Purpose of Review <p>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease marked by painful nodules, abscesses, and scarring primarily in intertriginous areas. Although HS affects individuals of all racial and ethnic backgrounds, patients with skin of color (SoC), including Black, Hispanic, and South Asian populations, experience a disproportionate disease burden along with significant disparities in diagnosis, treatment, and outcomes. This review summarizes epidemiological trends, clinical variations, pathophysiologic insights, diagnostic challenges, treatment disparities, and psychosocial impacts of HS in SoC populations.</p> Recent Findings <p>Emerging data reveal that HS patients of SoC have unique clinical features, such as pigmentary changes, keloid formation, and altered erythema presentation, which may complicate recognition in darker skin tones. SoC patients remain underrepresented in clinical trials and are less likely to receive advanced therapies. Emerging evidence suggests that genetic, immunologic, and structural differences may contribute to variations in disease pathophysiology and treatment response. Systemic barriers, including limited access to dermatology, implicit bias, and cultural mistrust, further exacerbate these inequities.</p> Summary <p>Addressing these challenges requires inclusive research, enhanced provider education, and culturally competent care. This review outlines key priorities to advance equity and improve outcomes in HS management for patients with SoC.</p>