Objective To compare the effects of ffre needle and carbon dioxide laser on cyst regression time in patients with cystic acne. Methods A total of 60 patients with cystic acne treated in Jiangjin District Maternal and Child Health Hospital from August 2023 to February 2025 were selected as the research subjects. According to the random number table method, they were divided into group A and group B, with 30 patients in each group. Group A was treated with ffre needle, and group B was treated with carbon dioxide laser. The clinical efffcacy, cyst regression time, pain intensity, satisfaction and adverse reaction rate were compared between the two groups. Results The total effective rate of group B (96.67%) was higher than that of group A (76.67%) (P<0.05). The cyst regression time in group B was shorter than that in group A (P<0.05). The immediate postoperative VAS score of group B was lower than that of group A (P<0.05). The satisfaction rate of group B (93.33%) was higher than that of group A (70.00%) (P<0.05). The incidence of adverse reactions in group B (10.00%) was lower than that in group A (40.00%) (P<0.05). Conclusion In the treatment of cystic acne, the clinical effect of carbon dioxide laser is good. It can not only effectively promote cyst regression and improve patient satisfaction, but also relieve intraoperative pain and reduce the incidence of adverse reactions. The overall safety is good.