Hidradenitis Suppurativa Diet: Foods To Eat and Avoid

If you have hidradenitis suppurativa (HS), you know just how hard it can be to manage your symptoms. And if you’re looking for ways to lessen the likelihood of flare-ups and keep painful skin lesions at bay, you may want to consider altering your diet to focus on anti-inflammatory foods.

Registered dietitian Devon Peart, RD, MHSc, BASc, explains how your diet can affect your hidradenitis suppurativa, and shares which foods to embrace and which to avoid in the ongoing quest to manage symptoms.

How diet affects hidradenitis suppurativa

Hidradenitis suppurativa, also known as acne inversa, is an inflammatory skin disease. And what you eat (and don’t eat) can contribute to or calm inflammation in your body. Your diet can also have an impact on the severity of your body’s inflammatory response.

“Some foods are inflammatory, meaning they increase inflammation, and some foods are anti-inflammatory, meaning they reduce inflammation,” Peart explains. “When you have hidradenitis suppurativa, there is a potential role for nutrition in terms of reducing inflammation — or at least not making it worse — and preventing flare-ups.”

Diets that may help with hidradenitis suppurativa

Nutrition and inflammatory skin diseases are closely connected. If you have hidradenitis suppurativa, the way you eat can have an impact on whether your symptoms are better or worse.

Peart shares some eating styles and habits that may help your hidradenitis suppurativa.

Try an elimination diet

Peart suggests removing certain foods from your diet temporarily — a minimum of two weeks — to see how your HS reacts. This is called an “elimination diet.”

In particular, she recommends, “Try avoiding gluten, brewer’s yeast and alcohol for a trial period to see if your symptoms improve.”

Foods to avoid if you have hidradenitis suppurativa

Certain foods are thought to make hidradenitis suppurativa worse. “It’s not yet clear if foods contribute to or cause diseases like HS (and if so, which ones), but foods can trigger flare-ups or worsen symptoms or severity,” Peart affirms.

Everyone’s body is a little different, so there’s no one-size-fits-all answer to what’s best for you. But Peart says some foods are known to be more inflammatory than others, and it’s all about figuring out which ones most affect you.

“As with most conditions, there are individual differences with respect to food sensitivities and what foods might trigger inflammation,” she notes. “By keeping a food journal or diary, you may be able to identify triggers for your flare-ups so that you can minimize or avoid those foods.”

Peart walks us through some of the foods that may cause hidradenitis suppurativa flare-ups.

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.

Dairy

Bad news, ice cream lovers: Peart says high-fat dairy products can be inflammatory because of their saturated fat content. This includes ice cream, butter, whole milk, cheese and heavy cream.

But there’s good news, too. 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.)

Sugar

By now, we all know that there are plenty of health risks associated with sugar. But if you have hidradenitis suppurativa, here’s another reason to scale way back: 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,” Peart explains.

Brewer’s yeast

One study showed that brewer’s yeast — a type of yeast found in beer, bread and a number of other foods — may cause HS flare-ups. That may only be the case in people who are already sensitive to gluten, but if you have hidradenitis suppurativa, you may see some relief by avoiding products made with brewer’s yeast.

Refined carbs

There are various types of carbs, but refined carbs are those that contain processed (white) flour or added sugar. “Refined carbs are not as nutrient-rich as less processed carbs like whole grains and sweet potato for example. Refined carbs include desserts, white bread, white rice, pasta, chips, crackers and pretzels,” Peart says. “They lack fiber and other nutrients.”

Foods like these lead to a greater insulin response and affect 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,” she adds.

Alcohol

Alcohol can have all kinds of effects on your body, impacting everything from your liver to your pancreas to your heart. And it can also play a role in your hidradenitis suppurativa.

“Alcohol is known to be inflammatory,” Peart warns. Drinking less or eliminating alcohol entirely may improve your HS symptoms.

Try an anti-inflammatory diet

An anti-inflammatory diet is exactly what it sounds like: An eating plan designed to reduce inflammation in the body. But what this means for you is specific to your body and its individual needs, so it’s important to work with a professional.

“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,” Peart says. They’ll also make sure you’re still getting all the vitamins and nutrients your body needs.

Embrace the Mediterranean diet

Certain foods — like fruits, veggies, chicken and fish — seem to improve HS symptoms, likely due to high concentrations of micronutrients such as zinc and B12, Peart notes. And there’s one anti-inflammatory eating style in particular, that focuses on all of them.

Known as a healthy diet for your heart, the Mediterranean diet focuses on whole, minimally processed foods, especially those that are plant-based. “This encourages diverse gut bacteria, which is beneficial for health and immunity,” she continues. “You want to be sure you’re eating fiber- and nutrient-rich foods.” That includes:

• Beans
• Healthy fats, like olive oil
• Fruits and vegetables
• Lean proteins, like fish and chicken
• Whole grains

Try to stabilize your blood sugar

Medical professionals don’t yet know whether having diabetes makes a person more prone to developing HS or if having HS can contribute to diabetes, but they’re thought to be related somehow.

“Either way, nutrition choices that help stabilize blood sugars is a good precautionary measure and may help manage symptoms of HS,” Peart states.

That means:

• Choosing fiber-rich foods, like fruit, veggies, nuts, seeds, beans, lentils and whole grains
• Pairing fiber-rich foods with protein-rich foods like fish, meat and eggs
• Eating smaller, more frequent meals and snacks

Other lifestyle adjustments that could help manage hidradenitis suppurativa

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.
• Vitamin D supplements. Peart recommends talking to your provider about vitamin D supplements. Though more research is still needed, studies show that many people with HS are deficient in vitamin D. And the worse their deficiency, the more severe their HS symptoms are.
• Get your omega-3s. Your body can’t make omega-3 fatty acids. But they are essential, meaning we must get them from food. Your body needs these unsaturated fatty acids for a variety of health reasons, including reducing inflammation. “The best source is fish,” Peart says, “so aim to have oily fish, like salmon, trout, mackerel, arctic char or sardines, at least twice a week.”

If you have hidradenitis suppurativa, talk to your medical provider about the role nutrition plays in your condition. “It’s important for dermatologists and other healthcare providers to be aware of the growing body of evidence concerning nutrition and inflammatory skin diseases, including HS,” Peart encourages.