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.

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

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

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.

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.

Medical research has confirmed that weight gain and having obesity are linked to hidradenitis suppurativa. Talk with your doctor about if a weight loss plan is right for you, and what foods trigger your symptoms.

There’s no cure for this condition. Medical treatment is necessary along with healthy lifestyle choices. Treatments such as medication, laser therapy, and protective silicone bandages may help relieve recurring skin irritation, pain, and swelling.

Further studies are needed on how your diet may help treat hidradenitis suppurativa. An elimination diet can help you find out if a certain food is a trigger for you. A dietitian can help you with this plan.

Make your new diet a part of your lifestyle. Then it’ll become a daily choice and not a temporary diet.