Living with hidradenitis suppurativa (HS) can mean looking for ways to ease the painful lumps and abscesses on your skin. You may wonder whether outside factors, like what you eat, can help control inflammation and improve your symptoms.

There’s no single diet that works for everyone with HS. But some people notice that certain foods make their symptoms better or worse. Nightshade vegetables are one group that often gets attention as a possible trigger.

“I’ve been struggling with HS for years,” one myHSteam member said. “I get sebaceous cysts on the back of my neck, and they are so painful. I also just had a pilonidal cyst — my first and I hope only. I have cut all nightshade vegetables out of my diet, and I have seen improvement.”

Some people report fewer symptoms after removing nightshade vegetables from their diet, but research on this is still limited. Cutting out nightshades may also have risks, since these foods offer valuable nutrients. Understanding the science behind why these vegetables may affect your condition can help you and your healthcare team decide whether to include nightshades in your hidradenitis suppurativa diet.

What Are Nightshade Vegetables?

Nightshade vegetables are part of the Solanaceae plant nightshade family. It’s believed that they got the name “nightshade” because they flower in the shade. Nightshade foods include the following vegetables, fruits, herbs, and spices:

• Eggplant
• Peppers
• Tomatoes
• Bell peppers
• Goji berries
• Golden berries
• Cayenne pepper
• Crushed red pepper
• Paprika

“Another trigger that really gets me flaring up is capsaicin, which is found in peppers,” a member of myHSteam said. “This generates a full-on immune response for me on my already overactive immune system. Also, that’s a nightshade (on most doctors’ ‘avoid’ list).”

Are Nightshade Vegetables Healthy?

Nightshade vegetables are low in calories and rich sources of vitamins, minerals, and antioxidants, or substances that help protect your cells. The American Institute for Cancer Research has even ranked some nightshades, such as tomatoes, among the top cancer-fighting foods. Here are a few highlights:

• Tomatoes — Vitamin C, potassium, and lycopene (an antioxidant that has heart and health benefits and prevents some forms of cancer)
• Potatoes — Vitamin C, B6, potassium, and fiber
• Peppers — Vitamin C, vitamin A, and antioxidants
• Eggplants — Fiber, vitamins, and phytonutrients that support overall health

Some research has linked nightshades to inflammation and chronic conditions. These include inflammatory bowel disease (IBD) psoriasis, arthritis, and HS.

Do Nightshade Vegetables Cause Inflammation?

HS is an autoinflammatory disease that causes your body to attack its own hair follicles, which leads to inflammation. Some people believe certain foods can make inflammation better or worse. There is no solid evidence that nightshade vegetables cause problems for inflammatory conditions, but there are a few possible reasons they may trigger reactions, such as intolerance or sensitivity. Some people with inflammatory conditions such as HS do report that nightshades make their symptoms worse.

“Ate a lot of foods I don’t normally eat. Lots of spices and noticed five new flares. Is it related?” one myHSteam member asked.

“Food is a trigger for some, but not all,” another member replied. “Nightshades definitely can be a trigger! Stress is another huge trigger for those with HS!”

Nightshades contain chemicals that act like natural pesticides, protecting the plants from insects. These chemicals include alkaloids such as solanine and lectins. These are thought to be harmful to humans in large doses. In very large amounts — or in people who are sensitive — alkaloids may cause unpleasant symptoms. These may include joint pain, fatigue, digestive issues, and swelling.

Best Hidradenitis Suppurativa Diets

There’s no single diet that works for everyone with HS. What matters most is working with your doctor or dietitian to find any triggers while making sure you still get the nutrition you need for overall health.

Elimination Diet

Some common hidradenitis suppurativa trigger foods include dairy, brewer’s yeast, nightshade vegetables, and sugar. If you think you may be sensitive to nightshade vegetables or other foods, you can consider an elimination diet. This diet involves cutting out certain foods and then slowly adding them back to see if they cause a reaction. If you decide to try it, make sure you do so with medical guidance.

Mediterranean Diet

Some foods are known to promote inflammation, such as sweets, processed meats, and white pasta or bread. Reducing these foods and choosing a more anti-inflammatory diet may help. Some researchers have noticed that people with HS who follow a Mediterranean diet have fewer flare-ups.

The Mediterranean diet includes plenty of fresh fruits and vegetables, fish, legumes, whole grains, and olive oil. It also limits sugar, processed meat, fried foods, and fast food. If you suspect that nightshade vegetables may be a trigger for you, you can still follow a Mediterranean diet by making these swaps:

• Sweet potatoes instead of white potatoes
• Zucchini, squash, or carrots instead of eggplant
• Leafy greens like spinach or kale instead of tomatoes
• Cucumbers or snap peas instead of bell peppers

Weight Loss Diet

Some small studies suggest that weight loss may lead to fewer HS lumps and flares. Gradual weight loss may also help reduce friction and inflammation in areas where flare-ups often occur. A balanced weight loss plan focuses on lean proteins, fruits, vegetables, whole grains, and healthy fats. It also gently reduces calorie intake and increases activity. One way to do this is by making simple swaps in your daily cooking techniques.

How To Eat Nightshade Vegetables With HS

Here are a few practical ways to approach eating nightshade vegetables if you’re living with hidradenitis suppurativa and wondering whether they affect your symptoms.

Keep Track

If you think nightshade vegetables may trigger your symptoms, keeping a food diary can help you spot patterns and sensitivities. Write down what you eat each day and note any flare-ups. Also consider other lifestyle factors, such as medications, hydration, stress, sleep, and exercise.

Cooking Thoroughly

Cooking nightshade vegetables may lower some of the alkaloids and lectins they contain. This may make them easier for some people to tolerate. Methods like roasting, steaming, or boiling can help break down these compounds and may make the vegetables gentler on digestion.

Swap Other Vegetables

Many people struggle to eat enough vegetables, which could lead to nutrient deficiencies. If you choose to avoid nightshade vegetables, make sure you get enough nutrients from other fruits and vegetables. Leafy greens, carrots, beets, squash, and cauliflower can help you meet your nutritional needs without missing important vitamins and minerals that support your skin and overall health.

Consult Professionals

Always work with your doctor, dermatologist, and a registered dietitian who understands HS. They can help you create a personalized nutrition plan and you decide whether nightshades are an issue for you. They can also make sure your diet stays balanced to support your health and your skin.

Join the Conversation

On myHSteam, people share their experiences with hidradenitis suppurativa, get advice, and find support from others who understand.

Do you notice any effects from eating nightshade vegetables? Let others know in the comments below.