Objective To investigate the effect of skin repair dressing combined with recombinant mussel adhesive protein hydrogel dressing on facial acne scar after CO2 fractional laser treatment. Methods A total of 132 patients with acne scars admitted to our hospital from May 2023 to January 2024 were selected as the research objects. According to different intervention methods, they were divided into four groups, with 33 patients in each group. The control group was intervened by ice compress, the dressing group was intervened by skin repair dressing on the basis of the control group, the hydrogel group was intervened by recombinant mussel adhesive protein hydrogel dressing on the basis of the control group, and the combined group was intervened by skin repair dressing+ recombinant mussel adhesive protein hydrogel dressing on the basis of the control group. The degree of skin repair, clinical related indexes, skin barrier indexes and patient satisfaction were compared among the four groups. Results The postoperative crusting time and complete crust shedding time in the combined group were shorter than those in the control group, dressing group and hydrogel group, and the differences were statistically significant (P <0.05). The wound exudation time, pain duration and edema time in the combined group were shorter than those in the control group, dressing group and hydrogel group, and the differences were statistically significant (P <0.05). After 3 days and 7 days of treatment, the percutaneous water loss, erythema index and pigmentation level in the combined group were lower than those before treatment, and those in the combined group were lower than those in the control group, dressing group and hydrogel group, the differences were statistically significant (P <0.05). The satisfaction of patients in the combined group was higher than that in the control group, dressing group and hydrogel group, and the difference was statistically significant (P <0.05). Conclusion The application of skin repair dressing combined with recombinant mussel adhesive protein hydrogel dressing to repair facial acne scars after CO2 fractional laser treatment is effective, which can effectively shorten the skin repair time and improve patient satisfaction. It is worthy of clinical application.