Successful treatment of Acne conglobata is only possible by surgical excision. Two procedures are most favoured. Gross excision and fine trimming by dermabrasion with subsequent secondary reepithelization gives excellent results without scars: If a radical excision is preferred or if cartilage is exposed, a full thickness skin graft has to be applied. The results are good although slight difference in colour between facial skin and skin graft must be noted. For each of these two procedures a case is presented and treatment and results are discussed.