Background <p>Charles Darwin’s letters and diaries frequently describe painful “boils” that disrupted his scientific work. We evaluated whether these lesions satisfy modern criteria for hidradenitis suppurativa (HS) and explored their impact on his productivity.</p> Methods <p>A systematic review of his correspondence and private diaries was carried out, indexing all episodes mentioning his recurrent boils.</p> Results <p>Twenty-three discrete inflammatory episodes were identified. Collectively, the data fulfilled all three diagnostic criteria for HS—typical lesions, sites and chronic relapsing course—while alternative explanations lacked consistent support. Darwin’s lifelong tobacco use emerged as a plausible triggering factor.</p> Discussion <p>Darwin’s recurrent “boils” most plausibly represent HS. Recognizing this diagnosis in an iconic scientist highlight both the historical reach of HS and its potential to erode productivity and morale, while demonstrating the value of archival correspondence in reconstructing the natural history of chronic skin disease.</p>