Planning a Pregnancy with HS

The pre-conception appointment

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

Review articles on HS in pregnancy consistently recommend a conversation before conception. The reason is practical: some questions — about the treatment plan, or about planned procedures — can be answered differently with lead time than they can on the spot.

Say what the appointment is about when you book it. An appointment flagged as a pre-conception conversation usually gets more time than a routine review.

• Bring a list of every treatment you currently use — including anything you buy without a prescription.
• Note how your disease course has been over recent months and where symptoms are active now.
• Record whether any procedures are planned or have been discussed, and when.
• Clarify who your contact is if symptoms appear during a pregnancy.
• Ask whether dermatology and obstetric care should be in direct contact — and who initiates that.

Putting the treatment plan on the table

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

Reviewing the treatment plan before a planned pregnancy is standard in the specialist literature. What comes out of that review is individual: it may mean everything stays as it is, or that something changes. This website deliberately names no individual medicines and makes no statements about them.

One point, though, is general and important enough to state plainly: do not change, pause or end a prescribed treatment on your own — not after a positive test, and not on the basis of information found online. Doing so has consequences of its own, and the judgement belongs to the people who prescribed your treatment.

Smoking

Strong evidence Well supported by international guidelines and high-quality studies.

Smoking is the factor with the strongest evidence base in this article — and the one on which dermatology and obstetrics agree without reservation. In HS, smoking is associated with a more severe course, and the risks of smoking in pregnancy are well established independently of that.

Stopping is also hard, and blame does not help anyone do it. The more useful question is what concrete support is available: structured programmes, counselling and medical support work better than resolve alone. How a quit attempt is supported during pregnancy is something to discuss with your care team.

Taking co-occurring conditions into account

Moderate evidence Backed by consistent observational studies or smaller trials.

HS occurs more often alongside other conditions — among them metabolic and cardiovascular conditions, polycystic ovary syndrome, and depression and anxiety. That matters for pregnancy planning, because some of these need preparation and follow-up of their own.

Population-level studies report certain pregnancy and maternal complications more often in women with HS than in women without it. These associations overlap heavily with co-occurring conditions and cannot be cleanly separated from them in the available data. For you personally such figures predict nothing — they are an argument for well-coordinated care, not a reason for alarm.

Weight, daily life and self-management

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

Weight comes up frequently in connection with HS — often in ways people experience as shaming. Factually: higher body weight is associated with a more severe HS course, and weight plays a role in pregnancy care in any case. Whether and how it should be a topic in your case is for your care team to decide with you — not for a website or a guide.

Practical everyday matters, by contrast, can be prepared regardless: friction in skin folds, wound care and clothing all change during pregnancy because the body changes. Those topics have dedicated guides on this site.

Planned procedures and timing

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

If surgery has been discussed or is scheduled, timing belongs in the same conversation. Wound healing takes time, and appointments, aftercare and capacity are easier to plan with notice.

Whether a procedure makes sense before a planned pregnancy is purely an individual medical decision. What you can do is raise the question early.

Who talks to whom?

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

In practice, much fails not for want of knowledge but for want of coordination. Dermatology, obstetrics, general practice and midwifery each see one part of the picture. Studies of disease course during pregnancy note explicitly that many people receive no dermatology care at all while pregnant.

You do not have to organise that coordination yourself — but you can start it by asking, in every consultation, who is being told.