Two people having a supportive conversation in a quiet living room.

Reproductive health hub

HS, Pregnancy & Family Planning

Evidence-based information for people living with hidradenitis suppurativa before pregnancy, during pregnancy and after birth.

Why this hub exists

HS disproportionately affects people of reproductive age, yet reproductive health is one of the least discussed topics in HS care. In a survey study of people with HS published in JAMA Dermatology:

  • 83% had received no counselling about how HS may affect a pregnancy
  • 80% had received no information about heritability
  • 71% had received no counselling about HS medicines and pregnancy

Adelekun et al., JAMA Dermatology 2021. The figures describe one survey population, not care everywhere — but they match what people with HS consistently report, and they are the reason these pages were written.

What is known, what is not, and what is yours to ask

Reproductive questions in HS fall into three very different groups. Telling them apart is the most useful thing this hub can offer, because it shows which answers you can expect from research and which can only come from your own care team.

What is reasonably established

Points supported by several studies or by guideline consensus.

  • Hidradenitis suppurativa does not, in itself, rule out pregnancy.
  • The course during pregnancy varies widely: some people report improvement, some report worsening, and many report no clear change.
  • Flares after birth are common and are consistently reported across several studies.
  • Clustering in families is well described: roughly 30 to 40 per cent of people with HS report at least one other affected family member.
  • Many people with HS receive little or no counselling about conception, pregnancy and breastfeeding — this is well documented in surveys.

Where the evidence is limited

Questions research currently cannot answer reliably.

  • Whether HS will improve or worsen during pregnancy cannot be predicted for an individual.
  • Whether HS itself affects fertility is barely studied; robust evidence is largely missing.
  • How the condition behaves specifically during breastfeeding has been captured in very few studies.
  • How much co-occurring conditions contribute to pregnancy outcomes cannot be cleanly separated in the available data.
  • Whether any particular approach before conception changes the later course has not been tested in controlled trials.

What only personalised advice can answer

Questions that belong in your consultation — not on a website.

  • Whether a particular treatment is continued, adjusted or paused in your situation.
  • What your treatment plan should look like before a planned pregnancy.
  • Whether and when surgery makes sense in relation to a planned pregnancy.
  • How birth is planned when the groin or genital area is involved.
  • How your symptoms can be managed while you are breastfeeding.

Five steps through the hub

Each page stands on its own, and each ends in questions you can take to an appointment. Reading them in order follows the life stage from planning to after birth.

  1. Step 1 Can HS Affect Fertility? What is known about fertility and heritability, which common assumptions do not hold, and how to raise the topic. Limited evidence Read this page →
  2. Step 2 Planning a Pregnancy with HS The pre-conception appointment, the treatment plan, smoking, co-occurring conditions, and coordination between specialties. Limited evidence Read this page →
  3. Step 3 Living with HS During Pregnancy What studies show about the disease course, what changes physically, how to make appointments work, and what often follows birth. Moderate evidence Read this page →
  4. Step 4 Breastfeeding and HS Practical barriers, breast and underarm involvement, positioning, and what to discuss before the birth. Limited evidence Read this page →
  5. Step 5 Questions to Ask Before Pregnancy A printable checklist gathering every question from this hub into one page for your appointment. Read this page →

Frequently asked questions

Does HS cause infertility?

There is no evidence for that. HS is an inflammatory condition of the skin and hair-follicle units and does not involve the internal reproductive organs. The question has, however, barely been studied, so there are no robust figures on fertility in HS.

Do I have to stop my treatment if I want to become pregnant?

This website cannot and must not answer that. There is no blanket answer — the judgement depends on the treatment, your disease course and your situation, and it belongs to the people who prescribed it. Only one thing is general: do not make that decision on your own.

Does HS improve during pregnancy?

For some people yes, for others no. In a meta-analysis about a quarter reported improvement and about a fifth reported worsening; the majority had an unchanged or worse course. Prediction for an individual is not possible.

Can I breastfeed with HS?

Many people with HS breastfeed. Whether it works well in your case depends among other things on whether the breast or underarm is involved and on your treatment — both belong in a conversation before the birth.

