Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic skin condition that causes lumps, lesions, and scars on various parts of the body. HS is caused by inflammation and causes discomfort and pain.
Body composition and diet can affect the treatment of hidradenitis suppurativa. A balanced, nutrient-dense diet can help manage weight and regulate the inflammation behind HS by providing fiber, antioxidant nutrients, vitamins like B12 and D, and minerals like zinc.
If you have HS, you may benefit from eating foods that provide a wide range of nutrients, including the following:
1. Complex carbohydrates
Carbohydrates make up the majority of most people’s diets. However, not all carbohydrates have the same nutritional value. Complex carbohydrates are rich in fiber, vitamins and minerals, while simple or refined carbohydrates (including added sugar) lack fiber and nutrients.
The American Academy of Dermatology recommends eating foods with complex carbohydrates instead of simple carbohydrates. The fiber and nutrients in these foods can help with inflammation and weight management.
Complex carbohydrate sources include:
- Whole grains: Whole grain bread, whole grain pasta, brown rice, oats, quinoa and bulgur
- Beans, peas and lentils: Black beans, chickpeas, green peas and lentils
- Fruits and vegetables: Apples, berries, avocado, spinach and kale
- Nuts and seeds: Walnuts, almonds, chia seeds and pumpkin seeds
2. Food rich in zinc
People with HS may be at greater risk of zinc deficiency. Zinc supplementation is believed to help symptoms by managing inflammation.
In one study, people who took zinc supplements for 90 days reported a significant reduction in the number and length of acute HS attacks at 12 and 24 weeks.
You can also increase your intake of zinc through food. Foods high in zinc include:
- seafood: Oysters, blue crab, shrimp and sardines
- Meat: Beef, pork and turkey
- grains: Breakfast cereals and oats
- Dairy products: Cheese, milk and yogurt
- lens: A type of legume
3. Food rich in vitamin D
Vitamin D deficiency is thought to be common among people with HS. People deficient in both HS and vitamin D tend to have higher levels of inflammatory markers in their blood.
Vitamin D may be beneficial for people with HS because it plays an important role in managing immune function and inflammation.
Although the main source of vitamin D is sun exposure, some foods also contain vitamin D, including:
- Cod liver oil
- A fish
- Milk
- Mushrooms that have been exposed to ultraviolet (UV) light
- Fortified cereals
4. Food rich in vitamin B12
Vitamin B12 plays a key role in breaking down homocysteine, an amino acid that the body naturally produces and uses to make protein.
High levels of homocysteine are known to contribute to inflammation. A small study showed higher blood homocysteine levels in people with HS. Higher levels are significantly associated with greater disease severity.
While the evidence is limited, experts think vitamin B12 may help manage HS because of the vitamin’s role in breaking down homocysteine.
Foods high in vitamin B12 include eggs and the following:
- Organic meat and meat: Beef liver, beef, chicken and turkey
- Fish and seafood: Salmon, canned tuna, clams and oysters
- Dairy products: Milk and cheese
- Tempeh: Food made from fermented soybeans
5. Food rich in omega-3 fatty acids
Omega-3 fatty acids may benefit HS by controlling inflammation. Although the evidence for HS is limited, omega-3 fatty acids have been shown to improve other inflammatory skin conditions, such as psoriasis and atopic dermatitis.
Foods that contain omega-3 fatty acids include walnuts and the following:
- Oily fish and shellfish: Salmon, herring, mackerel, trout, oysters and shrimp
- Oils: Canola and soybean oil
- Seeds: Flax seeds and chia seeds
6. Food rich in antioxidants
Antioxidants are substances that can prevent or delay cell damage. Examples include vitamins A, C, D, and E; minerals like selenium and zinc; and many non-nutritive compounds found mainly in plant-based foods. Antioxidant compounds are key in reducing inflammation, which can benefit people with HS.
Foods rich in antioxidants include:
- Green leafy vegetables: Spinach, kale and broccoli
- Citrus fruits: Oranges, lemons and grapefruits
- Berries: Blackberries, blueberries and raspberries
- Nuts and seeds: Almonds, Brazil nuts, pumpkin seeds and sesame seeds
People with HS may have different responses to different foods. Foods high in simple carbohydrates, dairy, or yeast have been reported to worsen symptoms in some people.
Simple carbohydrates
A diet high in simple carbohydrates is thought to worsen HS symptoms.
Simple carbohydrates can increase insulin and other hormones, which can cause overgrowth of skin cells (hyperkeratinization) that blocks hair follicles. Blocked hair follicles can cause the follicles to expand, where bacteria can enter, causing inflammation, scarring and worsening HS symptoms.
Simple carbohydrates include packaged foods with added sugar, sweets, candy, sugary drinks and white bread, rice and pasta.
Dairy products
Dairy products, such as milk, cheese, yogurt, and cream, are believed to have the same effect on hormones and hair follicle changes as simple carbohydrates, leading to worsening of HS symptoms.
Dairy products are a good source of important nutrients, such as calcium, phosphorus and vitamin D. Although dairy products may contribute to symptoms in some people with HS, the evidence is limited. You should consult your doctor before removing food groups from your diet.
Food with brewer’s yeast
Foods containing brewer’s yeast, or Saccharomyces cerevisiaemay worsen HS symptoms. Some people with HS may have an immune reaction to yeast. When they consume yeast, their body produces antibodies against the fungus, causing inflammation.
Foods and drinks that contain brewer’s yeast include:
- Baked products
- Black tea
- Vinegar
- I am a willow tree
- Old cheese
- Mushrooms
- Wine and beer
Here is an example of a meal for someone with hidradenitis suppurativa:
Breakfast
Breakfast options include:
- Bruschetta topped with eggs, avocado, green onion and tomato
- Oatmeal with banana, walnuts and milk of your choice
- Mushroom quiche cups filled with a mixture of spinach, garlic and egg
Lunch
Simple lunch options include:
- Fish and mixed vegetables cooked in one pan in the oven
- Grilled chicken salad with avocado, potatoes and red pepper
- Falafel made from chickpeas and vegetables, wrapped in pita bread with lettuce
Dinner
Dinner options include:
- Stuffed peppers with brown rice, black beans and salsa
- Meatball soup cooked with mixed vegetables
- Fried tofu on stewed spinach, topped with sesame seeds
There is no specific diet for hidradenitis suppurativa, but you may benefit from eating in a way that helps control weight and inflammation levels. Mediterranean and brewer’s yeast-free diets have been shown to help manage HS.
The Mediterranean diet emphasizes mostly plant-based foods, such as whole grains, fruits, vegetables, nuts, seeds, and seafood. It also includes moderate amounts of lean meat, eggs and dairy products. Diet can reduce markers of inflammation, so it can improve HS and reduce disease severity.
A diet without brewer’s yeast has been shown to improve pain and symptoms in people with HS. However, the evidence is limited due to the small number of studies, small study sizes, and results based on self-reported outcomes.
There is no standard diet for hidradenitis suppurativa (HS).
Following a balanced diet rich in fiber, antioxidant nutrients, zinc, and vitamin D can help reduce inflammation and manage weight—two factors that can improve HS symptoms.
You should also consider limiting foods that may make symptoms worse. Although these can vary from person to person, they include foods high in sugar, yeast and dairy. Talk to your healthcare provider to see what they recommend you eat and what you should limit.