with higher patients' satisfaction.