Hidradenitis suppurativa can cause complications in pregnancy, but treatments may help manage symptoms and improve pregnancy outcomes.

Hidradenitis suppurativa (HS) is an inflammatory skin condition that may increase the risk of certain pregnancy complications.

This article looks at how HS may affect pregnancy, how to treat and manage HS safely during pregnancy, its outlook, and when to contact a doctor.

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According to a 2022 study, having hidradenitis suppurativia may increase the risk for pregnancy complications, including:

HS links to many coexisting conditions, which may negatively impact pregnancy outcomes, including:

Changes in hormones can affect symptoms of HS for some people, and sometimes, people may find symptoms of HS improve during pregnancy.

Some research suggests some people’s HS symptoms may worsen during pregnancy, while others may notice no difference in symptom severity.

There is no known cause for HS, but it may occur due to a combination of genetic, environmental, and behavioral factors.

Risk factors for HS include:

  • having a blood relative with HS
  • having obesity
  • having metabolic syndrome
  • smoking, which may trigger HS
  • being female, which may be due to hormones impacting HS
  • being between puberty and 40 years old
  • being African American, Hispanic, or biracial
  • having psoriasis

The following treatments for HS are suitable for people during pregnancy and breastfeeding:

  • topical antibiotics, including clindamycin, erythromycin, and metronidazole
  • oral clindamycin and rifampin, a combination oral antibiotic
  • dapsone, an oral antibiotic
  • metformin, an oral diabetes medication
  • biologics, including adalimumab and infliximab, are safe during pregnancy and breastfeeding, although a doctor may suggest stopping the medication in the third trimester to avoid passing on antibodies to the fetus
  • acetaminophen, to help manage pain

It is important to talk with a doctor about any treatments for HS before becoming pregnant.

Rifampin may interact with certain medications, so it is important for people to tell a doctor about any other medications they are taking before starting treatment.

People will need to avoid aspirin, ibuprofen, and naproxen during pregnancy, as they can negatively affect a fetus. People can take ibuprofen after birth when breastfeeding, though.

People will also need to avoid prescription pain medications during pregnancy, although tramadol is safe when breastfeeding.

In people with severe cases, surgery may be necessary for HS symptoms. In general, doctors do not advise surgical procedures during pregnancy.

Excisional surgery is safe during pregnancy though, and removes affected skin if symptoms are severe.

Cryoinsufflation is a procedure that uses liquid nitrogen to freeze the tunnels of skin which can form with HS.

The HS Foundation recommends the following tips to help manage HS during pregnancy:

  • avoiding smoking, as this may make HS symptoms worse and can also increase the risk of birth defects
  • eating a healthy diet
  • maintaining a moderate weight, as obesity or being overweight may worsen HS symptoms
  • taking baths with a tiny amount of chlorine bleach, which is similar to the chlorine in swimming pools, to help manage any odor from sores
  • applying wound dressings to HS sores to help prevent stains on clothing or bed linen
  • taking steps to support mental health, such as joining a support group or talking to a counselor

HS can increase the risk of complications during pregnancy compared to people without HS.

Managing HS and any coexisting conditions early on may help reduce the potential risks.

A team of healthcare professionals, including dermatologists and obstetricians, can help people manage HS during pregnancy and closely monitor people to help prevent complications.

If people have HS and are planning to become pregnant, they will need to speak with a doctor to discuss which treatments are safe for them during pregnancy and steps to help reduce any potential risks.

This section answers some frequently asked questions about hidradenitis suppurativa and pregnancy.

Can hidradenitis suppurativa cause miscarriage?

HS may increase the risk of miscarriage. A 2022 study compared 1,862 pregnancies in people with HS to 64,218 pregnancies in people without HS.

The study found there was a 37% increased risk of miscarriage in people with HS compared to those without HS. The risk of miscarriage in people with HS was 15.5%, compared to 11.3% in people without HS.

Can you get pregnant with hidradenitis?

People can get pregnant with HS, but HS may affect factors relating to fertility.

According to a 2021 study, the fertility rate is lower in people with HS compared to people without HS.

The impact of HS may alter how a person feels about becoming pregnant, such as:

  • reducing their quality of life, due to HS symptoms
  • negatively impacting sexual function due to HS
  • lowering self-esteem or body image
  • increasing the risk of mental health issues, including anxiety and depression
  • having coexisting conditions that may negatively affect fertility rates, such as obesity, diabetes, cardiovascular disease, or polycystic ovary syndrome

Research has found that eating a healthy diet, particularly a Mediterranean diet, and getting regular exercise, may help improve fertility rates in people with HS.

Medications, such as TNF blockers, may also help treat infertility in people with HS.

How can I control my HS while pregnant?

People can use certain treatments to manage HS, which are safe to use during pregnancy. These include:

  • certain topical and oral antibiotics
  • acetaminophen, for pain relief
  • lifestyle changes, such as avoiding smoking
  • chlorine bleach baths and wound dressings for sores

Hidradenitis suppurativa (HS) is an inflammatory skin condition that may increase the risk of pregnancy complications.

Certain treatments for HS are safe to use during pregnancy and may help control symptoms.

People can speak with a doctor about the best treatment plan for HS to ensure a safe pregnancy and to effectively manage the condition.