Searching online for information about a “hidradenitis suppurativa diet” can often lead to conflicting advice, including varied results from Reddit threads, blog posts that advocate miracle foods, and elimination diets that are challenging to follow. One person swears cutting out dairy changed their life. Another found salvation in the keto lifestyle. Someone else is thriving on a plant-based plan. So what’s the truth? Does your diet really affect hidradenitis suppurativa (HS), or is it just nutritional noise?
Let’s separate the kale from the clutter and take a science-based, patient-centered look at the intricate relationship between your diet, gut microbiome, and HS.
First Things First: What Is HS?
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful nodules, abscesses, and tunnels (sinus tracts) that typically develop in areas where skin rubs together, such as the armpits, groin, buttocks, and under the breasts. There is no universal trigger, which can be frustrating for patients. Genetics, hormones, stress, smoking, weight, and even diet may all play a role.
One increasingly compelling area of interest is the gut microbiome. This complex ecosystem of bacteria, fungi, and other microorganisms plays a crucial role in regulating the immune system, controlling inflammation, and maintaining skin health. A healthy, diverse microbiome helps keep inflammation under control, while an imbalanced one (a condition called dysbiosis) may contribute to worsening HS symptoms.
The Allure of the “Miracle Diet”
When you’re living with a chronic disease that causes daily discomfort, it’s only natural to search for a measure of control. Diet feels like something you can control, and the idea that a simple food swap could ease symptoms is incredibly appealing. But without a thoughtful approach, this search can sometimes lead to disappointment, food fears, or even disordered eating.
So let’s explore what the evidence actually tells us—and where the science is still uncertain.
Dairy and HS: Frenemies or Foes?
Some patients find that eliminating dairy helps reduce their HS symptoms, and emerging evidence suggests this may be worth exploring [1]. Dairy products contain hormones and bioactive molecules, such as insulin-like growth factor 1 (IGF-1), that have been linked to inflammation and acne-like skin conditions [2,3]. However, one comprehensive review found that dairy may actually have anti-inflammatory effects for many individuals, suggesting that its impact may vary based on personal tolerance and underlying health conditions [4].
The takeaway? If you suspect dairy might be a trigger, consider a trial elimination for 6-8 weeks, then reintroduce it to see how your body reacts. However, don’t cut dairy solely because of internet trends—especially if it’s one of your primary sources of calcium and protein.
Sugar, Insulin Resistance, and HS
Here’s where the science gets interesting: HS is associated with metabolic syndrome, insulin resistance, and obesity. Studies show that individuals with HS are significantly more likely to meet the criteria for metabolic syndrome and insulin resistance compared to the general population [5]. Diets high in sugar can spike insulin levels, causing inflammation and hormonal imbalances that may worsen HS flares [6].
Cutting back on processed sugars and refined carbohydrates is smart, particularly for those with HS. But don’t worry—this doesn’t mean you have to give up carbs altogether or follow a restrictive diet. Instead, focus on whole foods, fiber-rich ingredients, and low-glycemic options. Think of your diet as a way to nourish your body with what it truly needs; not as a list of things you can’t have, but as a path to feeling your best while still enjoying the foods you love.
And here’s a bonus: fiber doesn’t just support healthy digestion. It also feeds the good bacteria in your gut, helping to maintain a balanced microbiome. A strong, diverse microbiome may play a key role in regulating your immune system and could reduce the frequency of HS flares [7].
Gluten and Autoimmunity: A Weak Link
Some HS patients experiment with gluten-free diets, especially those with coexisting autoimmune conditions like celiac disease. However, there’s no strong scientific evidence that gluten directly affects HS in most people.
If you feel better without gluten and your doctor supports it, then go for it—but there’s no need to self-impose this restriction without a valid reason.
Anti-Inflammatory Diets: Mediterranean for the Win
Research often points to the Mediterranean diet as beneficial for health, including for those managing HS.
