Objective To explore the effect of self-regulation intervention combined with group psychological counseling in patients with facial acne depressed scar. Methods A total of 80 patients with facial acne depressed scar admitted to Aoyang Hospital Affiliated to Jiangsu University from February 2023 to February 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was given conventional nursing, and the observation group was provided with self-regulation intervention combined with group psychological counseling on the basis of the control group. The skin repair, pigmentation, adverse reaction rate, psychological status and self-efficacy were compared between the two groups. Results The wound healing time and redness and swelling regression time of the observation group were shorter than those of the control group (P <0.05). The mMASI scores of the observation group at 3 days, 10 days and 4 weeks after nursing were lower than those of the control group (P <0.05). The incidence of adverse reactions in the observation group was 2.50%, which was lower than 15.00% in the control group (P <0.05). The scores of HAMA and HAMD in the observation group after nursing were lower than those in the control group, and the score of GSES was higher than that in the control group (P <0.05). Conclusion The application of self-regulation intervention combined with group psychological counseling in patients with facial acne depressed scar has a definite effect. It can promote skin repair, reduce pigmentation, reduce the risk of adverse reactions, and help to improve patients' psychological status and enhance their self-efficacy.