Objective To explore the improvement effect of sequential therapy with long-pulse 1064 nm Nd:YAG laser combined with intense pulsed light (IPL) on facial sensitive skin symptoms. Methods A total of 120 patients diagnosed with sensitive skin in the Department of Dermatology, Jiangyin Hospital of Traditional Chinese Medicine from October 2019 to May 2023 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 60 patients in each group. The control group received IPL therapy, and the observation group received sequential therapy with long-pulse 1064 nm Nd:YAG laser combined with IPL on this basis. The clinical efficacy, skin barrier function, skin sensitivity symptom scores and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group (93.33%) was higher than that in the control group (80.00%) (P <0.05). After treatment, the skin moisture content and TEWL in the observation group were better than those in the control group, and the scores of erythema, tingling, burning, itching and tightness were lower than those in the control group (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Sequential therapy with long-pulse 1064 nm Nd:YAG laser combined with IPL can effectively improve the clinical symptoms of patients with facial sensitive skin, enhance the skin barrier function, reduce the sensitivity index, and has high treatment safety.