Objective To evaluate the effect of intense pulsed light combined with poly-L-lactic acid in the treatment of facial rejuvenation and skin cosmesis. Methods A total of 82 patients scheduled for facial rejuvenation and skin cosmesis in Urumqi Huamei Plastic Surgery and Aesthetic Hospital from January 2024 to December 2025 were selected, and they were divided into the control group (n=41) and the experimental group (n=41) by the random number table method. The control group was treated with intense pulsed light, and the experimental group was treated with additional poly-L-lactic acid on the basis of the control group. The treatment effect, facial skin condition, skin barrier function and cosmetic satisfaction were compared between the two groups. Results The total effective rate of treatment in the experimental group was 97.56%, which was higher than 82.93% in the control group (P<0.05). After treatment, the scores of skin laxity and wrinkle severity in the experimental group were lower than those in the control group (P<0.05). After treatment, the scores of skin texture, red area and porphyrin area in the experimental group were higher than those in the control group (P<0.05). The cosmetic satisfaction rate of the experimental group was higher than that of the control group (P<0.05). Conclusion The combination of intense pulsed light and poly-L-lactic acid can improve the treatment effect of facial rejuvenation and skin cosmesis, maintain facial youthful state and intact skin barrier function, and enhance cosmetic satisfaction.