Background: The reasons or the motivations that compel people to get a tattoo or a body piercing (BP) are plentiful and personal. Patients with chronic cutaneous or systemic conditions may be interested in getting tattooed or pierced. Objective: To determine the frequency of body art practices in hidradenitis suppurativa (HS) and to evaluate the possible impact of HS in the decision-making process. Methods: An anonymous specific paper-based questionnaire was prospectively offered to patients (≥18 years) consecutively managed for HS from September 2016 to March 2017 in a French specialized center. Results: In total, 209 patients participated in the study, of whom 77 (37%) and 50 (24%) had tattoos and BP, respectively. These proportions were higher than those reported in the French population. HS prevented the decision to get a BP or a tattoo in 2 and 5%, respectively (fear of infection or healing difficulties). Fifteen patients (7%) got tattooed to hide a surgical HS scar (n = 5, 2%), to regain control over the pain or their bodies (n = 9, 4%), or to turn others’ eyes away from HS lesions or scars (n = 1, 0.5%). HS severity influenced a proportion of patients who intended to get a new tattoo. Conclusion: HS is associated with a significant increase in body art practices.