Objective To analyze the effect of glycolic acid combined with comedone extraction and red and blue light irradiation on scar retention rate and skin smoothness improvement in acne patients. Methods A total of 50 acne patients admitted to the Department of Dermatology and Cosmetology of our hospital from January 2025 to November 2025 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 25 patients in each group. The control group was treated with comedone extraction and red and blue light irradiation, and the study group was treated with glycolic acid combined with comedone extraction and red and blue light irradiation. The scar retention rate, skin smoothness improvement, adverse reaction rate and satisfaction were compared between the two groups. Results The scar retention rate of the study group (20.00%) was lower than that of the control group (60.00%) (P<0.05). The scores of pores, pigment spots and texture in the study group after intervention were better than those in the control group (P<0.05). There was no signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). The satisfaction rate of the study group (96.00%) was higher than that of the control group (72.00%) (P<0.05). Conclusion The effect of glycolic acid combined with comedone extraction and red and blue light irradiation in acne patients is good, which can effectively reduce the scar retention rate and improve skin smoothness, without increasing the risk of adverse reactions. It is conducive to improving patient satisfaction, which is worthy of clinical application.