Objective To analyze the effect of photorejuvenation on skin lesions in patients with facial telangiectasia. Methods A total of 60 patients with facial telangiectasia admitted to the Department of Plastic Surgery, Beijing Fengtai Hospital from May 2023 to June 2025 were selected, and they were divided into the reference group and the experimental group by the random number table method, with 30 patients in each group. The reference group received conventional treatment, and the experimental group received photorejuvenation treatment. The skin lesions, skin barrier function, clinical efffcacy and adverse reaction rate were compared between the two groups. Results At 3 months after treatment, the absolute score of red area detected by VISIA and CEA score in the experimental group were lower than those in the reference group (P<0.05). At 3 months after treatment, the epidermal water content, erythema area and sebum content of the experimental group were better than those of the reference group (P<0.05). The total effective rate of treatment in the experimental group (96.67%) was higher than that in the reference group (73.33%) (P<0.05). The incidence of adverse reactions in the experimental group (3.33%) was lower than that in the reference group (20.00%) (P<0.05). Conclusion The clinical effect of photorejuvenation in patients with facial telangiectasia is deffnite, which can effectively reduce the symptoms of skin lesions, improve the skin barrier function, reduce the risk of adverse reactions, and has high safety.