Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition often characterized by nodules, cysts, and tunneling sinus tracts. Incidence of HS varies by study, anywhere from 0.1% to 2% of the general population, and is increasing over time. Despite its common occurrence, the only FDA approved therapies for HS are antibodies against TNFα (Adalimumab) and IL-17A (Secukinumab). Response rates can be as low as 40%, underscoring the necessity of further investigation and new therapies. Female sex, obesity, and metabolic syndrome have the strongest associations with HS. In addition to metabolic syndrome, there are other hormonal associations with HS—the average age of onset is between 21 and 24, and prepubertal HS is rare. Additionally, 78% of adult females with HS report flares associated with their menstrual cycle. Another association in HS is ultra-processed foods (UPFs) consumption; Non-Hispanic Black populations consume the most UPFs and have the highest HS incidence, while Hispanic populations consume the least UPFs and have the lowest HS incidence, despite similar rates of obesity. Overall, the association of HS with UPF consumption and endocrine disorders suggest novel avenues of investigation.