Objective To explore the effect of fire needle combined with doxycycline combined with intensive pulsed light in the treatment of patients with acne vulgaris. Methods A total of 126 patients with acne vulgaris admitted to our hospital from March 2021 to February 2023 were randomly divided into control group and experimental group, with 63 patients in each group. The control group was treated with doxycycline combined with intensive pulsed light, and the experimental group was treated with fire needle on the basis of the control group. The recovery of skin lesions, clinical efficacy, adverse reactions and recurrence rate were compared between the two groups. Results The total score of GAGS in the experimental group was lower than that in the control group at the 4th, 8th and 12th week of treatment, and the difference was statistically significant (P0.05). The recurrence rate of the experimental group was lower than that of the control group, and the difference was statistically significant (P