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5 Vitamins for Hidradenitis Suppurativa: Can They Help?

Posted on August 16, 2022
Medically reviewed by
Diane M. Horowitz, M.D.
Article written by
Jane Chung, PharmD, RPh

Many people with hidradenitis suppurativa (HS) — an inflammatory skin condition — consider making dietary changes, such as taking supplements, to help manage their condition.

No specific supplements or diets have been proved to cure HS, also known as acne inversa. However, some evidence suggests that avoiding dairy products and brewer’s yeast (found in beer and bread) and getting more of certain nutrients may help relieve symptoms.

Keep reading to learn about the role of vitamins and supplements, such as vitamin D, zinc, turmeric, and more, in HS.

1. Vitamin D

Vitamin D is known to reduce inflammation and enhance the immune system. It is also an important part of maintaining skin homeostasis (the balance of growth and death of skin cells), especially in hair follicles.

The best way to get vitamin D is through a healthy diet. Some foods are naturally high in vitamin D, while others are fortified — nutrients are added to them. Good food sources of vitamin D include:

  • Beef liver
  • Egg yolks
  • Fortified cereals, milk, and orange juice
  • Salmon

Vitamin D supplements are available in two forms: cholecalciferol (D3) and ergocalciferol (D2). Vitamin D3 comes in capsules, and vitamin D2 can be taken as capsules or in liquid form.

Vitamin D deficiency is common in certain populations and geographic locations. Research shows that people with HS have a higher chance of being deficient in vitamin D.

One small study found that 79 percent of people with HS and a vitamin D deficiency responded to treatment with vitamin D supplementation. At six months, the participants’ number of nodules and frequency of flare-ups decreased by at least 20 percent.

Another study found that 50 percent of people with HS who stopped using vitamin D supplements experienced a relapse (worsening health after a period of improvement). This finding suggests that vitamin D plays a role in preventing flare-ups rather than improving existing symptoms.

Some myHSteam members have seen positive results from taking vitamin D. “I had my first instance in my underarms in 2016. I had my vitamin D levels tested then, and they were in the ‘severe deficiency’ range,” a myHSteam member posted. “I’ve been taking supplements ever since to get my levels up but haven’t been so consistent lately with it. My next flare-up happened a few months ago but seemed to clear up quite quickly once I started taking my vitamin D every day again.”

Taking too much vitamin D — also called vitamin D toxicity — can increase the amount of calcium absorbed by the body. Excess calcium in the blood, known as hypercalcemia, can lead to nausea, vomiting, muscle weakness, and dehydration. In extreme cases, too much vitamin D can cause kidney failure, irregular heartbeat, and even death.

2. Zinc

The body needs only small amounts of zinc, which is known as a trace mineral. Even so, zinc plays an important role in the body, supporting the immune system and reducing inflammation.

Researchers have found that people with HS are more likely to have low zinc levels compared to people without the skin condition. However, the suggestion that zinc supplements, which are generally available as pills, could help manage HS hasn’t been proven.

In a small study that looked at the effects of using zinc gluconate, a salt form of zinc, to treat people with HS, all 22 participants showed improvement. Eight people had a complete response, defined as the disappearance of lesions or no new lesions for six months or more. The other 14 participants had a partial response — either the treatment reduced the number of nodules by at least 50 percent or each inflammatory lesion didn’t last as long.

Another study also looked at using zinc gluconate supplements, along with triclosan, a topical antibacterial medication, in people with HS. After three months of this treatment, the 66 people who participated noted improved quality of life, with fewer inflamed nodules, new boils, or flare-ups and decreased redness.

Members of myHSteam have had mixed results with zinc supplementation. “I use zinc tablets. It helps a lot for me,” one member commented. Another had a different experience: “I haven’t seen an improvement. But everyone’s body reacts differently, so it’s worth a try.”

Although zinc is considered relatively nontoxic, especially when taken by mouth, it can cause problems if used in excess. Symptoms of zinc toxicity include nausea, vomiting, tiredness, and pain in the upper abdomen.

