Unlock Relief: The Ultimate Hidradenitis Suppurativa Diet to Manage Symptoms Naturally

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory skin condition that can significantly impact a person's quality of life. While there is no cure for HS, dietary modifications can play a crucial role in managing symptoms, reducing flare-ups, and supporting overall well-being. This article explores the connection between diet and HS, providing insights into which foods may trigger symptoms, which may help lower inflammation, and how to approach dietary changes for optimal results.

Understanding Hidradenitis Suppurativa and Inflammation

Hidradenitis suppurativa affects areas of the body with sweat glands, such as the armpits, groin, and buttocks, causing deep, inflamed skin lesions or sores that may look like boils. Excess weight, stress, hormonal changes, heat, and humidity may worsen symptoms. The condition usually develops after puberty and may be genetic, and is more common in people with obesity.

Inflammation is a major component of HS. The body’s natural defense mechanism against any foreign substance that it perceives as harmful. If the body does not resolve inflammation, it can destroy healthy cells. An anti-inflammatory diet may bring significant improvement by minimizing symptom severity and frequency.

The Role of Diet in Managing HS

Research suggests that diet can reduce or worsen symptoms of hidradenitis suppurativa. Following a balanced diet may help lower skin flare-ups and prevent chronic conditions such as diabetes and heart disease.

Key Considerations for an HS Diet

Weight Management: Excess weight is a main factor, so keeping your weight in check and at a healthy number is a good idea. Losing weight for people with obesity can significantly lower symptoms.
Blood Sugar Control: High blood sugar seems to contribute to flare-ups of hidradenitis suppurativa. High consumption of added sugars and refined carbohydrates has been linked to a host of health problems beyond HS, including obesity, diabetes, and cardiovascular disease.
Inflammation Reduction: An anti-inflammatory diet, such as the Mediterranean diet, that’s high in antioxidant-rich foods is helpful in lowering symptoms of hidradenitis suppurativa while improving overall health.
Identifying Trigger Foods: Certain food items are thought to worsen Hidradenitis Suppurativa. Although it’s unclear if food causes Hidradenitis Suppurativa (and if so, which ones), food triggers can result in flare-ups or worsen HS symptoms.

Foods to Limit or Avoid

Certain foods may increase inflammation and lead to flare-ups in people with hidradenitis suppurativa.

