Intimacy can be challenging for anyone, but if you have hidradenitis suppurativa (HS), it brings unique difficulties.
“Bumps, abscesses, and scars in sensitive areas can be painful to the touch, making intimate activities uncomfortable or distressing,” explains Sarah McClees, MD, an assistant professor of dermatology at the University of Alabama at Birmingham. You may feel self-conscious about their appearance or odor, worry that your partner will think HS is contagious, or be anxious about your partner’s reaction to your bumps or scars – all of which can create emotional barriers to intimacy, she says.
For those newly diagnosed, the idea of opening up to a partner about HS, let alone getting intimate, can feel daunting.
“For someone with HS, the fear of being seen as unattractive and disfigured can be nothing short of traumatizing in many cases,” says Joshua C. Klapow, PhD, a licensed clinical psychologist and performance coach. “Moreover, wondering how a person might react to the physical signs of HS can create significant anxiety, avoidance, and a lack of desire to connect.”
But know this: HS doesn’t have to stand in the way of meaningful connections. With open communication and the right approach, you can build meaningful relationships while managing your condition.
Starting the Conversation: ‘I Have HS’
Opening up about HS to your partner can be tough, especially with worries about how they might react. It’s normal to feel a mix of fear and self-consciousness. But being open with them about your HS, you allow your partner the chance to understand what you’re going through and offer support.
Prepare yourself first. Before discussing HS with a partner, take a moment to process your emotions and accept yourself. You don’t need to love every part of your skin or symptoms, but being comfortable with your reality can help you speak more confidently, Klapow says.
“Accept what you have versus HS being who you are.” This mindset shift can help you view HS as part of your life, not the whole of it.
Be honest, but keep it simple. When you’re ready, approach the conversation openly. Start by letting your partner know this is a personal topic, McClees says. Describe HS simply and explain that it can affect your skin, sometimes making intimacy tricky. Share what you’re comfortable with, and reassure them that HS is neither contagious nor a reflection of who you are.
Encourage questions. Many partners will likely have questions or misunderstandings. By encouraging them to ask questions, you can clear up misconceptions and open a safe space for both of you. McClees recommends explaining that HS “is not contagious and does not pose a risk to your partner” and is “not an infection.”
Offer patience. Keep in mind that open communication is a leap of faith, Klapow says. Understand that after you open up and share your condition with your partner, they may need time to adjust and adapt.
“Sitting with uncertainty is, unfortunately, how the path of connection is formed,” Klapow says. A caring partner will appreciate your honesty, even if they need a moment to understand your journey with HS.
How to Ease Into Intimacy With HS
Living with HS can come with physical discomfort, particularly in areas where intimacy naturally involves close contact. Fortunately, there are ways to reduce pain and build comfort with your partner so HS doesn’t hold you back.
Carefully plan intimate moments. Consider planning intimate moments when your HS symptoms are milder and avoiding them during active flare-ups, especially when your skin sensitivity or pain is at its peak.
“Find ways to minimize friction or pressure on affected areas to reduce pain and make intimate activity more comfortable,” McClees says.
Focus on emotional connection. Intimacy doesn’t have to mean just physical closeness. Try focusing on ways to connect emotionally with your partner, like holding hands, touching gently, or cuddling. These moments can help build trust and a connection that’s just as powerful as physical intimacy.
Communicate boundaries. Let your partner know what’s comfortable and what’s not. You may find that certain positions or activities cause less irritation or pain, and discussing these openly can prevent discomfort.
“Trying to hide and cover yourself may feel right, but it creates a barrier to intimacy,” Klapow adds. Talking openly about your needs, even if it’s tough at first, can help create a safe space for both of you.
Consider different intimate activities. Physical closeness doesn’t always mean traditional sex. You and your partner can explore other ways to connect, like massage or gentle touch, to avoid putting pressure on sensitive areas, McClees says. This can keep intimacy positive and fun without added discomfort.
Supporting Your Self-Confidence
HS can bring self-conscious feelings about appearance, which can affect self-confidence. While these feelings are valid, it’s possible to manage them with support and self-care.
Shift focus from appearance to connection. Remember, intimacy is about connecting with your partner, not about how you look. Klapow highlights that although “sight is core to who we are,” intimacy is more about closeness and mutual support. With the right partner, your connection will outweigh any physical insecurities.
Build confidence through self-care. Take steps to feel good in your skin. Exercise, comfortable clothing, or skin care routines can make a difference. Small efforts to feel better physically can make it easier to approach intimacy with confidence.
Seek help from professionals. Working with a health care provider to manage HS flares through medication or lifestyle changes can reduce physical limitations. Counseling or therapy can help address emotional challenges related to HS and improve communication between partners.
Join a support group. Connecting with others who understand HS can offer a major confidence boost. Online support groups or forums can provide a helpful space to talk through experiences, share tips, and get encouragement from others who understand your challenges. It can remind you that you’re not alone in this journey.
Looking Ahead: You and Your Partner, Together With HS
“HS can make intimacy more challenging, but with supportive partners, communication, and self-care, many people with HS can maintain fulfilling intimate relationships,” McClees says. By taking things at your own pace, focusing on emotional closeness, and prioritizing self-care, you can keep HS from standing in the way of love and connection.
With time, trust, and understanding, you and your partner can work through the challenges HS may bring to your intimate life. You’re more than your condition, and the right person will see that, embracing all that makes you unique.
Remember, intimacy with HS is possible – one conversation, one gentle touch, and one day at a time.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Sarah McClees, MD, dermatologist, University of Alabama at Birmingham.
Joshua C. Klapow, PhD, associate professor of public health, University of Alabama at Birmingham.