3. Turmeric

Turmeric, a spice thought to have medicinal properties, is derived from the Curcuma longa plant, found mainly in India and Southern Asia. The health benefits are attributed to curcumin, turmeric’s main active ingredient, which is available as a spice and in pill form.

Curcumin is an anti-inflammatory and antioxidant agent. Although no studies have looked at the effects specifically in HS, turmeric’s general effectiveness as an anti-inflammatory agent has been well established by multiple studies since the 1970s.

Turmeric has been endorsed by myHSteam members. One wrote, “Turmeric is great. I take it almost daily except when I forget. It is very helpful to me!”

One of the major drawbacks of turmeric is that the body does not easily absorb curcumin taken orally. The body digests and gets rid of turmeric quickly, leaving the active ingredient little time to work. On the bright side, this means people are unlikely to experience side effects from too much turmeric.

However, when taken with piperine (black pepper), the bioavailability of curcumin increases. This means the body can better absorb the curcumin — but then could take in too much, which can lead to liver injury. Symptoms include:

  • Fatigue
  • Nausea
  • Poor appetite
  • Dark urine
  • Jaundice (yellowing of the skin and eyes)

4. Omega-3 Fatty Acids

Omega-3 fatty acids are oils with well-established health benefits. Omega-3 fatty acids have shown great potential in reducing inflammation, which could help manage chronic inflammatory skin diseases such as psoriasis, acne, and HS.

Evidence strongly suggests that this ability to ease inflammation makes omega-3 fatty acids beneficial in chronic inflammatory diseases. However, there is no research surrounding the use of omega-3 fatty acids in HS, so it’s not clear if or how these supplements affect people with the condition.

Omega-3 fatty acids are available naturally in some foods. A great example is fish, such as salmon, mackerel, tuna, and sardines. Nuts and seeds like flaxseed, chia seeds, and walnuts also provide omega-3. Plant oils such as flaxseed oil, soybean oil, and canola oil are great sources, too.

Foods can also be fortified with omega-3 fatty acids. Examples include eggs, yogurt, juices, milk, and soy beverages.

Omega-3 supplements, sometimes referred to as fish oil, are available in pill form. They usually produce mild side effects, including:

  • Unpleasant taste
  • Bad breath
  • Headache
  • Nausea
  • Diarrhea

Another consideration is that omega-3 supplements may interact with medications that affect the blood’s ability to clot. In addition, it’s unclear whether people with seafood allergies can safely take fish oil supplements.

Some myHSteam members have found omega-3 supplementation effective: “I had been taking fish oil for a while but stopped and noticed I got a flare a day or two later, so I think the fish oil helps.”

5. Vitamin B12

Vitamin B12 supports the development and function of the central nervous system. This nutrient is also required to form DNA and healthy red blood cells.

Foods like eggs, beef, salmon, and tuna are great sources of vitamin B12. Dairy products, such as milk and yogurt, and cereals are fortified with vitamin B12.

Vitamin B12 is also available as a dietary supplement and as a prescription medication. The many forms include injections, nasal sprays, and pills.

The beneficial roles of vitamin B12 include:

  • Producing healthy red blood cells
  • Maintaining brain function
  • Boosting energy

Evidence for using vitamin B12 in HS is not very strong, as no large clinical trials have been done. However, in the few instances where it has been used, results so far have been positive.

In one case, a person with a 36-year history of HS had been treated with oral and topical antibiotics as well as isotretinoin, which had no effect on the condition. Despite having normal levels of vitamin B12, they were given vitamin B12 injections into the muscle every other week for six weeks, then once a month.

Vitamin B12 supplementation resulted in improved HS and fewer new flare-ups. The person continued to respond to vitamin B12 therapy for more than three years, up to the writing of the report.

One drawback is that muscle injections, which was how vitamin B12 was delivered in the study, can be painful and are inconvenient compared with swallowing a pill.