Dairy: Milk and other dairy products may raise levels of certain hormones that lead to hidradenitis suppurativa symptoms. Limited research has demonstrated that eliminating dairy products may help lower hidradenitis suppurativa symptoms in some people. Bad news, ice cream lovers: high-fat dairy products can be inflammatory because of their saturated fat content. This includes ice cream, butter, whole milk, cheese, and heavy cream. Dairy foods that are lower in fat don’t appear to be inflammatory, and yogurt actually reduces inflammation because of its high probiotic content, which is good for your gut. (Just be sure you’re not reaching for sugary sweet versions. Plain, nonfat yogurt is best.)
Sugary Foods and Refined Carbs: Sugary foods and refined, simple carbs can cause a spike in blood glucose. According to research, this may trigger inflammation and cause symptoms. It may be helpful to limit simple carbohydrates and foods that are high in added sugars, such as: high-fructose corn syrup; soda and other sugary drinks like fruit juice; bread, rice, or pasta made from white flour; noodles; biscuits and cookies; cake, doughnuts, and pastries; and potato chips. Studies show that simple sugars are a common trigger for inflammation and may worsen HS symptoms. Sugary foods spike insulin which can lead to inflammation, as well as potentially more stored fat and weight gain. Refined carbs are those that contain processed (white) flour or added sugar. They lack fiber and other nutrients, leading to a greater insulin response and affecting other factors that can lead your cells to produce too much sebum - an oil your body makes to keep your skin moist. This can lead to blocked follicles that can trigger acne and hidradenitis suppurativa.
Brewer’s Yeast: Brewer’s yeast may be a trigger for hidradenitis suppurativa symptoms because the yeast causes a reaction in your immune system. A 2020 study of 185 participants found that people who excluded brewer’s yeast (along with other foods) from their diets had a 70% improvement in symptoms. When participants added brewer’s yeast back to their diet after some time, 87% of them experienced symptom recurrence. If you have hidradenitis suppurativa, you may want to check your food labels and avoid anything that may contain brewer’s yeast, including: beer, wine, fermented spreads, some soy sauces, some stock cubes, some dried or canned soups, some breads, cakes, and pizzas, some gravies and dips, and some vinegars and salad dressings. In a French study, 12 people with HS were given a food intolerance test and found to have had an immunologic reaction to Brewer’s yeast and wheat. The diet caused “immediate stabilization of clinical symptoms”, and the remaining skin lesions improved throughout the 12 months. If any of the participants accidently ate food containing brewer’s yeast, their HS lesions recurred almost immediately. Another small study of 20 people with hidradenitis suppurativa demonstrated an improvement in HS related Pain, intensity of inflammation, days of impairment and levels of discharge for HS lesions, after 3 months of brewer’s yeast elimination.
Alcohol: Alcohol is known to be inflammatory, and drinking less or eliminating alcohol entirely may improve your HS symptoms.
Highly Processed Foods: Highly processed foods and foods with lots of additives negatively impact your gut flora. By “gut flora,” we mean the “good” bacteria that live in your gut and keep your immune system healthy. Gut bacteria ferment dietary fibers to make short-chain fatty acids, which play an important role in reducing inflammation.
Nightshade Vegetables: Some individuals with HS report flare-ups after consuming nightshade vegetables like tomatoes, potatoes, and peppers. Nightshade Vegetables such as white potatoes, tomatoes, eggplant, bell peppers, cayenne pepper and paprika contain a substance called solanine, which some believe cause inflammation in the body.

Foods to Include in Your Diet

Following a healthy diet rich in anti-inflammatory foods and low in processed foods is likely to benefit people with hidradenitis suppurativa.

Fiber-Rich Foods: Foods that are high in fiber help balance blood sugar and hormone levels. Fiber also helps you feel full faster, which may help you keep a moderate weight for your body size. Consider replacing simple, sugary carbohydrates with whole foods and complex carbohydrates, such as: fresh and frozen fruits and vegetables; fresh and dried herbs; beans; brown rice; barley; oats; couscous; and quinoa. Fiber is essential for everyone, and HS patients aren’t an exception. Fiber has several benefits for people with HS. First, it increases feelings of fullness or satiety, which can reduce the intake of unhealthy foods and lead to weight loss. Additionally, high-fiber foods help regulate blood sugar levels and improve gut function, which can help reduce inflammation. Department of Health and Human Services, recommend that adults consume 22 to 34 grams of fiber per day, depending on age and sex.
Omega-3 Fatty Acids: Research shows that omega-3 fatty acid foods may help to lower inflammation in your body. Reducing overall inflammation may help prevent or soothe symptoms of hidradenitis suppurativa, such as inflamed sores. Further research is needed to confirm the benefits of omega-3 fatty acids for hidradenitis suppurativa, but these healthy fats are also good for your heart, blood vessels, and brain. Try adding them to your diet by eating: salmon; sardines; walnuts; flaxseed and flaxseed oil; avocados; pumpkin seeds; and chia seeds. The American Heart Association recommends eating two servings of fatty fish per week to meet the recommended intake of omega-3s. Omega-3 fatty acids have been shown to have anti-inflammatory properties, which can help reduce inflammation in the body and potentially improve symptoms of HS. Fatty fish, such as salmon and tuna, are a great source of omega-3 fatty acids.
Anti-Inflammatory Foods: An anti-inflammatory diet is exactly what it sounds like: An eating plan designed to reduce inflammation in the body. Turmeric contains curcumin, a powerful anti-inflammatory compound. Foods like spinach, kale, and Swiss chard are packed with vitamins, minerals, and antioxidants that combat inflammation. Blueberries, strawberries, and raspberries are bursting with antioxidants that can help neutralize harmful free radicals and promote skin health. Vibrant vegetables like bell peppers, carrots, and tomatoes are excellent sources of antioxidants such as vitamins A, C, and E.
Gut-Healing Foods: Supporting a healthy gut microbiome may help reduce inflammation and improve HS symptoms. Fermented foods like yogurt, sauerkraut, and kefir contain beneficial bacteria that promote a healthy gut. Whole grains, legumes, fruits, and vegetables are high in fiber, which acts as food for the beneficial bacteria in your gut.
Plant-Based Foods: A plant-based diet consists of healthy fresh foods of a plant-based nature including vegetables, fruits, legumes, nuts and whole-grains. Plant foods are rich in antioxidants which are beneﬁcial compounds that can be found in plant foods and they may help improve blood sugar regulation and reduce inﬂammation. Incorporating a variety of plant-based foods may support HS. Eating fruits and vegetables, especially those high in antioxidants like leafy greens and berries, supports overall skin health and reduces inflammation. It may also be beneficial to add anti-inflammatory herbs or spices like turmeric.

