Objective To explore the effect of fractional laser (FL) combined with hyaluronic acid (HA) biological dressing on skin barrier function in patients with skin aging. Methods A total of 60 patients with skin aging admitted to Binzhou Central Hospital from January 2023 to June 2025 were selected, and they were divided into the control group and the study group by the random number table method, with 30 patients in each group. The control group was treated with FL combined with conventional dressing, and the study group was treated with FL combined with HA biological dressing. The clinical efffcacy, VISIA skin image analysis system scores, skin barrier function and quality of life were compared between the two groups. Results The total effective rate of treatment in the study group was 96.67%, which was higher than 80.00% in the control group (P<0.05). After treatment, the scores of spots, pores, texture and wrinkles in the study group were lower than those in the control group (P<0.05). After treatment, the epidermal sebum content and stratum corneum hydration in the study group were higher than those in the control group, and TEWL was lower than that in the control group (P<0.05). The DLQI score of the study group after treatment was lower than that of the control group (P<0.05). Conclusion FL combined with HA biological dressing in the treatment of skin aging can improve clinical efffcacy, optimize skin condition, enhance skin barrier function and promote quality of life.