This approach to eating—abundant in fruits, vegetables, whole grains, fatty fish, olive oil, and nuts—has been associated with reduced inflammation, enhanced metabolic function, and improved overall well-being. For people living with HS, that can mean fewer painful flares and a higher quality of life.
A small study published in the Journal of the American Academy of Dermatology found that individuals with HS who followed a Mediterranean-style diet experienced fewer disease flares and reported feeling better overall [8].
This diet reduces inflammation and is beneficial for gut health, which is a critical factor in managing HS [9]. Thanks to its high fiber content and inclusion of prebiotic and probiotic foods, the Mediterranean diet helps nourish a diverse and balanced gut microbiome. Since the gut and skin are closely connected, improving microbiome health may help regulate inflammation and maintain healthier skin overall.
Weight Loss and Symptom Relief
Weight can impact health. HS is not caused by being overweight, but excess weight may exacerbate symptoms, due to increased friction, inflammation, and hormonal imbalance.
Losing even 5-10% of your body weight can reduce the severity and frequency of HS flares [10], but here’s the key: it’s not about fad diets or punishing yourself. Sustainable, supportive lifestyle changes that include balanced nutrition, movement, and stress reduction are far more effective (and kind).
Positive dietary changes often lead to improved gut health. Supporting your microbiome with a diverse, fiber-rich diet can make weight loss more sustainable and reduce inflammatory cycles.
What About Supplements?
You may come across vitamin D [11], zinc [12], and turmeric [13] in the news or online discussions about HS. Some emerging evidence suggests these supplements may help reduce inflammation in certain people. They may also support gut health—for instance, zinc plays a role in maintaining the intestinal lining and supporting immune function.
But remember, supplements are just that—supplementary. Always check with your physician before supplementing your diet with anything new.
The Gut-Skin Axis: An Exciting Frontier
One of the most promising areas of HS research is the gut-skin axis—the connection between the gut microbiome and skin health. Your gut hosts trillions of bacteria that communicate with your immune system. When this ecosystem is out of balance (a condition known as dysbiosis), it may contribute to systemic inflammation and trigger HS flares.
A healthy microbiome can support immune regulation and skin integrity. Diets rich in plant fibers, polyphenols, and fermented foods can help restore microbial balance [14]. Think: artichokes, garlic, oats, berries, and cultured foods like yogurt, kimchi, and sauerkraut.
Some researchers believe targeting the microbiome through diet or even probiotic therapy could be part of future HS treatment strategies. While we’re not there yet, these early insights give us powerful, practical steps to take now.
Listen to Your Body, Not Just the Internet
If there’s one key takeaway from this blog, let it be this: hidradenitis suppurativa is incredibly personal. What triggers one person’s flare-up may have no impact on someone else. While there’s no single “HS diet,” there is value in tuning into your body’s signals and tracking patterns.
Keep a “food and symptoms” journal for a few weeks. You might notice trends that help you craft a personalized nutrition plan that supports your skin, gut, and overall health.
We’re Here to Support You
At Thrive Reconstructive Surgery, we understand that healing from HS takes more than surgery alone. That’s why we take a whole-person approach, supporting patients with everything from wound care to nutrition. Our network includes knowledgeable dietitians who understand the unique needs of HS patients, and we can help you build a plan that nourishes your skin and microbiome—without feeling restrictive.
We also stay current on the latest research on the gut-skin axis, and we’re here to help you navigate the emerging science on diet, microbiome health, and inflammation in HS.
We believe in progress, not perfection. Whether you’re just starting to explore dietary changes or managing multiple aspects of HS, you don’t have to do it alone.
Bottom Line: Eat to Thrive, Not Just to Survive
So can diet help HS? Absolutely—but it’s not a magic bullet. Think of nutrition as a powerful ally in your healing journey. The right foods can lower inflammation, support your microbiome, ease flares, and boost your overall quality of life. But the real magic happens when diet is woven into a broader, more compassionate treatment plan—one that includes medical care, surgery when indicated, mental health support, and lifestyle strategies tailored to you.
