Objective To explore the effect of acupuncture and moxibustion therapy on skin status in patients with facial acne. Methods A total of 90 patients with facial acne who visited the Department of Dermatology, Hongze District Hospital of Traditional Chinese Medicine from January 2022 to March 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 45 patients in each group. The control group was given conventional western medicine treatment, and the observation group was given conventional western medicine combined with acupuncture and moxibustion therapy. The GAGS score, inflammatory factor levels, skin status, clinical efficacy and adverse reaction rate were compared between the two groups. Results The GAGS score of the observation group after treatment was lower than that of the control group (P <0.05). The levels of IL-6, TNF-α and CRP in the observation group after treatment were lower than those in the control group (P <0.05). The skin moisture content, sebum secretion and skin fineness of the observation group after treatment were better than those of the control group (P <0.05). The total effective rate of the observation group was 95.56%, which was higher than 80.00% of 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 Acupuncture and moxibustion therapy can improve the clinical efficacy of facial acne. It not only effectively improves objective skin status such as sebum secretion, moisture content and fineness, but also promotes inflammation regression and reduces GAGS score, with good treatment safety.