Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease closely associated with obesity and metabolic dysfunction, which contribute to increased disease severity, reduced treatment response, and impaired quality of life. Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists, are increasingly used for obesity and metabolic disease, prompting interest in their potential adjunctive role in HS management. To synthesize the available human evidence on the use of incretin-based therapies in patients with HS, focusing on clinical outcomes, weight change, and patient-reported measures. A narrative review of the published literature was conducted using major medical databases. Eligible publications included case reports, case series, and observational studies reporting HS outcomes in patients treated with GLP-1 RAs or dual GIP/GLP-1 receptor agonists. Findings were summarized descriptively and interpreted in the context of metabolic modulation. The current evidence base consists predominantly of case-level reports and a limited number of observational cohorts. Across studies, incretin-based therapies were associated with significant weight loss and concurrent improvements in HS disease activity, flare frequency, pain, and quality of life. Improvements in HS outcomes generally paralleled weight reduction, suggesting that metabolic effects play a primary role. Evidence supporting weight-independent anti-inflammatory effects remains limited and inconclusive. Incretin-based therapies appear to offer potential benefit as metabolic adjuncts in HS, particularly for patients with coexisting obesity or metabolic syndrome. However, available data are observational and hypothesis-generating. Prospective controlled studies are required to clarify mechanisms, identify optimal patient populations, and define the role of incretin-based therapies within comprehensive HS management.
