Can Diet Improve Hidradenitis Suppurativa?
Healthy diets are the best allies for the prevention and treatment of many diseases. So, why not consider a diet for hidradenitis suppurativa?
The treatment of this skin condition relies on a therapeutic guide where the patient’s diet is part of the general non-pharmacological measures, according to the Argentine Society of Dermatology.
The studies don’t provide a great deal of evidence. However, the omission of some dairy, refined foods, sugars, and yeasts could improve symptoms.
Also, some supplements, such as vitamin D, zinc, and turmeric could be beneficial. So, let’s take a closer look at how a diet for hidradenitis suppurativa is helpful.
What is hidradenitis suppurativa?
Hidradenitis suppurativa (HS) is a chronic, recurrent, autoinflammatory skin disease that harms the quality of life. The hair follicle becomes clogged and forms bumps that become inflamed and rupture.
We also know it as inverted acne because the skin lesion appears underneath the skin. They’re common especially in areas where rubbing occurs, such as the armpits and groin.
It has a worldwide prevalence of 0.05% to 4% and women between the ages of 20 and 40 are more likely to suffer from it. Experts aren’t sure about the cause of the obstruction. However, genetics, obesity, skin rubbing, and smoking are among the risk factors.
How can diet help in the treatment of hidradenitis suppurativa?
Dr. Lawrence Gibson says that what you eat can have an impact on hidradenitis suppurativa. Nutritious, balanced diets can control excess weight and obesity, which are both risk factors.
There’s not enough evidence that any specific diet cures hidradenitis suppurativa. However, patients and physicians know the importance of nutritional management in the control of this pathology. Here, we’ll review some of the recommendations and advances.
A dairy-free diet
In the Journal of the American Academic of Dermatology, researchers highlight that, generally, dairy can contribute to acne and HS. By applying a dairy-free diet to 47 patients with the disease, 83% of the cases improved. Of the remaining 17%, none of them worsened.
Dairy products contain casein, whey, and hormones known as androgens, which clog the hair follicle. The researchers concluded that a dairy-free diet can reduce new lesions and decrease symptoms of hidradenitis suppurativa.
Therefore, recommendations include excluding milk, fresh cheeses, ricotta, cottage cheese, ripened cheeses, dairy ice cream, and yogurt. In the same way, you should stay away from heavy cream, buttermilk, and butter, among others.
Read also: How to Make Dairy-Free Coconut Ice Cream
A low glycemic load diet
A group of experts indicated that foods rich in simple carbohydrates, such as soft drinks, sweets, and ice cream, increase blood sugar levels. And, consequently, the secretion of insulin. This leads to an increase of androgens and an increase in the appearance of HS.
To lower the glycemic load of your diet, there are several items you should eliminate from your diet. These include sugars, desserts, sugary drinks, sweets, syrups, corn syrups, chocolate bars, and breakfast cereals. Likewise, you should increase your fiber intake by consuming vegetables, legumes, and fruits.
A wheat and yeast-free diet
Experts have linked wheat and yeast to an increase in the occurrence of HS symptoms. The production of beer, wine, and CO2 gas for bread doughs uses saccharomyces yeast. Several researchers found that this yeast causes a reaction in the immune system, producing intolerance.
A small study of 12 patients suffering from hidradenitis suppurativa who went on a yeast-free diet for 1 year showed that the lesions disappeared. What’s more, their quality of life improved. But when the patients ingested wheat or beer again, their symptoms returned.
Unfortunately, the sample size and the lack of a control group don’t allow for the generalization of the results. Also, it0 unclear whether the yeast problem occurs only in patients with wheat intolerance.
Just the same, recommendations include eliminating fermented alcoholic beverages, such as beer and wine. Also bread, cakes, pizza, soy sauces, dry soups, and all foods containing wheat and yeast.
The Mediterranean diet
The journal Nutrients shows the results of a study in 41 patients with HS who had low consumption of foods typical of the Mediterranean diet. At the same time, another group of patients who consumed them didn’t suffer from the condition.
The Mediterranean diet includes vegetables, fresh fruits, whole grains, beans, extra virgin olive oil, fish, and seafood. Meanwhile, it reduces the consumption of refined and processed foods. It has a low glycemic load and a high fiber content.
