Objective To investigate the effect of tanshinone combined with tetracycline hydrochloride in the treatment of acne patients and its effect on serum sex hormone levels and sebum secretion rate. Methods Sixty patients with acne admitted to Ningqiang County Tianjin Hospital from January to December 2023 were randomly divided into control group and observation group, with 30 cases in each group. The control group was treated with tetracycline hydrochloride, and the observation group was treated with tanshinone combined with tetracycline hydrochloride. The sebum secretion rate(SER), clinical efficacy, serum hormone level and psychological state were compared between the two groups. Results After treatment, the SER in the observation group was lower than that in the control group (P <0.05). The total effective rate of treatment in the observation group was 96.67%, which was higher than 73.33% in the control group (P <0.05). After treatment, the levels of LH, FSH and E2 in the observation group were higher than those in the control group, and the level of T was lower than that in the control group (P <0.05). After treatment, the scores of SDS and SAS in the observation group were lower than those in the control group (P <0.05). Conclusion The application of tanshinone combined with tetracycline hydrochloride in the treatment of acne patients has a good effect, which can improve the serum sex hormone level of patients, reduce the sebum secretion rate, help reduce their negative emotions, and promote recovery.