Should You Try a Paleo Diet With Hidradenitis Suppurativa?

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Could what you eat really affect your hidradenitis suppurativa (HS)? There are many different reports about the effect of diet on HS, also known as acne inversa, a rare skin condition that results in painful lumps under the skin. Some people who’ve changed their diet have seen little to no effect on their condition, while others have reported a full recovery.

The Paleo Diet, in particular, has received a lot of attention as a way to improve HS symptoms. This diet consists of mostly fresh fruits and vegetables and some meats, and eliminates dairy, cereal grains, refined sugar, beans, legumes and processed foods. Although no specific diet has been proven to cure HS, and further research is needed, there is some evidence that certain food choices may be helpful.&

The Diet and Symptom Connection

When you’re living with HS, one of the main goals is to prevent new lesions from forming. Lesions develop when hair follicles become blocked and inflamed. Though the reasons for this aren’t clear, some possible causes could be hormonal activity, genetics, an irregular immune system response or excess weight.

Since what we eat can affect our hormones and immune system, some studies suggest avoiding certain foods may help keep lesions from progressing and possibly prevent new ones. Eating a balanced and nutritious diet can also prevent weight gain. Extra weight can cause friction in areas where lesions often appear, so keeping the weight off can provide some physical relief. And you will likely feel better about how you look and feel, which can help with any issues of self-esteem you may have because of your condition.

Foods to Avoid

  • Dairy. Milk, cheese and other dairy products can raise insulin levels and promote hormone growth.

  • Sugar. Too much sugar can also raise insulin levels. Try to cut back on foods with added sugars and syrups, such as cereals, candy and sodas.

  • Processed foods. Most processed and fast foods are full of insulin-raising sugar and carbohydrates. Try to avoid the inner aisles of the grocery store, where most of these processed and packaged foods are found.

  • Wheat. Cutting out wheat, found in many products (not just bread and baked goods), and other grain products (wheat, rye, barley, oats, rice, corn, sorghum and millet) has been reported to reduce inflammation and improve symptoms.

  • Red meat. Some claim that red meat makes their HS symptoms worse, so you may consider removing this from your diet to see if your symptoms improve.

What to Eat

Eating a natural, low-glycemic diet, like a Paleo Diet, with zero dairy can help you control your weight by minimizing spikes in your blood sugar and insulin levels. When combined with exercise, this type of diet may lessen the symptoms of HS and promote healing of lesions. Low-glycemic foods include:

  • Healthful proteins, such as beans, fish and skinless chicken

  • Non-starchy vegetables — which have fewer carbohydrates and calories — such as broccoli, spinach, artichokes, asparagus, beets, cauliflower and carrots

  • Fruits, such as apples, pears, peaches, berries, bananas, mangoes and papayas

  • Low-processed grains, such as brown rice, whole-kernel bread, stone-ground bread, steel-cut oats, natural granola and muesli breakfast cereals

  • Moderate amounts of healthful fats, such as olive oil, nuts and avocados

Try to eat three meals and one or two snacks a day, and be sure not to skip breakfast, which has been shown to help with weight control. To avoid overeating, eat slowly, and stop when you are full.

Patience is Key

Of course, making changes to your diet doesn’t happen overnight, and it may take several weeks or even months for you to notice improvement in your symptoms. Before making any significant dietary changes, talk to your doctor. Though changing what you eat may help, he or she may still recommend other hidradenitis suppurativa treatment, such as medication or surgery, for your condition.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Oct 3

  1. HS/AI Information. Hidradenitis Suppurativa Foundation.

  2. Diet in the prevention of Hidradenitis Suppurativa (Acne Inversa). US National Library of Medicine, National Institutes of Health.

  3. Hidradenitis Suppurativa and Diet: What’s recommended? Mayo Clinic.

  4. Hidradenitis Suppurativa. Mayo Clinic.

  5. 8 principles of low-glycemic eating. Harvard Health Publishing.

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