Dating With Hidradenitis Suppurativa: A Guide for Both Sides

Dating with hidradenitis suppurativa is possible, and it does not have to wait until your skin is clear. I want to say that first because the numbers show how few of us believe it: in a 2025 systematic review on HS and sexual quality of life, 90.6 percent of people with HS felt the condition hurt their chances of having a relationship. Read that again. Almost all of us carry the same fear, which also means the fear is a symptom of the disease, not an accurate measurement of your worth. This article is for both sides of the table: for you if you have HS and are dreading the conversation, and for you if you love someone who has it and want to get it right. There is no cure for HS, and a partner is not a treatment plan. But shame shrinks when it is shared, and that is something the research and my own life agree on.

Why does dating feel so hard with HS?

Because HS attacks exactly the things dating asks you to offer: skin, closeness, spontaneity. The lumps and scars show up in intimate places, armpits, groin, buttocks, under the breasts. Flares can drain and can have an odour. None of that is your fault, but a qualitative study by Esmann and Jemec found that the stigma of HS comes less from the lesions themselves than from the fear that other people will read them as unclean, and that worries about smell and appearance sit at the centre of how HS interferes with being close to people.

The load is not just social. A meta-analysis in JAMA Dermatology found depression in about 17 percent of adults with HS, and closer to 27 percent when measured with screening questionnaires. Dating while managing a painful condition and a low mood is genuinely harder, and pretending otherwise would be dishonest.

I know this from the inside. In my book I joke that during my worst years I spent more time with Google than with any girlfriend. Behind the joke was a real pattern: pain, fear of being judged, and the quiet decision that it was safer not to let anyone close enough to see. If you are in that place now, I am not going to rush you out of it. I am going to show you what helped, and what the evidence says.

When should you tell someone you have HS?

There is no single right moment, but there are a few principles that come up over and over in HS communities, and they match my experience.

You do not owe a stranger your medical history. A first date does not need your Hurley stage. It is not lying to simply not bring it up yet.
Tell them before hiding becomes a project. The exhausting part of HS in dating is not the conversation, it is the choreography of avoiding it: the lights kept low, the arm kept down, the excuses. When you notice you are managing a secret rather than enjoying a person, that is usually the signal.
If they ask directly, be honest. A vague answer is fine early on, a false one plants a problem you will have to dig up later.
Pick a calm moment, not a vulnerable one. A conversation with clothes on, on a walk or over dinner, goes better than an explanation delivered mid-undressing, when both of you are exposed and neither of you is at your most articulate.

And a reframe that took me years: disclosure is also a test that works in your favour. The reaction tells you early whether this person is capable of the kind of care a life with a chronic condition sometimes needs. Someone who responds badly to a skin condition has answered a question you would otherwise have spent years finding out.

How do you explain HS to someone who has never heard of it?

Most people have never heard the words hidradenitis suppurativa, so what they need first is reassurance about what it is not. The American Academy of Dermatology states it plainly: HS is not contagious, it is not a sexually transmitted disease, and it is not caused by unclean skin. Those three facts do most of the heavy lifting in the conversation, because they answer the fears a partner is too polite to say out loud.

After that, a short script is enough. Something like: "I have a chronic inflammatory skin condition called HS. My immune system overreacts around hair follicles where skin rubs on skin, so I get painful lumps that come and go in flares. It's not an infection you can catch, it has nothing to do with hygiene, and I manage it." If they want the full picture, you can point them to an explainer like what hidradenitis suppurativa actually is and let them read on their own time. Letting a partner learn independently spares you the job of being both the patient and the professor.

What about sex and intimacy?

This is the part most articles tiptoe around, so let me give you the honest numbers. The 2025 review in the Journal of Clinical Medicine found sexual dysfunction in roughly 52 to 62 percent of people with HS, compared with 31 to 42 percent in the general population, with women reporting more sexual distress than men. Among people with HS who had partners, 71 percent felt the disease affected the relationship.

But the same review contains the most useful finding I can offer you: disease severity did not correlate with sexual dysfunction or distress. A so-called mild case can weigh on intimacy as much as a severe one, because what matters is pain, where the lesions sit, and how you feel about your body, not the stage written in your chart. I read that in both directions. It means your struggles are valid even if a doctor called your HS mild. And it means a severe case is not a sentence to a life without intimacy, because intimacy tracks with things that can actually be worked on: communication, timing, comfort, and how safe you feel with the person next to you.

