Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with profound impairment in health-related quality of life (HRQoL). Compared to other dermatologic conditions such as psoriasis, atopic dermatitis, and chronic urticaria, HS exerts a greater burden across physical, psychological, sexual, occupational, and financial domains. Patients with HS experience persistent pain, malodor, drainage, and restricted mobility, as well as heightened rates of depression, anxiety, suicidal ideation, and significant sexual dysfunction. Psychiatric comorbidities are highly prevalent and amplify the psychological and emotional burden of the disease. Sexual health is markedly impacted by HS, with high rates of sexual distress, impaired body image, and difficulty forming or maintaining intimate relationships, particularly among women and patients with anogenital disease involvement. Work function is significantly impaired, with high rates of absenteeism, presenteeism, unemployment, and career limitations contributing to long-term socioeconomic consequences. Disease severity, early age of onset, anogenital involvement, and the number of affected anatomical regions are major predictors of worsened HRQoL outcomes. In addition to substantial direct healthcare costs, HS patients frequently utilize high-cost healthcare settings, such as emergency departments and hospitalizations, at greater rates than patients with other chronic inflammatory skin diseases. We conclude that recognizing and addressing the multidimensional impact of HS, including its profound physical symptoms, psychological distress, sexual health impairment, occupational dysfunction, and financial burden, is critical for optimizing comprehensive patient care and improving long-term outcomes.