A Low-calorie diet
In some research, it’s been observed that many patients with hidradenitis suppurativa are obese and there is a direct relationship between body mass index and disease severity. Dr. Boer published that low-calorie diets that promote weight loss reduce the occurrence of the disorder.
In a retrospective study of obese patients undergoing bariatric surgery, it was found that those who reduced 15% of their weight reduced the severity of HS.
On the other hand, low-calorie diets include foods with high fiber content, as they produce satiety. Also, products with a high glycemic load, such as sugars and refined sugars, are excluded.
A vegan diet
Several studies connect good gastrointestinal function with skin health. This is related to the microorganisms that grow in the intestines (the gut microbiota). People with a higher diversity of microbiota are those who eat more vegetables.
The North American Guidelines for the Clinical Management of HS published that patients with hidradenitis suppurativa and low vegetable intake had a lower diversity of microbiota. The control group without HS and a diet rich in vegetables stood out for having greater diversity.
On the other hand, it seems that the exclusion of vegetables belonging to the Solanaceae family could improve symptoms, as occurs in some autoimmune diseases. These include potato, eggplant, tomato, paprika. However, there are no studies to support the information.
What supplements can help support the hidradenitis suppurativa diet?
Although there’s little progress in clinical trials on the use of supplements in the treatment of hidradenitis suppurativa, some specialists recommend them as adjuvant therapy.
Brocard and Dréno found that zinc gluconate at a dose of 90 milligrams per day worked to restore innate immunity in 22 patients with advanced stages of HS. Meanwhile, other professionals recommend 30 to 60 milligrams per day to improve the inflammatory process of acne.
Vitamin D also plays an important role in decreasing inflammation and experts have discussed its application in HS. In fact, a group of researchers observed that 63% of patients with HS and vitamin D deficiency had a small improvement after taking supplements.
Also, they recommend using vitamin D through food or as a supplement, rather than through the sun’s rays, as it can worsen the clinical picture.
Some studies refer to the capacity of turmeric as an antioxidant, anti-inflammatory, and immune system regulator. Its active compound, curcumin, modulates inflammation-producing compounds known as cytokines.
Therefore, turmeric could ameliorate the inflammatory process in hidradenitis suppurativa. Although there are no definite conclusions on dosage and formulation, experts recognize its positive effect.
There’s not just one diet for hidradenitis suppurativa
In conclusion, if you have hidradenitis suppurativa and you’re thinking of changing your diet, it’s best to consult your dermatologist immediately. That way, the professional can advise you on the type of diet that’s best suited to the stage of HS you’re in.
It’s also a good idea to consult a nutritionist to determine the nutritional status and the right foods to selected in the case of food intolerance. At the same time, the professional should consider special forms of preparation to increase fiber and zinc.
All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
- Danby FW. Diet in the prevention of hidradenitis suppurativa (acne inversa). J Am Acad Dermatol. 2015 Nov;73(5 Suppl 1):S52-4.
- Barrea L, Fabbrocini G, Annunziata G, Muscogiuri G, Donnarumma M, Marasca C, Colao A, Savastano S. Role of Nutrition and Adherence to the Mediterranean Diet in the Multidisciplinary Approach of Hidradenitis Suppurativa: Evaluation of Nutritional Status and Its Association with Severity of Disease. Nutrients. 2018 Dec 28;11(1):57.
- Choi F, Lehmer L, Ekelem C, Mesinkovska NA. Dietary and metabolic factors in the pathogenesis of hidradenitis suppurativa: a systematic review. Int J Dermatol. 2020 Feb;59(2):143-153.
- Danby FW, Margesson LJ. Hidradenitis suppurativa. Dermatol Clin. 2010 Oct;28(4):779-93.
- Rinaldi M, Perricone R, Blank M, Perricone C, Shoenfeld Y. Anti-Saccharomyces cerevisiae autoantibodies in autoimmune diseases: from bread baking to autoimmunity. Clin Rev Allergy Immunol. 2013 Oct;45(2):152-61.
- Kim Y, Chen J, Wirth MD, Shivappa N, Hebert JR. Lower Dietary Inflammatory Index Scores Are Associated with Lower Glycemic Index Scores among College Students. Nutrients. 2018;10(2):182.