Sweets, Grains, Dairy, and High-Fat Foods May Exacerbate Hidradenitis Suppurativa

A group of superfoods
A group of superfoods
Foods most likely to exacerbate and alleviate symptoms in patients with hidradenitis suppurativa (HS) were identified.

Sweets, grains, dairy, and foods high in fat are likely to cause exacerbations in hidradenitis suppurativa (HS), according to findings from a survey published in Dermatologic Therapy.

The survey was an anonymous web-based questionnaire distributed to participants of Facebook HS support groups and patients at 3 specialty HS clinics in the United States from 2017 through 2019. Questions on the survey asked participants about demographics, disease characteristics, and dietary choices.

Participants were specifically asked if eating certain types of food worsened or made their disease better. A list of foods was provided for participants to select in their answers. Foods that participants said worsened HS were considered “exacerbating foods,” whereas “alleviating foods” were foods that participants reported improved their HS.

A significantly higher mean BMI was observed in participants with Hurley stage 2 or 3 vs stage 1 (36.6 and 36.4 vs 31.9 kg/m2, respectively; P <.001). Participants who resided 8 or fewer kilometers from a grocery store had significantly lower BMI compared with those who lived more than 16 km away (35.4 vs 38.0 kg/m2, respectively; P =.013). Approximately 35.2% of the overall cohort said they were receiving dietary counseling from a healthcare provider.

A total of 770 people with HS (age, 36.5±10.8 years) participated in the survey. Approximately 12.0% of participants identified alleviating foods, including vegetables (78.7%), fruit (56.2%), chicken (51.7%), and fish (42.7%). A larger percentage of participants (32.6%) reported they had experience with exacerbating foods, including sweets (67.9%), bread/pasta/rice (51.1%), dairy (50.6%), and high-fat foods (44.2%).

This study was subject to several limitations, including recall bias, the inclusion of participants with a self-reported diagnosis of HS, as well as the lack of a controlled environment in which food intake and exacerbations could have been monitored.

Although the investigators of the study noted that future research will need to evaluate the mechanism underlying the link between diet and HS, they added that patients with HS “may benefit from incorporating dietary changes into a comprehensive HS management plan.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Fernandez JM, Marr KD, Hendricks AJ, et al. Alleviating and exacerbating foods in hidradenitis suppurativa. Published online August 29, 2020. Dermatol Ther. doi:10.1111/dth.14246