Eat foods that make you feel good. Observe, don’t obsess. Be curious, not critical. And most of all, be gentle with yourself.
You deserve healing. You deserve hope. And you deserve a team that helps you THRIVE!
References
- Silfvast-Kaiser, Annika, Ronnie Youssef, So Yeon Paek. 2019. “Diet in hidradenitis suppurativa: a review of published and lay literature.” International Journal of Dermatology 58 (11): 1225–30. https://doi.org/10.1111/ijd.14465.
- Danby, F. William. 2010. “Nutrition and acne.” Clinics in Dermatology 28 (6): 598–604. https://doi.org/10.1016/j.clindermatol.2010.03.017.
- Adebamowo, Clement A., Donna Spiegelman, F. William Danby, et al. 2005. “High school dietary dairy intake and teenage acne.” Journal of the American Academy of Dermatology 52 (2): 207–14. https://doi.org/10.1016/j.jaad.2004.08.007.
- Bordoni, Alessandra, Francesca Danesi, Dominique Dardevet, et al. 2017. “Dairy products and inflammation: A review of the clinical evidence.” Criticial Reviews in Food Science and Nutrition 57 (12): 2497–2525. https://doi.org/10.1080/10408398.2014.967385.
- Özkur, Ezgi, Yasemin Erdem, İlknur Kıvanç Altunay, et al. 2020. “Serum irisin level, insulin resistance, and lipid profiles in patients with hidradenitis suppurativa: a case-control study.” Anais Brasileiros de Dermatologia. 95 (6): 708-13. https://doi.org/10.1016/j.abd.2020.04.009.
- Melnik, Bodo C., Christos C. Zouboulis. 2013. “Potential role of FoxO1 and mTORC1 in the pathogenesis of Western diet-induced acne.” Experimental Dermatology 22 (5): 311-15. https://doi.org/10.1111/exd.12142.
- Gilbert, Jack A., Martin J. Blaser, J. Gregory Caporaso, et al. 2018. “Current understanding of the human microbiome.” Nature Medicine 24 (4): 392-400. https://doi.org/10.1038/nm.4517.
- Barrea, Luigi, Gabriella Fabbrocini, Guiseppe Annunziata, et al. 2019. “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 11 (1): 57. https://doi.org/10.3390/nu11010057.
- Khavandegar, Armin, Ali Heidarzadeh, Pooneh Angoorani, et al. 2024. “Adherence to the Mediterranean diet can beneficially affect the gut microbiota composition: a systematic review.” BMC Medical Genomics 17 (1): 91. https://doi.org/10.1186/s12920-024-01861-3.
- Lyons, Daniel, Anusha Louly Nathan, Emily Pender, et al. 2024. “Semaglutide for weight loss in people with obesity as an adjunctive treatment for hidradenitis suppurativa: its impact on disease control and quality of life.” British Journal of Dermatology 191 (4): 631-33. https://doi.org/10.1093/bjd/ljae216.
- Seetan, Khaled, Batool Eldos, Muthanna Saraireh, et al. 2022. “Prevalence of low vitamin D levels in patients with Hidradenitis suppurativa in Jordan: A comparative cross-sectional study.” PLoS One 17 (3): e0265672. https://doi.org/10.1371/journal.pone.0265672.
- Brocard, Annabelle, Anne-Chantal Knol, Amir Khammari, et al. 2007. “Hidradenitis suppurativa and zinc: a new therapeutic approach.” Dermatology 214 (4): 325-27. https://doi.org/10.1159/000100883.
- Hewlings, Susan J., Douglas S. Kalman. 2017. “Curcumin: a review of its effects on human health.” Foods 6 (10): 92. https://doi.org/10.3390/foods6100092.
- Loo, Yit Tao, Kate Howell, Miin Chan, et al. 2020. “Modulation of the human gut microbiota by phenolics and phenolic fiber‐rich foods.” Comprehensive Reviews in Food Science and Food Safety 19 (4): 1268–98. https://doi.org/10.1111/1541-4337.12563.