Popular Diets for HS Management

Diets for hidradenitis suppurativa have become popular. They include the autoimmune protocol and the Whole30 diets. However, further research is still needed to determine their exact effectiveness. Some adults with hidradenitis suppurativa report good results on these diets. This may be because these diets restrict foods such as dairy and refined carbohydrates that are clinically shown to trigger symptoms.

Mediterranean Diet: Following a Mediterranean diet can improve disease severity in people with hidradenitis suppurativa. The Mediterranean diet is based on the foods eaten in countries like Greece, Spain, Italy and other countries of the Mediterranean Sea. Researchers in the 1960’s started examining the diets of people in the Mediterranean as they were found to have a lower risk of many different diet related heath problems like cardiovascular disease. The diet is based on eating plenty of fresh fruit, vegetables, whole grains and healthy fat like olive oil and avocados every day. Other foods central to the diet is a variety of fish and other seafood. Poultry, beans and eggs are eaten in moderation. Dairy products and red meat are only eaten occasionally. The Mediterranean diet is a healthy, nutritious and tasty way to eat. The diet is not as intense as others and allows for a large variety of food to be included.
Paleo Diet: The Paleo diet, which is low in grains, legumes, and dairy, is also a diet to consider. Paleo refers to a pre-historic time. While all the claims of a Paleo diet have not been conﬁrmed, there is evidence that a diet rich in lean protein and plant-based foods can make you feel more satiated, help control blood sugar and promote weight loss.
Ketogenic (Keto) Diet: The ketogenic (keto) diet, which is low in carbs and high in fat, may also be helpful in managing HS symptoms, particularly if it helps with weight loss.
Autoimmune Protocol (AIP) Diet: Another diet to consider is the autoimmune protocol diet, which is similar to the Paleo diet and designed for people with autoimmune conditions and inflammation. The AIP diet is believed to reduce inflammation in the body that’s is caused by leaky gut syndrome. Many people believe that leaky gut (intestinal permeability) causes toxins and food particles to be absorbed into the blood stream through tiny gaps in the lining of the intestine. The AIP diet proposes a very thorough elimination diet, wherein foods that contribute to leaky gut are removed and the gut lining has time to heal. The diet is very restrictive to start off, eliminating most foods except fresh meat, organ meat, animal fats, bone broth and vegetables. Once your HS symptoms improve, you start reintroducing different foods slowly. The AIP diet can be somewhat considered a very restricted version of the paleo diet. There is little scientific research into the AIP diet for hidradenitis suppurativa, however hundreds of people with HS have seen an improvement in their symptoms by following this diet. Some people follow the diet for 6 months or a year, others make a lifelong commitment to the diet, and live relatively HS free. It’s recommended to get some Tupperware so you can batch cook and plan meals to make following the AIP diet a bit easier. Eating out can be an issue for people following this diet, and even certain types of seasonings and cooking oil are excluded. But these sacrifices are worth it for some. Variety of fresh meats and organ products.

