Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Despite significant research efforts to discover new therapeutic molecules in recent years, antibiotics and conventional systemic therapies continue to be the indispensable first-line treatments for HS. In this study, we discussed well-known topical and systemic antibiotics and widely used systemic treatments (hormone-modulating therapies, retinoids, and immunosuppressants), and their combinations. Overall, since targeted biologics are not accessible to all patients with HS due to cost, availability, or contraindications, these therapies remain important for treating mild-to-moderate HS and serve as adjunct or bridge treatments in severe cases.