HS mostly affects people of reproductive age, and it involves parts of the body closely tied to sexuality and self-image. Even so, the subject of having children rarely comes up — in one survey, more than four in five participants said they had never been counselled about it.
This article does not answer individual medical questions. It exists so you can walk into a conversation with your care team prepared, and with realistic expectations of what the research currently supports.
In short
- There is no evidence that HS makes pregnancy impossible as such.
- Whether HS itself affects fertility has barely been studied.
- Clustering in families is well described — a simple inheritance pattern it is not.
- Pain and genital-area symptoms can make conceiving harder in practice, even when nothing biological stands in the way.
What the evidence currently says
Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.
There is no robust evidence that hidradenitis suppurativa causes infertility as such. People with HS conceive, carry pregnancies and have children — this is documented in cohort studies of pregnancy course, studies that were only possible because there were enough pregnancies to examine.
At the same time, the honest answer to "does HS affect fertility?" is currently: this is barely studied. There are no large studies that specifically measured time to pregnancy, or rates of involuntary childlessness, in people with HS compared with the general population. Absent evidence is not the same as evidence of absence — it means the question is open.
Common misconceptions
Moderate evidence Backed by consistent observational studies or smaller trials.
Part of the uncertainty around HS and family planning rests on assumptions that can be corrected clearly:
- HS is not a sexually transmitted infection and is not passed on through sex — not even when the groin or genital area is involved.
- HS is not contagious. Neither a partner nor a child can catch it.
- Affected skin in the groin does not mean the internal reproductive organs are affected. HS is a condition of the skin and of hair-follicle units.
- Scarring in the groin is not the same as impaired fertility; it can, however, cause symptoms that deserve attention in their own right.
- A diagnosis of HS is not a medical reason to advise against pregnancy.
Heritability: what families want to know
Moderate evidence Backed by consistent observational studies or smaller trials.
"Will my child get this too?" is among the most common questions — and among the least often answered. In the survey mentioned above, four in five participants had never received information about heritability.
What is known: HS clusters in families. Roughly 30 to 40 per cent of people with HS report at least one other affected family member, and twin studies point to a substantial genetic contribution. In only a small minority, however, can a single causative gene change be identified.
In practice: a familial predisposition is real, but it is not a prediction. A diagnosis of HS does not translate into a specific probability for an individual child, and HS arises from an interplay of predisposition and other factors.
Sexual health as part of the picture
Moderate evidence Backed by consistent observational studies or smaller trials.
Between "nothing biological stands in the way" and "this is easy in practice" there is often a wide gap. Pain, open lesions, drainage, worry about odour and fatigue all affect sexuality; international surveys describe exactly this, along with its links to anxiety and depressive symptoms.
For people trying to conceive, this means some couples face a practical barrier rather than a biological one. That barrier can be addressed and is a legitimate part of a consultation, not a side issue.
If you are preparing for a pregnancy
Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.
The most important practical point is timing: a conversation about wanting children is most useful before conception — not at the positive test. That gives your care team room to discuss the treatment plan calmly instead of reacting under time pressure.
What that preparation can look like is described in detail in the next article of this hub.
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.
- Is there anything in my case that argues against a pregnancy?
- What is known about fertility in HS — and what is still open?
- Given my family history, how likely is it that a child would also develop HS?
- Who can I turn to if genital-area symptoms are making sex difficult?
- Should anything in my treatment plan be discussed before I try to conceive — and when would be the right time?
- Who coordinates dermatology and obstetric care when the time comes?
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.
Can I pass HS on to my child?
Clustering in families is well described: roughly 30 to 40 per cent of people with HS have at least one other affected family member. There is no simple inheritance pattern, though, and a diagnosis does not translate into a specific probability for an individual child. Interpreting your own family history is a conversation for your clinicians.
Should I wait for my HS to improve before becoming pregnant?
That is an individual decision that depends on your disease course, your current treatment and your life circumstances — and it belongs in your consultation. This website cannot and must not answer it for you.
Is HS sexually transmitted?
No. HS is neither a sexually transmitted infection nor contagious, including when the groin or genital area is involved.