Overview Hidradenitis suppurativa, or acne inversa, is a chronic skin condition. It affects the areas of your body with sweat glands, such as your underarms. This condition can cause deep, inflamed skin lesions or sores that may look like boils. Hidradenitis suppurativa usually develops after puberty and may be genetic. It’s three times more common in women than in men. While there’s no cure for this condition, there are several ways to help soothe symptoms and prevent flare-ups. Your doctor may recommend treatments such as antibiotics, laser treatments, or surgery. Hidradenitis suppurativa is higher in people with obesity. Research has shown that losing weight can significantly reduce symptoms. It’s also associated with smoking, following an unhealthy diet, having high amounts of body fat, and metabolic syndrome — a cluster of conditions including high blood sugar and high blood pressure that increases heart disease risk. The foods you eat may also affect flare-ups. Certain foods may help reduce skin inflammation and balance hormones. Although certain dietary changes significantly improve symptoms in some people with hidradenitis suppurativa, it’s important to know that there’s currently no one diet recommended for the treatment of hidradenitis suppurativa, and research in this area is still ongoing. Maintaining a healthy diet to help reduce skin flare-ups is similar to eating a balanced diet to prevent chronic conditions such as diabetes and heart disease.

Foods that may cause hidradenitis suppurativa flare-ups Dairy Milk and other dairy products may raise levels of certain hormones that lead to hidradenitis suppurativa symptoms. Cow’s milk may also cause inflammation. Research has demonstrated that eliminating dairy products may be helpful in reducing hidradenitis suppurativa symptoms in some people. Dairy products include: cow’s milk

cheese

cottage cheese

cream cheese

buttermilk

butter

yogurt

ice cream Sugary foods Sugary foods and refined, simple carbs can cause a spike in blood glucose. According to research , this may trigger inflammation and cause symptoms. Studies suggest avoiding simple carbohydrates and foods that are high in added sugars: table sugar

corn syrup

high-fructose corn syrup

soda and other sugary drinks like fruit juice

bread, rice, or pasta made from white flour

white flour

noodles

boxed cereals

biscuits and cookies

cake, doughnuts, and pastries

crackers made from refined flour

potato chips

candy

chocolate bars

sugary protein bars Brewer’s yeast A small study found that brewer’s yeast may be a trigger for hidradenitis suppurativa symptoms. This may happen because the yeast causes a reaction in your immune system. Other research found that brewer’s yeast might only trigger symptoms in people with a wheat intolerance. Still, 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 pizza

some gravies and dips

some vinegars and salad dressings

some health supplements Other factors Although no clinical research trials have been conducted to date, some people with hidradenitis suppurativa report that eliminating nightshades from their diet improves symptoms. Nightshades are a group of plants that include edible vegetables like eggplants, potatoes, tomatoes, and peppers. Research from 2017 and 2019 has shown that dietary patterns that eliminate nightshades — along with many other foods such as grains and dairy — are effective in reducing symptoms in those with autoimmune disorders such as inflammatory bowel disease (IBD) and Hashimoto’s thyroiditis. Research has also found that hidradenitis suppurativa is associated with several autoimmune conditions such as lupus and IBD. Your immune system may also be involved with hidradenitis suppurativa. However, because there are no research studies investigating the potential association between nightshade consumption and symptoms in people with hidradenitis suppurativa, it’s unclear if this dietary change is beneficial for all people with this condition. If you would like to eliminate nightshades in your diet, cut out the following foods: tomatoes and tomato products

eggplant

potatoes

peppers

paprika

tomatillos

chili powder

pepper containing spice blends Others lifestyle factors that cause or worsen symptoms include: smoking cigarettes

tobacco use

obesity or weight gain

ingestion of foods with gluten if you’re gluten intolerant

Foods that may help hidradenitis suppurativa symptoms Fiber-rich foods Foods that are high in fiber help balance blood sugar and hormone levels. Fiber also helps you feel full faster and may reduce unhealthy food cravings. This may help you keep a healthy weight for your body size. Replace simple, sugary carbohydrates with whole foods and complex carbohydrates, such as: fresh and frozen fruit

fresh and frozen vegetables

fresh and dried herbs

lentils

beans

brown rice

barley

oats

bran

couscous

quinoa Omega-3 fatty acids Research shows that omega-3 fatty acid foods may help to reduce inflammation in your body. Reducing overall inflammation may help prevent or soothe symptoms of hidradenitis suppurativa, such as inflamed sores. Further research is needed on 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

flax seed and flaxseed oil

avocados

olive oil

pumpkin seeds

chia seeds Natural sweeteners If you have a sweet tooth, you can still enjoy desserts and sweet beverages occasionally. Choose foods and drinks made with natural sweeteners that don’t raise blood sugar levels drastically. Try replacing sugary drinks with sparkling or plain water, reducing the amount of sweetener you add to foods and beverages, and cutting back on foods high in added sugar, like candy, cakes, and sports drinks. Using small amounts of natural sweeteners like these can help to replace table sugar and other high-calorie sweeteners in your diet: stevia

monk fruit

Popular diets and hidradenitis suppurativa Diets for hidradenitis suppurativa have become popular. They include the autoimmune protocol and the Whole30 diets. 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 proven to trigger symptoms. However, some diets can be overly restrictive, and there’s currently no scientific evidence that any one diet works for hidradenitis suppurativa. What is known is that following an anti-inflammatory diet, such as the Mediterranean diet , that’s high in antioxidant-rich foods is helpful in reducing symptoms of hidradenitis suppurativa while improving overall health. In fact, a 2019 study showed that following a Mediterranean diet can improve disease severity in people with hidradenitis suppurativa. Overall, following a healthy diet rich in anti-inflammatory foods and low in processed foods is likely to benefit people with hidradenitis suppurativa.

Supplements Some research has shown that taking certain vitamin and mineral supplements may benefit people with hidradenitis suppurativa. For example, one study showed that high-dose B-12 supplementation improved symptoms in patients with hidradenitis suppurativa. Additionally, research has demonstrated that people with hidradenitis suppurativa are more likely to have low blood levels of zinc, and zinc supplementation may lead to partial or complete remission in patients that don’t respond to other treatment. People with hidradenitis suppurativa are also more likely to have low levels of vitamin D, and supplementation with this nutrient may reduce symptoms. If you’re interested in supplements that may improve hidradenitis suppurativa and correct possible deficiencies, speak with your healthcare provider.