Objective To observe the effect of acupuncture combined with minocycline on hormone levels in patients with acne. Methods A total of 80 patients with acne admitted to our hospital from January to December 2024 were selected as the research subjects. According to the random number table method, they were divided into the reference group and the observation group, with 40 patients in each group. The reference group received minocycline treatment, and the observation group received acupuncture combined with minocycline treatment. The hormone levels [serum testosterone (T), serum estradiol (E2)], treatment effect, quality of life and acne symptom improvement were compared between the two groups. Results After treatment, the levels of T and E2 in the observation group were lower than those in the reference group (P <0.05). The total effective rate of treatment in the observation group (95.00%) was higher than that in the reference group (80.00%) (P <0.05). After treatment, the DLQI score in the observation group was lower than that in the reference group (P <0.05). After treatment, the GAGS score in the observation group was lower than that in the reference group (P <0.05). Conclusion The application of acupuncture combined with minocycline in patients with acne can effectively improve their hormone levels, enhance the treatment effect, help to improve the quality of life of patients, and relieve their acne symptoms, which is worthy of clinical application.