Objective To explore the effect of refined nursing intervention on skin comfort in patients with acne conglobata undergoing ALA-photodynamic therapy. Methods A total of 40 patients with acne conglobata admitted to Afffliated Southwest Hospital of Youjiang Medical University for Nationalities from October 2023 to April 2024 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 20 patients in each group. The control group received conventional nursing, and the observation group received reffned nursing intervention on the basis of the control group. The skin comfort, nursing satisfaction, adverse reaction rate and psychological state were compared between the two groups. Results After nursing, the scores of NRS and VAS in the observation group were lower than those in the control group (P<0.05).After nursing, the scores of skin brightness, smoothness, absence of acne marks and absence of scars in the observation group were higher than those in the control group (P<0.05). The incidence of adverse reactions in the observation group (10.00%) was lower than that in the control group (40.00%) (P<0.05). After nursing, the scores of SAS and SDS in the observation group were lower than those in the control group (P<0.05). Conclusion Reffned nursing intervention can help to reduce the incidence of adverse reactions in patients with acne conglobata undergoing ALA-photodynamic therapy, while improving satisfaction, skin comfort and psychological state.