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Nutrition

HS Diet and Inflammation

What you eat can meaningfully affect your HS flare frequency and severity. Here is the evidence, and a practical guide to eating for lower inflammation.

Authoritative Resource

HS Nutrition & Lifestyle Guide

Evidence-informed guidance on anti-inflammatory eating, trigger foods, meal planning, and lifestyle adjustments for HS.

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The relationship between diet and HS is one of the most actively researched areas in HS management. While diet alone cannot cure HS, growing evidence suggests that specific dietary patterns can reduce flare frequency, decrease inflammation, and improve overall quality of life for many patients.

The key mechanisms involve insulin signaling, androgen production, and systemic inflammation, all of which are influenced by what we eat. Understanding these connections empowers you to make dietary choices that work with your medical treatment, not against it.

Dietary changes should complement, not replace, medical treatment. Consult a registered dietitian familiar with HS for personalized guidance.

Foods That May Trigger HS Flares

Evidence: Strong

Dairy Products

Why it matters: Contains IGF-1 and hormonal precursors that stimulate androgen production and sebaceous gland activity, key HS drivers.

Includes: Milk, cheese, yogurt, butter, ice cream, whey protein

Tip: Try dairy-free alternatives: oat milk, almond milk, coconut yogurt. Many patients see improvement within 4–8 weeks of dairy elimination.

Evidence: Strong

High-Glycemic Foods

Why it matters: Cause rapid insulin spikes that increase IGF-1 and androgen levels, promoting follicular occlusion and inflammation.

Includes: White bread, white rice, sugary drinks, pastries, candy, processed snacks

Tip: Replace with low-glycemic alternatives: whole grains, legumes, sweet potatoes. Pair carbohydrates with protein and fat to reduce glycemic impact.

Evidence: Moderate

Brewer's Yeast

Why it matters: May trigger immune responses in susceptible individuals. Reported by a subset of HS patients as a significant trigger.

Includes: Beer, certain breads (especially sourdough), nutritional yeast, some supplements

Tip: Try eliminating for 4–6 weeks to assess impact. Wine and spirits typically do not contain brewer's yeast.

Evidence: Anecdotal

Nightshade Vegetables

Why it matters: Contain alkaloids that may promote inflammation in some individuals. Evidence is primarily patient-reported.

Includes: Tomatoes, bell peppers, eggplant, potatoes, chili peppers

Tip: Nightshades are nutritious foods and not all HS patients are sensitive. Only eliminate if you notice a clear correlation with flares.

Anti-Inflammatory Foods to Emphasize

Rather than focusing only on what to avoid, building your diet around anti-inflammatory foods provides positive benefits for HS and overall health.

Food CategoryExamplesBenefit for HS
Fatty FishSalmon, sardines, mackerel, herringRich in omega-3s that reduce systemic inflammation
Leafy GreensSpinach, kale, Swiss chard, arugulaAntioxidants and anti-inflammatory compounds
BerriesBlueberries, strawberries, raspberriesAnthocyanins with potent anti-inflammatory effects
Olive OilExtra virgin olive oilOleocanthal mimics ibuprofen's anti-inflammatory mechanism
Nuts & SeedsWalnuts, almonds, flaxseed, chia seedsOmega-3s, zinc, and anti-inflammatory polyphenols
TurmericTurmeric, golden milk, curryCurcumin is a powerful anti-inflammatory compound
Zinc-Rich FoodsPumpkin seeds, beef, chickpeas, cashewsZinc deficiency linked to more severe HS
Whole GrainsOats, quinoa, brown rice, barleyLower glycemic index than refined grains; reduce insulin spikes

Sample Anti-Inflammatory Day of Eating

Breakfast

  • •Oatmeal with blueberries and walnuts
  • •2 eggs (scrambled or poached)
  • •Green tea or black coffee

Lunch

  • •Large salad with mixed greens, salmon, avocado, olive oil dressing
  • •Slice of whole grain bread
  • •Sparkling water with lemon

Dinner

  • •Baked salmon or chicken thighs with turmeric
  • •Roasted sweet potato and broccoli
  • •Brown rice or quinoa

Snacks

  • •Handful of mixed nuts and seeds
  • •Apple with almond butter
  • •Hummus with cucumber and carrot sticks

For a complete 7-day meal plan, visit our Nutrition & Lifestyle page.

Frequently Asked Questions

Does diet really affect hidradenitis suppurativa?
Yes, there is growing evidence that diet plays a meaningful role in HS disease activity. Multiple studies have found that dairy products and high-glycemic foods are the most commonly reported dietary triggers. The mechanism involves insulin-like growth factor 1 (IGF-1) from dairy and insulin spikes from high-glycemic foods, both of which stimulate androgen production and sebaceous gland activity , key drivers of HS inflammation.
What foods should I avoid with HS?
The most commonly reported HS dietary triggers are: dairy products (milk, cheese, yogurt, ice cream), high-glycemic foods (white bread, white rice, sugary drinks, pastries), brewer's yeast (beer, certain breads), and for some patients, nightshade vegetables (tomatoes, peppers, eggplant, potatoes). Individual responses vary significantly, an elimination diet can help identify your personal triggers.
What is the best diet for HS?
An anti-inflammatory diet is most commonly recommended for HS. This means emphasizing omega-3 rich foods (fatty fish, walnuts, flaxseed), colorful vegetables and fruits, whole grains, legumes, and olive oil while reducing dairy, refined carbohydrates, processed foods, and red meat. Some patients also benefit from a zinc-rich diet, as zinc deficiency has been associated with more severe HS.
Can going dairy-free help HS?
Many HS patients report significant improvement after eliminating dairy. A 2019 study found that 83% of HS patients who eliminated dairy reported improvement in their symptoms. The effect is thought to be related to IGF-1 and hormonal precursors in dairy that stimulate the same pathways involved in HS. Results are not universal, some patients see dramatic improvement while others notice little change.
Does intermittent fasting help HS?
Some HS patients report improvement with intermittent fasting, likely due to its anti-inflammatory effects and impact on insulin sensitivity. There is limited clinical research specifically on HS and fasting, but the mechanisms are plausible. If you have a history of disordered eating or other health conditions, discuss fasting approaches with your doctor before trying them.
How long does it take to see results from dietary changes?
Most patients who respond to dietary changes notice improvement within 4–12 weeks of consistently following an elimination diet or anti-inflammatory eating pattern. Flare frequency and severity are the most common metrics to track. Keep a food and symptom diary to identify correlations. Dietary changes work best as a complement to medical treatment, not a replacement.

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Medical References

  1. [1]Shen AS, et al. Dietary factors and hidradenitis suppurativa: a systematic review. Nutrients. 2023;15(23):4924. PubMed
  2. [2]Alikhan A, et al. North American clinical management guidelines for hidradenitis suppurativa. J Am Acad Dermatol. 2019;81(1):76-90. PubMed
  3. [3]Jemec GBE. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158-164. PubMed