Understanding and raising associated conditions
An overview of the health topics that come up more often in people with HS — keeping routine preventive care clearly apart from symptoms that deserve to be looked at in their own right.
HS involves more than the skin. See what belongs to routine preventive care and which symptoms are worth mentioning.
Living with HS, you can find articles about Crohn’s disease, PCOS, joints or metabolism online quickly enough — but usually only once you already know what to look for. This page turns that around.
It answers one question: which parts of my general health are worth a thought when I have HS, and which of them are already part of ordinary preventive care in Germany?
No account, nothing stored on a server, and no assessment of your answers.
These are routine adult health topics, whether or not you have HS. They are here because they come up repeatedly in HS recommendations — not because anything about you looks unusual.
High blood pressure and other cardiovascular conditions occur more often in groups of people with HS than in comparison groups. That is a group-level association — it says nothing about your own blood pressure.
Blood-pressure measurement is part of the general adult health check-up in Germany anyway, and can be done at almost any GP appointment.
Diabetes is one of the conditions consistently named in comorbidity-assessment recommendations for HS.
Whether laboratory testing is appropriate depends on age and individual risk profile and is a clinical decision — not something that follows from having HS.
Cholesterol and other blood lipids are part of the general cardiovascular assessment that HS recommendations ask clinicians to consider.
In the German health check-up, blood lipids are included from age 35; in younger adults they may be tested where the risk profile makes it appropriate.
In Germany, much of the metabolic and cardiovascular side of this picture is already part of general preventive care.
Official information on the Gesundheits-Check-up · gesund.bund.de (German Federal Ministry of Health)
HS is increasingly understood as a systemic inflammatory condition. In studies of large patient groups, certain metabolic, gastrointestinal, joint and mental-health conditions occur more often than in comparison groups without HS.
These associations are described at group level. They do not mean that an individual with HS has or will develop any of these conditions, and they do not establish a one-way chain of cause and effect.
How often they occur also differs substantially between regions and study populations. That is why you will find no percentages on this page: a figure from a North American clinic cohort says little about your situation in Germany.
The first question is: is my routine preventive care up to date? Blood pressure, blood sugar and blood lipids are routine adult health topics anyway, and in Germany they are part of the general health check-up.
The second question is: do I have symptoms that deserve to be looked at in their own right? This is not about investigating on suspicion — it is about not filing a symptom under HS automatically.
Whether every person with HS should be screened for every associated condition is not settled. A symptom- and risk-based approach — routine prevention plus deliberately raising symptoms — is what this page reflects.
Metabolic and cardiovascular conditions are among the best-studied companions of HS and are consistently named in comorbidity-assessment recommendations.
In practice that usually means nothing exotic: have your blood pressure measured, know when your last check-up was, and mention at the next appointment that you have HS.
Inflammatory bowel disease, especially Crohn’s disease, is one of the best-established connections in HS. In the perianal area the two conditions can also look similar, which makes them harder to tell apart.
Persistent diarrhoea, recurrent abdominal pain, blood in the stool or unintended weight loss have many possible causes. What matters is that they get raised rather than quietly attributed to HS.
Inflammatory joint disease, including spondyloarthritis, occurs more often in HS. Inflammatory back pain characteristically eases with movement rather than with rest, and morning stiffness lasts longer.
Those features are not a test and not a diagnosis. They only help to stop persistent symptoms being written off as ordinary muscular strain from the outset.
PCOS is described alongside HS more often than expected. Both conditions can involve skin changes and both are often recognised late, which is what makes the connection practically relevant.
HS on its own is not a reason for hormone testing, though. If changes to your cycle or increased hair growth concern you, that is the reason to raise it — and the clinician decides what is appropriate.
Anaemia occurs more often in people with HS than in comparison groups in pooled research, and persistent fatigue is a common part of living with HS. The two are easy to conflate, but fatigue does not diagnose anaemia, and anaemia is not automatically iron deficiency.
If tiredness feels disproportionate to your usual HS burden, or comes with symptoms such as breathlessness, palpitations or dizziness, that is worth raising in its own right rather than filing it under HS.
Pain, itch and draining wounds can also disrupt sleep, which can add to the exhaustion without being the same thing as anaemia. Both deserve their own explanation rather than a shared one.
Anaemia and iron deficiency with HSSleep and fatigue with Acne Inversa
The psychological burden of HS is well documented and explicitly included in comorbidity-assessment recommendations. Pain, drainage, odour and the location of affected areas all affect everyday life, work and relationships.
