Objective To analyze the effect of delicate pulsed light (DPL) combined with tacalcitol ointment on skin lesions in patients with erythromelanosis follicularis faciei et colli (EFFC). Methods A total of 48 patients with erythromelanosis follicularis faciei et colli admitted to our hospital from May 2023 to May 2025 were selected, and they were divided into the control group and the experimental group by the random number table method, with 24 patients in each group. The control group was treated with delicate pulsed light, and the experimental group was treated with topical tacalcitol ointment on the basis of the control group. The skin lesions, clinical efffcacy and adverse reactions were compared between the two groups. Results The scores of all skin lesion indicators in the two groups after treatment were lower than those before treatment, and those in the experimental group were lower than those in the control group (P<0.05). The total effective rate of the experimental group (95.83%) was higher than that of the control group (83.33%) (P<0.05). There was no signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The application of delicate pulsed light combined with tacalcitol ointment has a good clinical effect in the treatment of patients with EFFC, which can effectively improve skin lesions, without increasing the incidence of adverse reactions.