Skip to main content
This site provides educational information only, not medical advice. Always consult a qualified healthcare provider.
Cornerstone Guide~20 min read

Relationships, Intimacy, and HS

HS affects your relationships in profound ways, your body image, your dating life, your intimate partnerships, and your sense of self. This guide addresses all of it with honesty and compassion.

A note before we begin

This guide addresses topics that are deeply personal and often painful. We approach them with the respect and sensitivity they deserve. You deserve love, intimacy, and connection. HS does not change that. Whatever your current situation, you are not alone, and there is a path forward.

Body Image and Self-Worth

HS attacks the body in places that are deeply associated with intimacy, the armpits, groin, buttocks, and breasts. The wounds, the scarring, the drainage , these can make it feel impossible to feel comfortable in your own skin, let alone share your body with another person.

Research consistently shows that HS has a more severe impact on body image than many other chronic skin conditions. This is not vanity, it is a rational response to a condition that visibly and painfully affects your body in intimate areas.

But here is what is also true: your worth is not determined by your skin. You are not your wounds. You are not your scars. You are a whole person whose body is fighting a difficult battle every day, and that deserves respect, not shame.

Cognitive Behavioral Therapy (CBT)

CBT has strong evidence for improving body image in chronic illness. It helps identify and challenge negative thought patterns about your body.

Acceptance and Commitment Therapy (ACT)

ACT focuses on accepting difficult feelings without letting them control your behavior. Particularly effective for chronic illness-related distress.

Peer Support

Connecting with others who have HS and are living full lives, including romantic and sexual lives , can be profoundly normalizing.

Somatic Practices

Yoga, mindful movement, and body-positive practices can help rebuild a sense of connection with and appreciation for your body.

Dating With HS

Dating with HS is challenging, but it is absolutely possible. Many people with HS are in loving, fulfilling relationships. The key is finding partners who are capable of empathy and who see you as a whole person.

Online Dating

  • •You do not need to disclose HS in your profile
  • •Get to know someone before deciding whether to share
  • •HS communities sometimes facilitate connections between patients who understand each other
  • •Your profile should reflect who you are. HS is one part of that, not the defining feature

First Dates

  • •Choose comfortable, loose-fitting clothing
  • •Have a plan for managing pain if a flare is active
  • •You do not need to disclose on a first date
  • •Focus on connection, let the person see who you are beyond your condition

Disclosure Decisions

Deciding when and how to tell a partner about your HS is deeply personal. There is no single right answer, but there are principles that can guide you.

Early in dating (before physical intimacy)

Advantages

Allows you to assess compatibility early; reduces anxiety about 'the reveal'; builds trust

Considerations

May feel premature; some people may not be ready to hear it

When physical intimacy is approaching

Advantages

Natural timing; gives context for your body; allows partner to prepare

Considerations

May feel rushed; high-stakes moment

After establishing emotional connection

Advantages

Partner knows you as a person first; more likely to respond with empathy

Considerations

May feel like you 'hid' something; can create anxiety in the meantime

A disclosure script that works

"I want to share something with you. I have a chronic skin condition called hidradenitis suppurativa. It causes painful lumps in certain areas of my body, my armpits, groin, and sometimes other places. It's not contagious, it's not caused by anything I did wrong, and it doesn't define who I am. But it does affect my life, and I wanted you to know."

HS in Existing Relationships

For those already in relationships when HS develops or worsens, the challenges are different. Your partner is watching you go through something painful and difficult. They may feel helpless, scared, or unsure how to support you.

For the HS Patient

  • •Communicate your needs clearly, partners cannot read minds
  • •Tell them specifically what helps and what doesn't
  • •Let them know when you need space vs. when you need support
  • •Share reliable information about HS so they understand what you're going through
  • •Be honest about the emotional impact, not just the physical

For Partners

  • •Educate yourself about HS, this guide is a good start
  • •Ask how you can help rather than assuming
  • •Attend medical appointments if invited
  • •Acknowledge the emotional toll , it's real
  • •Take care of your own mental health too , caregiver support matters

Intimacy and Sexual Health

Physical intimacy with HS requires communication, flexibility, and self-compassion. It is possible, and for many patients, it is a deeply important part of life and wellbeing.

