Objective To analyze the effect of 500 nm delicate pulsed light (DPL) combined with medical skin healing biofilm on erythema parameter and skin physiological indicators in patients with sensitive skin. Methods A total of 80 patients with sensitive skin admitted to Jiaxing Shuguang Beauty Hospital from March 2024 to March 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 40 patients in each group. The control group was treated with medical skin healing biofilm for repair, and the observation group was treated with 500 nm DPL combined with medical skin healing biofilm for repair. The skin symptom improvement, erythema parameter, skin physiological indicators and adverse reaction rate were compared between the two groups. Results After treatment, the scores of skin symptom improvement and erythema parameter in the observation group were lower than those in the control group (P <0.05). After treatment, the TEWL in the observation group was lower than that in the control group, while the stratum corneum hydration and epidermal sebum content were higher than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 2.50%, which was lower than 12.50% in the control group (P <0.05). Conclusion The combination of 500 nm DPL and medical skin healing biofilm has an ideal effect in repairing sensitive skin. It can not only alleviate skin sensitive symptoms of patients, but also improve the skin physiological state, with high safety.