Objective To explore the effect of facial acupuncture combined with meridian massage on skin quality in patients with acne vulgaris. Methods A total of 80 patients with acne vulgaris admitted to the Department of Massage, Afffliated Hospital of Henan Vocational College of Tuina from February 2025 to March 2026 were selected as the research subjects, and they were divided into the conventional group and the study group by the random number table method, with 40 patients in each group. The conventional group was intervened with meridian massage alone, and the study group was intervened with facial acupuncture combined with meridian massage. The clinical efficacy, skin quality, treatment compliance and recurrence rate were compared between the two groups. Results The total effective rate of the study group (100.00%) was higher than that of the conventional group (85.00%) (P<0.05). After treatment, the scores of facial skin oil content, pore coarsening degree and skin roughness in the study group were lower than those in the conventional group, and the skin moisture content was higher than that in the conventional group (P<0.05). The treatment compliance of the study group (97.50%) was higher than that of the conventional group (82.50%) (P<0.05). The recurrence rate of the study group was 2.50%, which was lower than 17.50% of the conventional group (P<0.05). Conclusion Intervention of facial acupuncture combined with meridian massage for patients with acne vulgaris can effectively improve clinical therapeutic efffcacy, optimize skin quality, enhance treatment compliance, and reduce the recurrence rate.