The Elimination Diet Approach

An elimination diet can help you determine if a certain food triggers your condition. For an elimination diet, you stop eating certain foods to identify and treat food intolerances, allergies, and other conditions like irritable bowel syndrome, migraines, and hidradenitis suppurativa. It can be difficult to test for these intolerances, but an elimination diet may help identify problematic foods.

An elimination diet involves temporarily removing foods or food groups that are believed to cause adverse reactions, and then reintroducing them one at a time during a “challenge” phase. This strategy may help determine which foods trigger or worsen symptoms. You can follow different protocols (detailed plans) for an elimination diet. One way is to start by eliminating the most common food allergy and intolerance culprits (citrus, dairy, eggs, gluten, soy, peanuts, tree nuts like almonds, shellfish, beef, and corn) or additives (such as colors, preservatives, and flavor enhancers). You avoid these food groups for four to six weeks while seeing if your symptoms improve. Then you start consuming each food group again, one at a time, to see if one type of food triggers symptoms.

Tips for Implementing an Elimination Diet

Keep a Food Diary: Keeping a food diary is an important tool for people with Hidradenitis Suppurativa (HS) to help identify which foods may trigger or exacerbate their symptoms. By keeping a food diary, you can track your food intake and any symptoms you experience, such as pain, inflammation, and flare-ups.
Work with a Healthcare Provider: Your healthcare provider may recommend an elimination diet, where specific foods or food groups are eliminated from the diet one at a time to see if symptoms improve. This process can take time, as it can take several weeks or even months to see improvement.
Reintroduce Foods Slowly: Reintroducing different foods slowly once your HS symptoms improve.

Supplements for HS Management

Some research has shown that taking certain vitamin and mineral supplements may benefit people with hidradenitis suppurativa. For example, research has demonstrated that people with hidradenitis suppurativa are more likely to have low blood levels of zinc and vitamin D. Supplementing with these nutrients may help lower symptoms.

Read also: The Hoxsey Diet

Zinc: Some people with mild to moderate HS may benefit from a zinc supplement, as it can boost immune system activity. However, zinc supplementation can cause nausea and diarrhea in some people and may interact with certain medications, such as blood pressure and antibiotics.
Vitamin D: Vitamin D is another supplement that may be beneficial for people with HS, particularly those with more severe cases of the disease who tend to have lower vitamin D levels.
Vitamin B12: One small study suggested that vitamin B12 supplementation may be beneficial for people with HS.

It’s important to talk to your healthcare provider, particularly a Hidradenitis Suppurativa specialist, before taking any supplements if you have HS.

Additional Lifestyle Adjustments

Your hidradenitis suppurativa doesn’t stand alone; it’s also related to other things going on in your body. That means other health conditions and lifestyle concerns can impact your HS symptoms, including:

Smoking: Tobacco use is associated with hidradenitis suppurativa, so quit smoking to reduce the likelihood of HS flare-ups. (Ask your healthcare provider for advice and resources.)
Obesity: Having overweight or obesity increases insulin resistance and can lead to hormonal changes, which may contribute to HS symptoms.
Diabetes: One study found that 10.6% of people who have diabetes also have hidradenitis suppurativa. Stabilizing your blood sugar may help your HS.
Stress Management: While not directly related to the Hidradenitis Suppurativa diet, stress can trigger or worsen HS symptoms.

Consulting with Professionals

If you are considering making dietary changes to help manage HS symptoms, it’s essential to consult with a healthcare provider or a registered dietitian first. They can help you determine which diet may be most appropriate for you based on your individual needs and health status. A registered dietitian can guide you in planning a diet that is anti-inflammatory and can also help you identify which foods are triggers for symptoms in your individual case. They’ll also make sure you’re still getting all the vitamins and nutrients your body needs.

Read also: Walnut Keto Guide

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