Hidradenitis Suppurativa (HS) Diet: Best Foods

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic skin condition that causes lumps, lesions, and scars in various areas of the body. HS is driven by inflammation and causes discomfort and pain.

Body composition and nutrition can influence the management of hidradenitis suppurativa. A balanced, nutrient-rich diet can help manage weight and regulate the inflammation behind HS by providing fiber, antioxidant nutrients, vitamins such as B12 and D, and minerals like zinc.

If you have HS, you may benefit from eating foods that provide a wide variety 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 those foods can help with inflammation and weight management.

Complex carbohydrate sources include:

• Whole grains: Whole wheat 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, avocados, spinach, and kale
• Nuts and seeds: Walnuts, almonds, chia seeds, and pumpkin seeds

2. Foods High in Zinc 

People with HS may be at a higher risk of zinc deficiency. Zinc supplementation is believed to help symptoms by managing inflammation.

In one study, people taking zinc supplements for 90 days reported a significant reduction in the number and length of acute HS flares at 12 and 24 weeks.

You can also increase your zinc consumption through food. Foods that are high in zinc include:

• Seafood: Oysters, blue crab, shrimp, and sardines
• Meats: Beef, pork, and turkey
• Grains: Breakfast cereal and oats 
• Dairy products: Cheese, milk, and yogurt
• Lentils: A type of legume

3. Foods High in Vitamin D

Vitamin D deficiency is thought to be common among people with HS. People with both HS and vitamin D deficiency tend to have higher levels of inflammatory markers in their blood.

Vitamin D can be beneficial for people with HS because it plays an important role in managing immune function and inflammation.

Although the major source of vitamin D is sun exposure, some foods also contain vitamin D, including:

• Cod liver oil
• Fish
• Milk
• Mushrooms that have been exposed to ultraviolet (UV) light
• Fortified cereals

4. Foods High in Vitamin B12 

Vitamin B12 plays a crucial role in breaking down homocysteine, an amino acid that the body naturally produces and uses to make proteins.

High homocysteine levels are known to contribute to inflammation. A small study showed higher blood homocysteine levels in people with HS. Higher levels were significantly linked to 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 that are high in vitamin B12 include eggs and the following:

• Organ meats and meats: Beef liver, beef, chicken, and turkey 
• Fish and seafood: Salmon, canned tuna, clams, and oysters 
• Dairy products: Milk and cheese
• Tempeh: A food made from fermented soybeans

5. Foods High in Omega-3 Fatty Acids

Omega-3 fatty acids can benefit HS by managing inflammation. Although the evidence specifically on 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:

• Fatty fish and shellfish: Salmon, herring, mackerel, trout, oysters, and shrimp
• Oils: Canola and soybean oil
• Seeds: Flaxseeds and chia seeds

6. Foods High in Antioxidants 

Antioxidants are substances that may prevent or delay cell damage. Examples include vitamins A, C, D, and E; minerals like selenium and zinc; and many non-nutrient compounds found mostly in plant-based foods. Antioxidant compounds are crucial in reducing inflammation, which can benefit people with HS.

Foods high in antioxidants include:

• Leafy green 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 various foods. Foods high in simple carbohydrates, dairy, or yeast have been reported to worsen symptoms in some people.

Simple Carbohydrates

Diets high in simple carbohydrates are thought to worsen symptoms of HS.

Simple carbohydrates can increase insulin and other hormones, which can trigger excessive skin cell growth (hyperkeratinization) that blocks hair follicles. Blocked hair follicles can lead to expansion of the follicles, where bacteria can enter, causing inflammation, scarring, and worsening HS symptoms.

Simple carbohydrates include packaged foods with added sugars, candy, sweets, sugary drinks, and white bread, rice, and pasta.

Dairy

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 worsened HS symptoms.

Dairy is a good source of important nutrients, such as calcium, phosphorus, and vitamin D. Although dairy may contribute to symptoms in some people with HS, the evidence is limited. You should consult your healthcare provider before removing food groups from your diet.

Food With Brewer’s Yeast

Foods containing brewer’s yeast, or Saccharomyces cerevisiae, can 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 containing brewer’s yeast include:

• Baked goods
• Black tea
• Vinegar
• Soy sauce
• Aged cheese
• Mushrooms
• Wine and beer

Here are meal examples for someone with hidradenitis suppurativa: 

Breakfast 

Breakfast options include:

• Bruschetta topped with eggs, avocado, green onions, and tomatoes
• Oatmeal with banana, walnuts, and your choice of milk
• Mushroom quiche cups filled with a mixture of spinach, garlic, and eggs

Lunch

Easy lunch options include:

• Fish and mixed vegetables cooked in one pan in the oven
• Grilled chicken salad with avocado, potatoes, and red peppers
• Falafel made with 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 sautéed spinach, topped with sesame seeds

There is no specific diet for hidradenitis suppurativa, but you might benefit from eating in a way that helps with weight management and inflammation levels. The Mediterranean diet and a brewer’s yeast-free diet 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 meats, eggs, and dairy. The diet can reduce inflammation markers, so it may improve HS and lower disease severity.

A brewer’s yeast-free diet has been shown to improve pain and symptoms in people with HS. However, 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 could help reduce inflammation and manage weight—two factors that can improve HS symptoms.

You should also consider limiting foods that can worsen symptoms. While these may vary by person, they include foods high in sugar, yeast, and dairy. Speak with your healthcare provider to see what they recommend you eat and what you should limit.