The body absorbs only as much vitamin B12 as it needs, and the rest is removed through the urine, so the nutrient is generally considered safe even at higher doses. However, at very high doses, vitamin B12 can cause:

  • Headache
  • Nausea
  • Vomiting
  • Diarrhea
  • Weakness
  • Tingling in the hands and feet

Communicate With Your Health Care Provider

Before starting to take any vitamins or supplements, turn to your dermatologist or other health care provider for trustworthy medical advice. Keep your doctor and pharmacist updated on your medication list — including over-the-counter medications, vitamins, and supplements — to avoid potentially dangerous drug interactions.

Diet modification or over-the-counter supplementation is not a replacement for the treatment options your doctor prescribes.

Talk With Others Who Understand

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 26,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.

Are you living with HS? Have you tried taking vitamins or supplements to help manage symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Hidradenitis Suppurativa and Diet: What’s Recommended? — Mayo Clinic
  2. Vitamin D — National Institutes of Health
  3. Hidradenitis Suppurativa: Seeking More Pieces to the Puzzle — Practical Dermatology
  4. How To Get More Vitamin D From Your Food — Cleveland Clinic
  5. Vitamin D Deficiency in Adults: Definition, Clinical Manifestations, and Treatment — UpToDate
  6. The Role of Nutrition in Immune-Mediated, Inflammatory Skin Disease: A Narrative Review — Nutrients
  7. Verneuil’s Disease, Innate Immunity and Vitamin D: A Pilot Study — Journal of the European Academy of Dermatology and Venereology
  8. Serum Zinc Levels in Hidradenitis Suppurativa: A Case-Control Study — American Journal of Clinical Dermatology
  9. Dietary and Metabolic Factors in the Pathogenesis of Hidradenitis Suppurativa: A Systematic Review — International Journal of Dermatology
  10. Hidradenitis Suppurativa and Zinc: A New Therapeutic Approach. A Pilot Study — Dermatology
  11. Combination of Oral Zinc Gluconate and Topical Triclosan: An Anti-Inflammatory Treatment Modality for Initial Hidradenitis Suppurativa — Journal of Dermatological Science
  12. Zinc Toxicity — The American Journal of Clinical Nutrition
  13. Turmeric — LiverTox
  14. Traditional Uses, Therapeutic Effects and Recent Advances of Curcumin: A Mini-Review — Mini Reviews in Medicinal Chemistry
  15. Role of Pro-Oxidants and Antioxidants in the Anti-Inflammatory and Apoptotic Effects of Curcumin (Diferuloylmethane) — Free Radical Biology and Medicine
  16. Curcumin: An Orally Bioavailable Blocker of TNF and Other Pro-Inflammatory Biomarkers — British Journal of Pharmacology
  17. Curcumin: A Review of Its Effects on Human Health — Foods
  18. Omega-3 Versus Omega-6 Polyunsaturated Fatty Acids in the Prevention and Treatment of Inflammatory Skin Diseases — International Journal of Molecular Sciences
  19. Pharmacology and Therapeutics of Omega-3 Polyunsaturated Fatty Acids in Chronic Inflammatory Disease — Pharmacology & Therapeutics
  20. Omega-3 Fatty Acids — National Institutes of Health Office of Dietary Supplements
  21. Omega-3 Supplements: In Depth — National Center for Complementary and Integrative Health
  22. Vitamin B12 — National Institutes of Health Office of Dietary Supplements
  23. Vitamin B12 Benefits and Best Sources — Cleveland Clinic
  24. Cyanocobalamin (Vitamin B12): Drug Information — UpToDate
  25. A Role for B12 in Inflammatory Bowel Disease Patients With Suppurative Dermatoses? An Experience With High Dose Vitamin B12 Therapy — Journal of Crohn’s and Colitis
  26. Intramuscular Injection — StatPearls
  27. Vitamin B-12 — Mayo Clinic

All updates must be accompanied by text or a picture.
Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here.
Jane Chung, PharmD, RPh earned a Bachelor of Science in Pharmacy Studies and a Doctor of Pharmacy from Northeastern University in Boston, MA. Learn more about her here.

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