Hidradenitis Suppurativa (HS) is a debilitating chronic skin condition that causes boils, lesions and nodules to form on the skin. The affected areas can get very swollen and inflamed during flare-ups and so can be very sore and uncomfortable for the person.

HS usually develops after puberty and is more common in women than men. Some studies show HS to be genetic but no one fully knows the cause of it.

There is no cure for HS, so unfortunately, all doctors can do is offer patients treatments to ease the discomfort and try to prevent flare-ups. This can be a long process as what works for one HS patient may not work for another. There can be a long trial and error process before the patient finds a solution that works for them.

Many believe that obesity or weight gain can worsen the condition so it is advised that HS patients try to live a healthy life by eating a balanced diet and exercising. However, during flare-ups when the slightest of movements can be very painful, exercise is simply not an option, therefore, a diet will be important to a HS patient. In the rest of this blog post, we are going to concentrate on how your diet may help your HS. We advise you try different mixes until you figure out your own HS diet.

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Food that may cause flare-ups are also known as trigger foods

Some foods are known to cause inflammation and so should be avoided. Here are some of the foods you should consider limiting:

Cow’s milk

Cheese

Buttermilk

Butter

Yoghurt

Refined carbohydrates

Sugar

Syrup

Fizzy drinks

White flour including bread, rice and pasta made from white flour

Noodles

Cereal

Biscuits and cookies

Cakes and pastries

Crackers and crisps

Sweets and chocolate

Protein bars

What foods can help flare-ups

Whole Grains and whole foods

Fibre can help balance your blood sugars and hormone levels. Eating a high fibre diet can help you to feel fuller faster so it should reduce your cravings for unhealthy foods. To help maintain a healthy weight it is recommended to replace sugary carbohydrates with some of the whole foods listed below:

Fruit – Fresh, dried or frozen

Vegetables – Fresh or frozen

Herbs

Lentils and beans

Whole-wheat bread

Whole-grain pasta

Brown rice

Barley

Oats

Bran

Couscous and quinoa

Omega-3

Foods rich in Omega-3 can help to reduce inflammation and so is very good for your heart and brain.

Fish – specifically salmon and sardines

Walnuts

Flax seeds or flaxseed oil

Avocados

Olive oil

Pumpkin or chia seeds

Diets and HS

Diets that are specifically for HS have become popular. Some HS patients have seen positive results following these diets while others report no change. Many of the diets restrict the trigger foods we have listed above. It really is trial and error because everybody is different.

Many of the ‘HS’ diets can be very strict and extreme so we suggest avoiding making drastic changes as it will be harder to sustain in the long term. To start, don’t eliminate all the food listed in ‘food that may cause flare-ups’. Start slowly and look at limiting a few while trying to introduce more from the ‘foods that may help flare-ups’ list. Over time, you can limit and add more. The key is to do it in a way that will work for you so that you can maintain your new diet long term.

How to know if changing my diet is working for me?

Everyone, HS patient or not, has certain foods that do not necessarily agree with them. In your case, you may find there is a certain food that can trigger a flare-up. To find out what this food is we suggest an elimination diet. To do an elimination diet you should remove one type of food at a time, for example, dairy or simple carbs, for a period of a month or longer. Record any changes in symptoms and then when you are ready, slowly add it back into your diet. Again, record any symptoms. It would be a good idea to work with a dietician for this.

It is important to remember that you won’t see an improvement overnight. It can take a few months for improvements to show.

To make the process a little more sustainable, think of it as a lifestyle choice instead of a diet.