To explore the clinical effect of glycolic acid peels combined with 420 nm intensive pulsed light in the treatment of moderate to severe acne and its effect on skin beauty and patient satisfactio. Methods A total of 80 patients with moderate to severe acne admitted to our hospital from January 2021 to January 2023 were selected and divided into control group (40 patients) and observation group (40 patients) according to different treatment methods. The control group was treated with 420 nm intensive pulsed light, and the observation group was treated with glycolic acid peels combined with 420 nm intensive pulsed light. The clinical effect, skin beauty [Vancouver Scar Scale (VSS), skin erythema index (EI)] and patient satisfaction were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.50%, which was higher than 80.00% in the control group, and the difference was statistically significant (P <0.05). After treatment, VSS and EI in the observation group were lower than those in the control group, and the differences were statistically significant (P <0.05). The satisfaction degree of patients in the observation group was 95.00%, which was higher than 77.50% in the control group, and the difference was statistically significant (P <0.05). Conclusion The effect of glycolic acid peels combined with 420 nm intensive pulsed light in the treatment of moderate to severe acne is definite, which has a positive effect on improving skin beauty, and the patient satisfaction is high.