Acne fulminans (AF) is a rare, serious, sudden-onset and long-lasting skin diseasethat causes scarring of face and body. Standard treatment with combined long-term isotretinoin and prednisolone is not always sufficient and has a well-knownpropensity for adverse effects leaving an unmet need for improved therapy. Casereports suggest that tumor necrosis factor (TNF)-αinhibitors may play a role inthe management of AF. In a 3-year retrospective data collection from two der-matology centers and literature review of clinical cases of acne fulminans treatedwith anti-TNF-αtherapy, three clinical cases and twelve literature cases were iden-tified. A total of five different TNF-αinhibitors have been tested, with adalimumabbeing the most commonly used. Clinical response was seen after 1 month in 2/3(67%) clinical cases and 5/12 (42%) literature cases, respectively, and treatmentwas successful in 2/3 (67%) and 11/12 (92%) after a median 3–7 months. All repor-ted adverse effects were mild and reversible. Anti-TNF-αtreatment may providerapid improvement in patients with AF when initial treatment with isotretinoinand prednisolone fails. However, randomized controlled trials are lacking, andexact dosage and timing need to be explored before clinical implementation.