What patients eat matters in HS: pro‑inflammatory diets worsen disease; anti‑inflammatory patterns and targeted supplements may help
This literature review synthesizes recent studies connecting dietary patterns with hidradenitis suppurativa severity. Pro‑inflammatory diets (classically the Western diet, leucine‑rich regimens, and diets containing brewer’s yeast) are associated with HS exacerbation, with proposed mechanisms including mTOR activation and hormonal dysregulation. By contrast, anti‑inflammatory approaches such as the Mediterranean diet, very‑low‑calorie ketogenic diets, and dairy‑free regimens have shown promising reductions in flares and symptoms in observational studies and small interventional series. Supplementation with vitamin D and zinc produced clinical improvement in patients who had documented deficiencies, and emerging data suggest intermittent fasting may lower systemic inflammation and ease HS activity. The evidence base is heterogeneous, often observational or small, and mechanistic links are plausible but not yet proven in large randomized trials.
Clinical takeaway for practicing dermatologists: consider dietary history as part of HS assessment and discuss diet as an adjunctive, personalized strategy—prioritize anti‑inflammatory dietary patterns over blanket restrictive advice, test for and correct vitamin D or zinc deficiencies before empirical supplementation, and set realistic expectations about the current strength of evidence. Encourage collaboration with nutrition professionals for patients interested in structured dietary interventions, and watch for forthcoming randomized studies that may clarify which dietary changes most reliably alter HS course.
J Drugs Dermatol. 2025;24(11):1103-1105. doi:10.36849/JDD.9218
Blog write-up assisted by AI
