Objective:To explore the clinical effectiveness of loquat Qingfei decoction combined with red and blue light in the treatment of acne vulgaris on the face and its influence on the level of serum inflammatory indexes. Methods: From January, 2025 to December, 2025, 200 patients with facial acne vulgaris were randomly divided into observation group and control group. The control group was treated with red and blue light alone, while the observation group was treated with loquat Qingfei decoction on the basis of red and blue light. The total effective rate, acne comprehensive grading system (GAGS) score, and inflammatory indicators [tumor necrosis factor -α(TNF-α), interleukin -6(IL-6) and interleukin -1β(IL-1β)] were observed and compared between the two groups. Results: After 4 weeks of treatment with different methods, the total effective rate of the observation group was better than that of the control group, and the GAGS score of the observation group was lower than that of the control group. The detection levels of TNF-α, IL-6 and IL-1β in the observation group were lower than those in the control group, and the data comparison between the above groups showed statistical differences (P < 0.05). Conclusion: The clinical effect of Pipa Qingfei Decoction combined with red and blue light in the treatment of facial acne vulgaris is significantly better than that of red and blue light alone. It can also effectively reduce the acne symptoms of patients, improve the skin lesions, and significantly lower the levels of TNF-α, IL-6 and IL-1β in serum, thus playing a better anti-inflammatory role.