Scientific research and editorial review

Last editorially reviewed: · Next scheduled review:

Reproductive health in HS is an area where patient need clearly outruns the evidence. The disease course during pregnancy has been described in cohort studies and pooled in a meta-analysis; fertility and breastfeeding have barely been studied at all. Every page in this hub therefore carries an evidence grade, and sections state explicitly where the evidence stops.

Population-level findings about pregnancy outcomes are reported here as associations that overlap with co-occurring conditions — they are presented as a reason for coordinated care, never as a prediction about any individual pregnancy.

No page in this hub names an individual medicine or states whether a treatment is suitable during pregnancy or breastfeeding. Those questions are routed back to the clinicians who prescribe your care, because they are the only people who can weigh them for your situation.

This hub is source-linked and reviewed at least once a year. If a cited guideline, review or study changes, these pages are updated.

How we work: Editorial Policy

My HS Home Your appointment questions, saved tools and more in one place — no account needed. Prepare for an HS Treatment Conversation Build a question list for your next dermatology appointment. My HS Care Team Who may be involved beyond dermatology, and how to get the specialties talking to each other. Birth Control and HS Not planning pregnancy yet? How contraceptive method, HS symptoms and HS medications can intersect — and why contraceptive safety comes first. HS and Your Menstrual Cycle A different question from pregnancy: what the research says about period-related flares, and how to tell a repeatable pattern from a coincidence. HS, Perimenopause and Menopause A later hormonal life stage than this hub covers: what patient survey data actually show about HS after periods stop, and why improvement should not be assumed. Living With Acne Inversa The wider daily-life hub: routines, work, relationships and long-term coping. HS Wound Care & Dressing Guide Drainage, dressing changes and protecting clothing — organised by situation. HS Clothing & Friction Guide Why friction differs by body area — useful when your body is changing. Symptom Tracker Log flares, pain and patterns over time and take the summary to an appointment. Treatment Options for Acne Inversa How HS is treated, and how self-management sits alongside medical care.

Sources

  1. Adelekun AA, Villa NM, Hsiao JL, Micheletti RG. Pregnancy in Hidradenitis Suppurativa — Patient Perspectives and Practice Gaps JAMA Dermatology, 2021;157(2):227–230 — survey of counselling gaps on conception, heritability, medicines and sexual health
  2. Seivright JR et al. Impact of Pregnancy on Hidradenitis Suppurativa Disease Course: A Systematic Review and Meta-Analysis Dermatology, 2022;238(2):260–266 — pooled rates of improvement, worsening and postpartum flares
  3. Lyons AB et al. Evaluation of Hidradenitis Suppurativa Disease Course During Pregnancy and Postpartum JAMA Dermatology, 2020;156(6):681–685 — cohort study; frequent postpartum worsening alongside little dermatology care
  4. Fitzpatrick L, Hsiao J, Tannenbaum R, Strunk A, Garg A. Adverse pregnancy and maternal outcomes in women with hidradenitis suppurativa Journal of the American Academy of Dermatology, 2022;86(1):46–54 — population-level analysis; associations overlap with co-occurring conditions
  5. Barnes LA, Rinderknecht FB, Hsiao JL, Naik HB. Global barriers to sexual health, pregnancy, and breastfeeding in hidradenitis suppurativa International Journal of Women's Dermatology, 2026 — international survey of barriers to sexual health, pregnancy and breastfeeding care
  6. Özbek Ç et al. Hidradenitis Suppurativa Treatment During Pregnancy and Lactation: Navigating Challenges International Journal of Dermatology, 2025 — review of care during pregnancy and lactation
  7. Collier EK et al. Pregnancy and breastfeeding in hidradenitis suppurativa: A review of medication safety Dermatologic Therapy, 2021;34(2):e14674 — a review written for clinicians; a basis for medical judgement, not for self-directed decisions
  8. MedlinePlus Genetics (U.S. National Library of Medicine): Hidradenitis suppurativa Patient information on genetics; roughly 30 to 40 per cent of affected people have at least one other affected family member
  9. European S2k guideline for hidradenitis suppurativa / acne inversa, part 2: treatment Journal of the European Academy of Dermatology and Venereology, 2025 — framing of treatment and self-management