If you have hidradenitis suppurativa (HS), you may wonder if certain foods trigger your symptoms. Some members of myHSteam turn to elimination diets to help determine if what they eat affects their condition. “Nightshades are huge triggers for an HS flare-up for me. They might not be for you, but an elimination diet will help you figure that out,” one member advised another.

Although there’s no one-size-fits-all diet for managing HS, it may be helpful to take a break from certain foods to try to discover which could be causing problems related to HS.

An elimination diet involves removing certain foods from your diet to see if they cause a reaction in your body. Below is some key information to know if you have HS and are interested in trying an elimination diet. Make sure you talk with your doctor or dietitian before trying a new diet.

Nutrition for Hidradenitis Suppurativa

Hidradenitis suppurativa is characterized by inflammation and painful lumps under the skin. These lumps can fill with pus and then erupt. The main treatment goals for HS are to relieve pain, decrease how often new lesions appear, and stop the condition and related health issues from getting worse.

In addition to options like topicals (medications applied to skin) or biologics to treat HS, diet and other lifestyle changes may be beneficial. For some people, making certain diet changes may help reduce inflammation and symptoms.

Plant-Forward Diet

Incorporating a variety of plant-based foods may support HS. Eating fruits and vegetables, especially those high in antioxidants like leafy greens and berries, supports overall skin health and reduces inflammation. It may also be beneficial to add anti-inflammatory herbs or spices like turmeric.

In a small study, dermatologists reported that people with HS had less diverse gut microorganisms compared to those without HS. This finding suggests that people with HS ate fewer vegetables, fruits, and other healthy plant-based foods. More research is needed, but it’s possible that eating a plant-based diet could lead to fewer HS flare-ups.

One myHSteam member explained how they changed their diet: “Kale. Cranberry juice. Little meat, little carbs. Lots of water. Berries. Fresh veggies. I try to keep the inside of my body clear of too many bad things. I also switched to avocado oil.”

Mediterranean Diet

Some researchers believe that the Mediterranean diet may be related to HS symptoms. In a small study in Italy, where following the Mediterranean diet is common, 41 people with HS and 41 without the condition recorded their food intake for seven days. The results showed that people with HS ate fewer Mediterranean diet foods compared to the other group.

A Mediterranean diet mainly includes fresh vegetables and fruits, whole grains, fish, beans, seafood, and extra-virgin olive oil. Red meat is rarely consumed, and processed foods like sugary drinks, diet soda, bacon, cold cuts, and hot dogs are avoided.

Weight Loss Diet

Some research indicates that weight loss may reduce HS symptoms. One study found that losing at least 15 percent of total body weight following bariatric (weight loss) surgery was linked with less severe HS. It’s important to note that people of all body sizes can have HS. The study authors also noted that weight loss probably wouldn’t improve symptoms in slender people.

Talk to your doctor or a dietitian if you have questions about losing weight.

Foods That May Trigger Symptoms of Hidradenitis Suppurativa

Certain foods can potentially trigger or worsen HS symptoms. Triggers vary from person to person, but there are some common dietary culprits. Although research is limited, some people have reported that removing nightshade vegetables, dairy products, brewer’s yeast, and simple carbohydrates or sugars may be helpful. After speaking with your doctor, you may want to consider removing these with an elimination diet.

• Dairy products — Milk, cheese, yogurt, and ice cream
• Sugar — Soda, sweetened cereals, syrups, candy, and dessert
• Brewer’s yeast — Beer, vinegar, and bread baked with baker’s yeast (pizza dough, sourdough)
• Nightshade vegetables — Tomatoes, potatoes, eggplants, and peppers

Elimination Diet for Hidradenitis Suppurativa

For an elimination diet, you stop eating certain foods to identify and treat food intolerances, allergies, and other conditions like irritable bowel syndrome, migraines, and hidradenitis suppurativa. It can be difficult to test for these intolerances, but an elimination diet may help identify problematic foods.

An elimination diet involves temporarily removing foods or food groups that are believed to cause adverse reactions, and then reintroducing them one at a time during a “challenge” phase. This strategy may help determine which foods trigger or worsen symptoms.

You can follow different protocols (detailed plans) for an elimination diet. One way is to start by eliminating the most common food allergy and intolerance culprits (citrus, dairy, eggs, gluten, soy, peanuts, tree nuts like almonds, shellfish, beef, and corn) or additives (such as colors, preservatives, and flavor enhancers). You avoid these food groups for four to six weeks while seeing if your symptoms improve. Then you start consuming each food group again, one at a time, to see if one type of food triggers symptoms.

Is an Elimination Diet Right for You?

Some myHSteam members have had success with elimination diets. “I went on an elimination ketogenic diet — no dairy, no sugar, no processed foods. I have had great health benefits from it and some improvement of the HS,” reported one member. “Recently, I had LEAP MRT tests done to check for foods that I have an inflammatory response to, and it was very surprising. Several of the foods that are considered ‘healthy’ were staple items in my diet for decades! Now I have much more information to work with.” (LEAP stands for Lifestyle Eating and Performance, an elimination diet program, and MRT stands for Mediator Release Test.)

Before you try an elimination diet, it’s important to consider some key points. The diet can be tricky to follow, so be sure to get some guidance from a dietitian or doctor. The restricted eating may result in nutrient deficiencies if not done correctly. You need to pay close attention to food labels and ingredients that may be listed as names that aren’t familiar to you, and a dietitian can help. Also, it’s important to be aware of your mental well-being, especially if you have another medical condition or a history of disordered eating.

Keep in mind that during the first week, your symptoms may get worse before getting better. If symptoms become severe or get worse for a couple of days, check with your health care practitioner.

Example of an Elimination Diet: One Day of Meals

If you have your doctor’s OK and want to try the elimination diet, here’s an example of what one day of elimination diet meals looks like, created by a registered dietitian at EatingWell.

Check With Your Doctor or Dietitian

If you’re not ready for a full elimination diet, you can also talk with your doctor or dietitian about starting to cut out certain foods you think may be causing problems for you. “Try cutting out cow’s dairy and … nightshade vegetables,” suggested one myHSteam member.

What works for one person may not help you, so always check with your health care provider before trying any new type of treatment for your hidradenitis suppurativa. They can discuss pros and cons and help you determine the best, safest approach for you.

Talk With Others Who Understand

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 43,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.

What have you tried that helps your HS symptoms? How do you reach your healthy eating goals? Share your experience in the comments below, or start a conversation by posting on your Activities page.