This page deliberately runs no questionnaire and produces no score. It simply records that this belongs in the same appointment as everything else.
Tell your dermatologist if you also have recurrent pilonidal disease, severe acne-like disease elsewhere on the body, or unusual inflammatory ulcers. These associations are recognised and can matter for how your condition is understood.
You will deliberately not find a full list of rare syndromes here. For the great majority of readers it would create more worry than value — and it belongs in a dermatological assessment anyway.
A large part of what this page covers is not a special service at all — it is part of the general preventive care available to people with statutory health insurance in Germany anyway.
The check-up does not replace dermatological treatment of HS and is not an HS screening. It is the place where blood pressure, metabolism and risk profile get discussed regularly.
It cannot establish whether you have an associated condition, and it calculates no personal risk. It does not replace a medical examination and recommends no particular laboratory test.
What it can do: show you which topics exist at all, and help you raise two or three of them at your next appointment.
Each of the symptoms below has many possible causes. None of them means a particular condition is present — they are simply worth the sentence “I have noticed this too.”
Inflammatory bowel disease, particularly Crohn’s disease, occurs more often in people with HS than in comparison groups. Symptoms are still frequently put down to HS or “stress” instead of being raised in their own right.
HS is associated with inflammatory bowel disease, particularly Crohn’s disease. These symptoms have many possible causes and do not mean you have Crohn’s disease — but they are worth raising rather than attributing everything to HS. Whether any further assessment is appropriate is for your treating clinician to decide.
Inflammatory joint disease, including spondyloarthritis, occurs more frequently in people with HS. Persistent joint or back symptoms are easily dismissed as ordinary aches and stiffness.
Inflammatory joint disease, including spondyloarthritis, occurs more frequently in people with HS. Persistent symptoms therefore deserve to be looked at in their own right rather than assumed to be ordinary wear and tear. This is not an indication that you have such a condition.
Polycystic ovary syndrome (PCOS) is described alongside HS more often than expected. HS is not an indication of PCOS, though, and this section asks nothing about fertility or family planning.
PCOS is described alongside HS more often than expected — but HS on its own neither establishes a PCOS diagnosis nor makes any particular investigation necessary. If menstrual or androgen-related symptoms concern you, raise them; which assessment is appropriate is for the relevant clinician to decide.
The psychological burden of HS is well documented and part of recognised comorbidity-assessment recommendations. This section runs no questionnaire and produces no score — it simply records what you want to raise.
Psychological burden is a recognised part of comorbidity assessment in HS and deserves the same seriousness as physical symptoms. This selection is not an assessment of your mental health and does not mean that a condition needing treatment is present — it only records what you want to talk about. You can raise it in the same appointment as everything else on this sheet.
The discussion sheet records what you want to raise in a couple of minutes — and phrases the questions to go with it.
Open the discussion sheetNo. The associations described here apply to groups, not to individuals. Most people with HS do not have all of these conditions — and many have none of them.
No. There is no evaluation, no score and no “positive” or “negative” result. Your selections only produce a list of the points you want to raise yourself.
This page deliberately names none. Which investigation is appropriate depends on age, history, symptoms and risk profile, and is a clinical decision. That is why the discussion sheet is phrased as questions rather than requests.
Either works. Dermatology looks primarily after the skin; routine prevention and many of the topics here typically run through a GP practice. The sheet is written so that it works in both appointments.
No, HS is not a separate entitlement criterion. The general rules apply: once between 18 and 34, and every three years from age 35. You can, however, explicitly mention at the appointment that you have HS.
Only in your own browser while you use the page — no account, nothing sent to a server of this website, and no link anyone could open. Reloading clears the sheet, and “Delete my answers” removes it immediately.
Last editorially reviewed: · Next review:
Preventive-care details checked:
That certain metabolic, gastrointestinal, joint and mental-health conditions occur more often in HS is described in clinical recommendations and systematic reviews. These are group-level associations, not statements about individuals.
Reported frequencies differ substantially between regions and study populations. That is why we deliberately quote no percentages here and derive no personal risk from them.
Whether screening every person with HS for every associated condition is worthwhile is not settled. These pages therefore keep routine preventive care and symptom-triggered assessment explicitly apart.
The statements about the German health check-up reproduce official federal information and are re-checked more often than the rest of the text.