Recent research challenged previous theories about the pathogenesis of hidradenitis suppurativa (HS). Researchers found that apocrine glands may play a more significant role, particularly in follicular obstruction, contrary to earlier theories of apocrine gland inflammation. The study revealed smaller apocrine glands and histological damage in HS skin, altered cell junction genes, and enhanced signaling pathways; thus, indicating potential implications for immune activation and treatment strategies.