Objective To analyze the effect of skin cosmetic nursing on acne vulgaris. Methods A total of 77 patients with acne vulgaris who were treated in Macheng Third People's Hospital from August 2022 to August 2023 were selected as the study subjects. They were divided into reference group (n =37) and experimental group (n =40) by random number table method. The reference group was treated with routine nursing, and the experimental group was combined with skin cosmetic nursing on this basis. The psychological state, quality of life, skin appearance index, nursing satisfaction and clinical efficacy of the two groups were compared. Results The SAS and SDS scores of the experimental group after nursing were lower than those of the reference group (P <0.05). After nursing, the scores of personal social, family life and self-perception in the experimental group were lower than those in the reference group (P <0.05). The pigmentation and scar regression time of the experimental group were shorter than those of the reference group (P <0.05). The nursing satisfaction of the experimental group was 97.50%, which was higher than 81.08% of the reference group (P <0.05). The total effective rate of the experimental group was 95.00%, which was higher than 78.38% of the reference group (P <0.05). Conclusion For patients with acne vulgaris, skin cosmetic nursing can effectively regulate their psychological state, accelerate the regression of acne pigmentation and scar regression, improve the quality of life, improve clinical efficacy, and improve patient satisfaction.