During my own three pregnancies, I learned how even the smallest skin irritations can add up. Pregnancy had a way of making me aware of every sensation in my body. Most of the skin problems I had during pregnancy were minor irritations, like dry skin and acne, and they eventually went away. This was not the case with my hidradenitis suppurativa (HS). HS didn’t take a break just because I was pregnant. So what happens when the discomfort is something more chronic, something that doesn’t come and go with a specific week or quarter, but comes up again and again, like HS?
What is hidradenitis suppurativa (HS)?
HS is a long-term skin condition that causes recurring painful bumps, areas of drainage (abscesses), or pits and tunnels under the skin. These areas tend to appear where the skin folds and rubs together, such as the armpits, groin, inner thighs, under the breasts or along the buttocks. Over time, HS can also cause rope-like scars to develop, which can limit movement in certain areas. For example, scars in the armpits can make it difficult to fully lift the arms. HS can also cause pain, which can make daily activities, work, and intimate relationships difficult for people with HS.
Symptoms of HS can include ingrown hairs, infections, or cysts, so a diagnosis by a health care provider familiar with HS, such as a dermatologist, is important. HS is considered an inflammatory condition because the same spots can become inflamed again and again, often described as “flares”. HS is not caused by infection, poor hygiene, diet, or anything you did or didn’t do. HS is not contagious (it does not spread from person to person). Instead, HS is “multifactorial,” meaning it’s affected by many things at once, including the immune system, genetics, hormones, and more.
How do pregnancy and HS interact?
Everyone’s experience with HS in pregnancy is different. Some people notice that their symptoms improve during pregnancy, others notice little change, and some find that their symptoms worsen and flare-ups increase. Experiences may also be different between pregnancies. For two of my pregnancies, my symptoms stayed the same, but in my third, my breakouts increased and I was in a lot more pain.
Can HS affect pregnancy outcomes?
Pregnancy hormones, increased body heat, and sweating can sometimes make areas with HS feel more inflamed or tender. And as your body grows and shifts during pregnancy, areas that didn’t rub before may suddenly start rubbing now. Occasionally, an area of skin may become more irritated or show signs of infection. Because HS can get better or worse during pregnancy, it’s helpful to contact your healthcare provider whenever you notice new symptoms or changes in the way HS feels in your body.
Pregnancy complications such as miscarriage are common and can occur in any pregnancy for many different reasons. Birth defects can also occur in any pregnancy for different reasons. Of all babies born each year, about 3 in 100 (3%) will have a birth defect.
Many people with HS do not have complications during pregnancy. At the same time, recent research has suggested that HS may increase the chance for some pregnancy-related problems, not because HS directly causes them, but because the underlying inflammation in HS may play a role.
Several studies looking at more than 5,000 pregnant women with HS found that pregnant women with HS were more likely to miscarry and develop high blood pressure and/or diabetes during pregnancy compared to pregnant women without HS. And when looking at babies, these studies found that babies born to mothers with HS were slightly more likely to be born preterm (births before week 37). One study did show a slightly higher chance of birth defects, which was not seen in other studies. Learning this for the first time can feel scary, and I remember feeling that way too. However, while you have HS May increase the chance for certain problems related to pregnancy, this does not mean that if you have HS something will happen. We are still learning a lot about HS and pregnancy.
What do we know about HS drugs in pregnancy?
Some people may not need any treatment during pregnancy or may be able to stop certain medications. Others may need ongoing treatment to manage and treat HS symptoms. For some people, the potential benefits of treatment may outweigh the risks of using medication. In addition to reducing inflammation, treating HS in pregnancy can help improve comfort for some people and may reduce pain or reduce the chance of infections.
