Objective To investigate the effect of intense pulsed light (IPL) combined with ultra-pulsed carbon dioxide fractional laser on skin photoaging severity and skin barrier function in patients with facial skin photoaging. Methods A total of 50 patients with facial skin photoaging treated at Wuxi Dashan Medical Beauty Clinic from January 2025 to January 2026 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 25 patients in each group. The control group was treated with IPL, and the observation group was treated with IPL combined with ultra-pulsed carbon dioxide fractional laser. The clinical efficacy, skin photoaging severity and skin barrier function were compared between the two groups. Results The total effective rate of the observation group (96.00%) was higher than that of the control group (76.00%) (P <0.05). At 4 weeks after treatment, the scores of abnormal pigmentation, pore size, skin laxity, wrinkles, skin roughness and telangiectasia in the observation group were lower than those in the control group (P <0.05). After treatment, the TEWL and skin pH value in the observation group were lower than those in the control group, while the sebum content and stratum corneum hydration were higher than those in the control group (P <0.05). Conclusion IPL combined with ultra-pulsed carbon dioxide fractional laser can effectively improve the skin condition of patients with facial photoaging, relieve photoaging-related symptoms, and repair skin barrier, presenting favorable clinical efficacy.