Several modifiable lifestyle factors have been identified as pathogenic factors driving HS progression. This chapter discusses the impacts of obesity, tobacco use, mechanical and environmental factors, and diet exclusions and supplementations. We conclude that elevated BMI leads to significant systemic inflammation and can dampen treatment response; the effects of obesity can be ameliorated through diet, exercise, bariatric surgery, and GLP-1RA use. Certain foods, such as dairy and high-glycemic-index items, can trigger flares and contribute to systemic inflammation. Similarly, tobacco use is associated with a substantial inflammatory burden and may contribute to de novo HS risk while impairing treatment response. Moreover, mechanical and environmental factors such as shear forces and humidity can drive HS and lead to refractory treatment; in this chapter, we offer solutions for clothing and sweat management that may ameliorate symptoms. Finally, we underscore the importance of holistic care that takes psychological stressors into consideration when treating patients with HS.