Thinking about treatments during pregnancy can be confusing, especially when your symptoms change. For me, because I didn’t have breakouts in my first two pregnancies and didn’t need treatment, I was very nervous when my breakouts increased during my third pregnancy. Yes, I was in pain and uncomfortable every time I walked, but that wasn’t what worried me the most. I was worried about the stress HS was putting on my body and how the constant inflammation might affect my baby. It was the first time pregnancy made me feel uncertain about what my body might do next. I had to make decisions about the best course of treatment, and this felt overwhelming at first. The good news is that I didn’t have to make these decisions alone. With the help of my healthcare providers and the resources available at MotherToBaby, we talked about what was known about my treatment options and what made the most sense for my HS and made me more confident about my pregnancy.
Some of the treatment options we have discussed are included topical antibioticssuch as clindamycin and antiseptic washessuch as chlorhexidine or diluted bleach baths. Based on the available data, the use of antibiotic skin washes is not known to increase the risks for a pregnancy because most of the medicine is not well absorbed into the bloodstream, where it could reach the baby. Small amounts of corticosteroids it can be injected directly into inflamed bumps to soothe painful flare-ups. When a corticosteroid is injected into the skin, it mostly stays in that area and very little of the drug enters the bloodstream.
Antibiotics taken by mouth (oral antibiotics) are sometimes used to help manage HS symptoms or treat suspected infections. The antibiotics most commonly used to manage HS symptoms, cephalexin (Keflex) and clindamycin, are not expected to increase the chance of pregnancy complications or birth defects when used as directed. Some other antibiotics, however, have been associated with certain pregnancy-related complications.
People with HS may also use medications called biologicallythat target HS-induced inflammation. These may include drugs such as adalimumab (Humira), secukinumab (Cosentyx), and bimekizumab (Bimzelx). Some biologics, such as adalimumab, have been used to treat other inflammatory or autoimmune conditions in pregnancy and have been very reassuring. For newer biologics like secukinumab and bimekizumab, we don’t have as much information yet. Because antibiotic or biologic options can vary depending on your HS symptoms, you can always contact MotherToBaby to talk about what is known about a particular drug.
Other things that can also make a big difference for some pregnant women, especially as your body changes, include wearing loose, breathable clothing, minimizing friction in skin folds, using gentle, non-abrasive body soaps, changing out of wet or sweaty clothing as soon as possible, and trimming (not shaving) areas that are more susceptible to HS. Some health care providers may also recommend taking an additional zinc supplement.
Even if you take medication and follow all of these steps, you may experience HS flares in pregnancy. This is not your fault. HS is a long-term condition and pregnancy can add new layers to how it feels every day. But you don’t have to navigate it alone. I didn’t either. Understanding how HS and pregnancy interact, along with trusted resources like MotherToBaby, can give you comfort and confidence throughout your pregnancy. Your experience matters, as does feeling supported during it.
What can you do to help us understand more about HS and pregnancy?
We continue to learn about the relationship between HS and pregnancy to better support pregnant women and their babies. If you are pregnant and living with HS, your experience matters. MotherToBaby is currently enrolling participants in a study on HS in pregnancy and your story could help us learn more. Joining is simple, completely confidential and can be done from home. You can learn more at:
ES Resources:
References:
- Chen YN, Shen CH, Tai CC, Wang TY, Chi CC. Adverse pregnancy outcomes among pregnant women with hidradenitis suppurativa: a systematic review and meta-analysis. Clin Exp Dermatol. 2026 Mar 26; 51(4): 578-586. doi: 10.1093/ced/llaf515. PMID: 41268934.
- Ghanshani R, Lee K, Crew AB, Shi VY, Hsiao JL. A guide to the management of hidradenitis suppurativa in pregnancy and lactation. Am J Clin Dermatol. 2025 May; 26(3):345-360. doi: 10.1007/s40257-025-00935-x. PMID: 40131719;
- Rivin GM, Fleischer AB Jr. Women of Childbearing Age with Hidradenitis Suppurativa Commonly Prescribed Medications at Risk of Pregnancy. J Drugs Dermatol. 2023 July 1; 22 (7): 706-709. doi: 10.36849/JDD.6818. PMID: 37410037.
Author Disclaimer: AI tools were used for proofreading, grammar improvement and title development
