Hidradenitis suppurativa (HS) is characterized by painful nodules, abscesses, draining sinuses, and hypertrophic scars, localized in the areas with numerous apocrine glands. HS is one of the most severe, debilitating inflammatory dermatoses, with a prevalence of 0.05% to 4.1%. HS is characterized by painful nodules, abscesses, draining sinuses, and hypertrophic scars, localized in the areas with numerous apocrine glands. Treatment of HS is dependent on the severity of the disease. Despite efforts in medical treatment, radical surgery remains a cornerstone in the management of severe HS/AI with complete remissions. The main mechanism of action in HS seems to be that isotretinoin may prevent an affected pilosebaceous unit from being occluded by ductal hyperkeratosis. Alitretinoin has been used in an open trial with 14 women who persistently failed traditional medical treatments for HS. Oral retinoids have some value in milder cases of HS with a better response to acitretin and alitretinoin compared to etretinate or isotretinoin.