Practically, that looks like unglamorous honesty. Some days a flare in the groin makes certain touch off the table, and saying so beats enduring pain in silence. Some days it is a position change, a towel within reach, or simply agreeing that closeness tonight means lying together and nothing else. In the stress chapter of my book I write about affection, touch and orgasm as real physiological stress regulators, and stress management matters to me because stress and HS feed each other, something I have covered in more detail in how stress and HS interact. If pain during sex or genital involvement is part of your picture, that is worth bringing to a dermatologist rather than working around forever, and if the distress runs deep, a therapist who knows chronic illness is not an admission of defeat. It is maintenance for the relationship you are building.

If you love someone with HS: what actually helps

Judging by the questions partners post in HS communities, boyfriends, girlfriends and spouses genuinely want to help and are terrified of getting it wrong. I wrote a section of my book directly to you, and the heart of it is this: "Every hug, every touch, and every word matters more to us than you know." Here is the practical version.

Be discreet. Many of us have not told family, friends or employers. Who knows about their HS is their decision, never yours to make in passing conversation.
Do not flinch, and do not fuss. A matter-of-fact reaction to a draining lesion or a scar is worth more than a speech. Disgust wounds. So does treating someone like a patient instead of a partner.
Ask what helps, and believe the answer. During a flare some people want help with dressings, some want distraction, some want to be left alone with a heating pad. The only way to know is to ask.
Do not prescribe. Unsolicited diet tips and internet remedies land as pressure, not love. If they want to explore changes, explore them together at their pace.
Expect cancelled plans, and blame the disease. A flare the morning of a trip is the condition being a condition. Frustration is allowed, on both sides, but aim it at HS, not at each other.
Stay. In that same section of the book I wrote that sharing a life with us will not always be easy, and that if frustration sometimes makes us rude, we are not angry with you. Patience, presence and an ordinary held hand are the things people with HS remember years later.

What if the relationship itself is making things worse?

One more honest thing, because a guide about HS and love would be incomplete without it. HS and stress feed each other, and a relationship can be a stressor. In my book I suggest asking a hard question about any draining relationship: is this worth sacrificing my happiness and my health for? Boundaries are part of managing a chronic condition.

And there is a line no one should have to negotiate. A partner who weaponises your skin, who uses your condition to demean you or make you feel unleavable, is showing you contempt, not love. The stigma research above makes people with HS especially vulnerable to exactly this. If a relationship involves cruelty, coercion or fear, support from a trusted person or a professional service is the move, and you deserve it as much as anyone without HS does.

I will end where I started. There is no cure for HS, and I never promise one. In my case, years of work on my health, an elimination and reintroduction approach to food, and a lot of patience brought me to remission, and the full story is in my book. But the relationship part of my life did not wait for remission, and yours does not have to either. I am a patient, not a doctor, so for pain, genital involvement or anything medical in this article, talk to your dermatologist about your case.

FAQ

Is hidradenitis suppurativa contagious to a partner? No. The American Academy of Dermatology states that HS is not contagious and is not a sexually transmitted disease. A partner cannot catch it from touch, sex or shared towels, and it is not caused by poor hygiene.

When should I tell someone I am dating about my HS? There is no universal right moment. A useful rule: before hiding it becomes work. Early dates do not require your medical history, but once trust is building, a calm conversation with clothes on beats a surprise reveal, and a direct question deserves an honest answer.

Can you have a good sex life with HS? Research shows sexual difficulties are more common with HS, affecting roughly half or more of patients, but they track with pain and self-image rather than disease severity. Communication, timing around flares and comfort adjustments do real work, and a dermatologist or therapist can help with the medical and emotional parts.

What should I do if my partner has HS? Be discreet about their condition, react to flares matter-of-factly, ask what helps instead of guessing, skip unsolicited remedies, and blame cancelled plans on the disease rather than on them. Presence beats advice.

Does having HS mean I will end up alone? No. In one review, 90.6 percent of people with HS feared the condition hurt their relationship chances, yet those same studies were built on large numbers of partnered patients, people dating and married while living with the disease. The fear is near universal. It is also not a prophecy.