There is more data on how HS behaves during pregnancy than on any other topic in this hub — and still no answer for the individual case. That is not an evasion; it is the honest state of the evidence.
This article describes what is known from studies, what changes in daily life, and how care can be organised so that HS does not fall through the cracks during a pregnancy.
In short
- Improvement, worsening and an unchanged course all occur — prediction is not possible.
- Flares after birth are common and consistently reported across several studies.
- Many people receive no dermatology care while pregnant; that can be actively changed.
- If the groin or genital area is involved, that belongs in birth planning early.
How much the course varies
Moderate evidence Backed by consistent observational studies or smaller trials.
A systematic review with meta-analysis pooled data from several studies. The result: about a quarter of people reported improvement during pregnancy and about a fifth reported worsening — meaning the majority had an unchanged or worse course.
These figures describe groups. They say nothing about what will happen to a particular person, and they should be read neither as reassurance nor as a warning. Older ideas that HS "usually" improves in pregnancy do not hold up against the data.
What changes physically
Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.
Regardless of how inflammatory activity develops, pregnancy changes the mechanical conditions at exactly the sites where HS occurs:
- Skin folds change: abdomen, groin and the area under the breasts rest against each other differently than before.
- Sweating increases for many people, and moist skin is mechanically more fragile.
- Clothing that used to fit now presses or rubs in new places.
- Dressings sit differently and shift more easily as body shape changes.
- Movement patterns and sitting postures change, which moves pressure points around.
Self-management in daily life
Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.
Practical skin care, wound care and clothing are no different in pregnancy than at other times — they are simply more pressing, because the conditions change. Detailed, product-neutral guides are available on this site.
Two points are pregnancy-specific and worth raising: first, ask before applying or taking anything, including products available without a prescription. Second, capacity changes during pregnancy; what works in daily life and what does not will shift.
Preparing appointments and securing care
Moderate evidence Backed by consistent observational studies or smaller trials.
A large cohort study found that most people received no HS-directed treatment and no dermatology care during pregnancy — even though worsening was common. The authors explicitly call for closer collaboration between dermatology and obstetrics.
For you this means: assume you will have to put the topic on the agenda yourself — in antenatal care as much as in the skin clinic. Many obstetric teams have never seen HS; a short, factual explanation from you helps more than expecting it to be familiar.
- Say early in antenatal care that you have HS, and where you are affected.
- Ask who your contact is during a flare and how you can get an appointment at short notice.
- Ask for findings to be shared between the clinics involved.
- If the groin or genital area is involved: raise it early in birth planning. How a birth is planned is decided solely by your obstetric team, with you.
- Bring a short written note to appointments instead of relying on remembering in the moment.
Mental wellbeing
Moderate evidence Backed by consistent observational studies or smaller trials.
HS is associated with depression and anxiety, and pregnancy is a period of heightened vulnerability independently of that. Pain, exhaustion, a changing body image and the fear of not coping all meet here.
This is not a side issue and not a sign of weakness. Antenatal care has established routes to psychosocial support; you are allowed to ask for them, even when nobody offers.
The period after birth
Moderate evidence Backed by consistent observational studies or smaller trials.
The period after birth is the best-documented risk window in this article. In the cohort study, HS worsened after delivery in around two thirds of pregnancies; the meta-analysis reports a postpartum flare in over half of those studied.
This is exactly the phase in which there is least time for your own health. That is why it is worth clarifying before the birth who is responsible afterwards, and how an appointment happens when something becomes acute.
Questions to discuss with your healthcare team
These are prompts, not advice. Take the ones that fit your situation to your next appointment — the printable checklist collects them all.
- Who looks after my HS during the pregnancy?
- How do I get an appointment at short notice during a flare?
- What can I use for wound care and skin care while pregnant?
- What should my obstetric team know about my HS?
- Is my groin or genital area involved enough to matter for birth planning?
- What should I watch for in the weeks after birth?
- Where can I get psychosocial support if this is weighing on me?
Frequently asked questions
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.
Is a flare after birth normal?
Commonly, yes. Several studies consistently report worsening in the postpartum period — in one cohort study, in around two thirds of pregnancies. That is a good reason to arrange care for this period in advance.
Does HS affect how my baby is delivered?
If the groin or genital area is involved, that can matter for birth planning. How the plan is made is decided solely by your obstetric team together with you — which is why it is worth raising early rather than shortly before the birth.
Does my HS harm my baby?
HS is not contagious and affects the skin, not the unborn child directly. Population-level studies report certain pregnancy complications more often in HS, and these overlap heavily with co-occurring conditions; nothing about an individual case follows from them. What applies in your situation is for your care team to interpret.