Hidradenitis suppurativa (HS) is a chronic, painful, inflammatory skin condition. It has profound and far-reaching adverse effects on patients, such as persistent pain, limitations in mobility, social stigmatization, compromised body image, sexual wellbeing, work, and socioeconomic challenges. The consequences on mental and psychosexual health for patients are substantial. Patients with HS are significantly more likely to have depression and anxiety, have an increased risk of suicide and suicidal thoughts, as well as substance-related disorders, alcohol and substance abuse, and psychiatric issues, such as schizophrenia, bipolar disorders, and personality disorders. Finally, there are well-documented implications for the psychosexual health of patients, not least as the disease commonly affects the genital areas, but also related to symptoms and appearance-related comorbidities. In the first part of this chapter, clinical characteristics of HS are described to understand the burden the disease may have on patients’ life. Subsequently, specific aspects of mental health are analyzed in detail, referring to the recent scientific literature.