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How To Feel Better With HS: Diet

Posted on December 14, 2022

Living with hidradenitis suppurativa (HS) can sometimes mean looking for answers that aren’t easy to find. For instance, some people notice their HS symptoms tend to flare when they eat certain foods, while others believe they are symptom-free when they choose to avoid specific ingredients.

“I have been able to determine my major food trigger — will be staying away from potatoes and pork,” one myHSteam member wrote. Another said, “It will be good to share our experiences regarding food we either avoid or consume more of to manage our symptoms. My triggers are dairy, artificial sweeteners, honey, cashews, peanuts, pizza, peppers, and alcohol.”

While there is no specific diet to follow for HS, and very limited evidence1 that dietary modifications can assist in treatment, some researchers believe following a Mediterranean diet can reduce inflammation and help with HS severity.2

Following a Mediterranean diet3 includes consuming foods high in antioxidants and polyphenols, rich in fiber, and high in omega-3 fatty acids. This typically includes lean proteins such as fish, a variety of fruits and vegetables, whole grains, and legumes. Equally important as consuming these foods is eliminating fried and processed foods from your diet, including sugary beverages, bacon, diet sodas, hot dogs, and cold cuts.3

To maintain your overall health, consider the following foods that may be beneficial for living with HS.

Foods That May Benefit People With HS

Some studies suggest that consuming ingredients that fall within the Mediterranean diet can reduce inflammation and decrease the severity of HS symptoms.3

  • Omega-3 fatty acids — These are an important component to an anti-inflammatory diet. Research shows they may have special benefits for autoimmune diseases as well.4 Food sources include chia seeds, salmon, mackerel, flaxseed, walnuts, and canola oil.
  • Turmeric — Turmeric and its active component — curcumin — can promote anti-inflammatory benefits,5 but little is known about a direct link between turmeric and HS. However, one review of current studies6 showed curcumin can be beneficial for skin diseases in general, so it may help protect individuals with HS from inflammation.
  • Zinc and vitamin D — Low blood levels of these nutrients have been associated with increased lesions in individuals with HS, although more research on the subject is needed.7 Be sure to obtain routine blood work from your health care team and ask about supplementing if either of these levels are low.

Foods That May Worsen HS Symptoms

Foods that may trigger or worsen HS symptoms will vary from person to person. The best way to identify food triggers is to keep a food journal and track your symptoms.

Comment below to let others know which foods have triggered your HS symptoms.

Some people with HS can benefit from eliminating the following ingredients from their diets. Always talk to a dietitian or your doctor before changing your eating habits.

  • Dairy products — One review of observational studies concluded that eliminating dairy may improve symptoms of HS for some people, but more conclusive research is needed.7 If dairy is eliminated from the diet, it is important to consume foods with calcium and vitamin D, such as leafy green vegetables, salmon, and fortified beverages like almond milk.
  • Brewer’s yeast — This ingredient, found in beer and bread, may trigger exacerbation of HS symptoms in some individuals. One study that included 12 participants found that elimination of brewer’s yeast and wheat helped with symptoms. However, due to the small sample size of this study, the 2019 North American Clinical Management Guidelines for Hidradenitis Suppurativa stated there was insufficient evidence for doctors to recommend a diet excluding brewer’s yeast.7
  • Sugar — Higher insulin levels have been connected to HS flares, and consuming sugar can boost your insulin levels. Therefore, consuming less sugar could be helpful for people with HS.3

Managing Weight To Improve HS Symptoms

Researchers have demonstrated a connection8 between HS disease severity and higher body mass index (BMI). In fact, one study showed that losing weight caused HS symptoms to decrease by 35 percent, with fewer sites on the body affected as well. The researchers noted that losing more than 15 percent of body weight resulted in a significant reduction in the severity of HS.10

Weight loss diets may help improve HS symptoms. If you are interested in losing weight, talk to your physician or a dietitian about which foods and meal plans might work best for you.

References
  1. Silfvast‐Kaiser, A., Youssef, R., & Paek, S. Y. (2019). Diet in hidradenitis suppurativa: a review of published and lay literature. International Journal of Dermatology, 58(11), 1225–1230. https://doi.org/10.1111/ijd.14465. Accessed September 2021.
  2. Collier, E., Shi, V. Y., Parvataneni, R. K., Lowes, M. A., & Hsiao, J. L. (2020). Special considerations for women with hidradenitis suppurativa. International Journal of Women’s Dermatology, 6(2), 85–88. https://doi.org/10.1016/j.ijwd.2020.02.005. Accessed September 2021.
  3. “Is there a diet for hidradenitis suppurativa?” American Academy of Dermatology Association. Retrieved from https://www.aad.org/public/diseases/a-z/hidradenitis-suppurativa-diet. Accessed September 2021.
  4. Simopoulos, A. (2013). Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases. Journal of the American College of Nutrition, 21:6, 495-505. https://www.tandfonline.com/doi/abs/10.1080/07315724.2002.10719248?journalCode=uacn20. Accessed September 2021.
  5. Hewlings, S., & Kalman, D. (2017). Curcumin: A Review of Its Effects on Human Health. Foods, 6(10), 92. https://doi.org/10.3390/foods6100092. Accessed September 2021.
  6. Mantzorou, M., Pavlidou, E., Vasios, G., Tsagalioti, E., & Giaginis, C. (2018). Effects of curcumin consumption on human chronic diseases: A narrative review of the most recent clinical data. Phytotherapy Research, 32(6), 957–975. https://doi.org/10.1002/ptr.6037. Accessed September 2021.
  7. Sivanand, A., Gulliver, W. P., Josan, C. K., Alhusayen, R., & Fleming, P. J. (2019). Weight Loss and Dietary Interventions for Hidradenitis Suppurativa: A Systematic Review. Journal of Cutaneous Medicine and Surgery, 24(1), 64–72. https://doi.org/10.1177/1203475419874412. Accessed September 2021.
  8. Theut Riis, P., Saunte, D. M., Benhadou, F., Del Marmol, V., Guillem, P., El-Domyati, M., Abdel-Wahab, H., Antoniou, C., Dessinioti, C., Gürer, M. A., Beksaç, B., Szepietowski, J. C., Matusiak, L., Emtestam, L., Lapins, J., Riad, H., Doss, N., Massa, A. F., Hamzavi, I., & Nicholson, C. (2018). Low and high body mass index in hidradenitis suppurativa patients — different subtypes? Journal of the European Academy of Dermatology and Venereology: JEADV, 32(2), 307–312. https://doi.org/10.1111/jdv.14599. Accessed September 2021.
  9. Kromann, C., Ibler, K., Kristiansen, V., & Jemec, G. (2014). The Influence of Body Weight on the Prevalence and Severity of Hidradenitis Suppurativa. Acta Dermato Venereologica, 94(5), 553–557. https://doi.org/10.2340/00015555-1800. Accessed September 2021.

Posted on December 14, 2022
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Kimberly McCloskey, R.D.N., L.D.N. is a Philadelphia-based registered and licensed dietitian who specializes in weight management and behavioral change. Learn more about her here.
myHSteam My hidradenitis suppurativa Team

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