Timing

Intimacy is generally more comfortable between flares. Many patients track their flare cycles and plan accordingly. This does not mean intimacy is impossible during a flare, it means communication and adaptation are especially important.

Positioning and Adaptation

Positions that avoid direct pressure on affected areas are more comfortable. Communication with your partner about what feels good and what doesn't is essential. Intimacy can take many forms, penetrative sex is not the only option.

Pain Management

If pain is a barrier to intimacy, discuss this with your doctor. Pain management is a legitimate medical need. Topical anesthetics, timing of pain medication, and warm baths before intimacy can all help.

Emotional Intimacy

Physical intimacy is only one dimension of a relationship. Emotional intimacy, deep communication, vulnerability, shared experiences , can be maintained and deepened even when physical intimacy is limited by a flare.

For Partners and Caregivers

Being the partner of someone with HS is its own journey. You are watching someone you love in pain, often feeling helpless. You may be taking on additional responsibilities during flares. You may be navigating changes to your intimate relationship. Your experience matters too.

Resources for Partners

Our Caregiver Support page has dedicated resources for partners and family members, including how to provide effective support, manage caregiver burnout, and find your own community.

Visit Caregiver Support

Frequently Asked Questions

How do I tell a new partner about my HS?
There is no perfect script, but honesty and simplicity work best. A good approach: 'I want to tell you something about my health. I have a chronic skin condition called hidradenitis suppurativa. It causes painful lumps in certain areas of my body. It's not contagious, and it doesn't define who I am, but it does affect my life in some ways.' You do not need to share every detail at once. Gauge their response and share more as trust develops.
Can I have a normal sex life with HS?
Yes. Many people with HS have fulfilling, active sex lives. It requires communication, flexibility, and sometimes adaptation, but these are qualities that strengthen intimacy. Key strategies include: timing intimacy around flare cycles, communicating openly about pain and comfort, adapting positions to avoid pressure on affected areas, and focusing on connection rather than performance.
How does HS affect body image?
HS profoundly impacts body image for many patients. The visible wounds, scarring, and drainage can create deep shame and self-consciousness. These feelings are valid and understandable, but they are not the truth about your worth. Therapeutic approaches including CBT and acceptance-based therapy have strong evidence for improving body image in chronic illness patients. Peer support from others with HS can also be transformative.
What if my partner doesn't understand HS?
Education is the first step. Share reliable resources (like this site) with your partner. Consider attending a medical appointment together so they can hear directly from your doctor. Be patient. HS is complex and takes time to understand. If your partner is consistently dismissive or unsupportive of your medical needs, that is important information about the relationship.
Should I disclose HS when dating?
You are never obligated to disclose your medical history to anyone. However, in a developing relationship, disclosure before physical intimacy is generally advisable, both for your comfort and your partner's. The right person will respond with empathy and curiosity, not disgust or rejection. If a potential partner reacts poorly to your disclosure, that tells you something important about their character.
How can I improve my body confidence with HS?
Body confidence with HS is a journey, not a destination. Strategies that help: therapy (particularly CBT and ACT), connecting with the HS community and seeing others living fully with the condition, focusing on what your body can do rather than how it looks, practicing self-compassion, and working with a therapist who understands chronic illness. Your body is fighting a battle every day, it deserves your respect.

Relationships & HS Support

Compassionate guidance on relationships, intimacy, and living fully with HS, in your inbox.

No spam, ever. Unsubscribe anytime.

Medical References

  1. [1]Alavi A, et al. Quality of life and sexual health in patients with hidradenitis suppurativa. Int J Womens Dermatol. 2018;4(2):74-79. PubMed
  2. [2]Janse IC, et al. Sexual health and quality of life are impaired in hidradenitis suppurativa: a multicentre cross-sectional study. Br J Dermatol. 2017;176(4):1042-1047. PubMed
  3. [3]Kimball AB, et al. Burden of hidradenitis suppurativa: a systematic literature review of patient reported outcomes. Dermatol Ther. 2024;14(1):207-228. PubMed