Objective To explore the efficacy and safety of mucopolysaccharide polysulfate cream adjuvant to intense pulsed light in the treatment of patients with facial telangiectasia. Methods A total of 80 patients with facial telangiectasia admitted to Jurong People's Hospital from July 2024 to July 2025 were selected. According to the random number table method, they were divided into the reference group and the study group, with 40 patients in each group. The reference group was treated with intense pulsed light alone, and the study group was treated with mucopolysaccharide polysulfate cream adjuvant to intense pulsed light. The clinical efficacy, overall skin improvement and repair status, as well as adverse reaction rate were compared between the two groups. Results The total effective rate of the study group (90.00%) was higher than that of the reference group (72.50%) (P <0.05). The PGA scores of the study group were higher than those of the reference group both immediately after the completion of all treatments and at 1 month after the completion of all treatments (P <0.05). The incidence of adverse reactions in the study group was lower than that in the reference group, but the difference was not statistically significant (P >0.05). Conclusion The application of mucopolysaccharide polysulfate cream adjuvant to intense pulsed light in the treatment of facial telangiectasia can improve clinical efficacy and overall skin improvement and repair status, without increasing the risk of adverse reactions.