Objective To explore the effect of oral medication combined with intense pulsed light and microneedling therapy on symptom improvement in patients with rosacea. Methods A total of 36 patients with rosacea admitted to Changshu Xinyuan Medical Beauty Clinic from January 2024 to June 2025 were selected as the research subjects. According to the random number table method, they were divided into the reference group (n =18) and the observation group (n =18). The reference group received oral medication alone, and the observation group received oral medication combined with intense pulsed light and microneedling therapy. The clinical efficacy, symptom improvement and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 94.44%, which was higher than 72.22% in the reference group (P<0.05). The scores of symptom improvement and total score in the observation group were lower than those in the reference group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Oral medication combined with intense pulsed light and microneedling therapy exerts a synergistic effect in the treatment of rosacea, which can effectively improve clinical symptoms, and has good safety. It is worthy of clinical application.