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Peer-reviewedCC BY-NC 4.0Dermatology and Therapy

Hidradenitis Suppurativa from Preconception to Lactation: Clinical Treatment Decision-Making Review

  • Miłosz Lewandowski1,2
  • Wiktoria Szablewska3
  • Martyna Sławińska1,2
  • Aleksandra Kujach2,3
  • Roman J. Nowicki1,2
  • Wioletta Barańska-Rybak1,2
  1. 1Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17 Street, 80-214 Gdańsk, Poland
  2. 2Department of Dermatology, Venereology and Allergology, University Clinical Centre in Gdańsk,, Dębinki 7 Street, 80-952 Gdańsk, Poland
  3. 3Dermatological Students Scientific Association, Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Abstract

Hidradenitis suppurativa is a chronic, inflammatory skin disease that predominantly affects women of reproductive age and may require continuous therapeutic control during pregnancy and lactation. This review summarizes current evidence on the safety and practical use of topical, systemic, biologic, metabolic, and procedural therapies for HS throughout the preconception, gestational, peripartum, and breastfeeding periods. Topical clindamycin, benzoyl peroxide, chlorhexidine, and selected beta-lactam antibiotics appear to represent preferred options for mild disease or acute flares, whereas tetracyclines, retinoids, spironolactone, apremilast, Janus kinase inhibitors, and most glucagon-like peptide-1 (GLP-1) receptor agonists require avoidance or discontinuation because of fetal or neonatal safety concerns. Among biologics, tumor necrosis factor-α inhibitors remain the best-characterized agents, with certolizumab pegol offering minimal placental transfer and adalimumab or infliximab requiring individualized decisions regarding continuation and timing of discontinuation. Evidence for newer agents, including secukinumab and bimekizumab, is evolving but remains more limited. The review also highlights the importance of preconception counseling, medication transition, multidisciplinary delivery planning, postpartum flare prevention, breastfeeding-compatible therapy, and individualized procedural management. The management considerations presented herein are intended to support individualized clinical decision-making and should not be interpreted as formal guideline recommendations.

Graphical abstract available for this article.

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Cite

BibTeXRIS
BibTeX
@article{lewandowski2026hidradenitis,
  title = {{Hidradenitis Suppurativa from Preconception to Lactation: Clinical Treatment Decision-Making Review}},
  author = {Miłosz Lewandowski and Wiktoria Szablewska and Martyna Sławińska and Aleksandra Kujach and Roman J. Nowicki and Wioletta Barańska-Rybak},
  journal = {Dermatology and Therapy},
  year = {2026},
  month = sep,
  doi = {10.1007/s13555-026-01909-5},
  url = {https://doi.org/10.1007/s13555-026-01909-5},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Hidradenitis Suppurativa from Preconception to Lactation: Clinical Treatment Decision-Making Review
AU  - Miłosz Lewandowski
AU  - Wiktoria Szablewska
AU  - Martyna Sławińska
AU  - Aleksandra Kujach
AU  - Roman J. Nowicki
AU  - Wioletta Barańska-Rybak
PY  - 2026
DA  - 2026/09/01
JO  - Dermatology and Therapy
DO  - 10.1007/s13555-026-01909-5
UR  - https://doi.org/10.1007/s13555-026-01909-5
AB  - Hidradenitis suppurativa is a chronic, inflammatory skin disease that predominantly affects women of reproductive age and may require continuous therapeutic control during pregnancy and lactation. This review summarizes current evidence on the safety and practical use of topical, systemic, biologic, metabolic, and procedural therapies for HS throughout the preconception, gestational, peripartum, and breastfeeding periods. Topical clindamycin, benzoyl peroxide, chlorhexidine, and selected beta-lactam antibiotics appear to represent preferred options for mild disease or acute flares, whereas tetracyclines, retinoids, spironolactone, apremilast, Janus kinase inhibitors, and most glucagon-like peptide-1 (GLP-1) receptor agonists require avoidance or discontinuation because of fetal or neonatal safety concerns. Among biologics, tumor necrosis factor-α inhibitors remain the best-characterized agents, with certolizumab pegol offering minimal placental transfer and adalimumab or infliximab requiring individualized decisions regarding continuation and timing of discontinuation. Evidence for newer agents, including secukinumab and bimekizumab, is evolving but remains more limited. The review also highlights the importance of preconception counseling, medication transition, multidisciplinary delivery planning, postpartum flare prevention, breastfeeding-compatible therapy, and individualized procedural management. The management considerations presented herein are intended to support individualized clinical decision-making and should not be interpreted as formal guideline recommendations.  Graphical abstract available for this article.  Graphical Abstract:
SN  - 2193-8210
SN  - 2190-9172
ER  -