Evidence-Based Nutrition

Anti-Inflammatory Diet

Chronic inflammation is linked to heart disease, diabetes, cancer, and autoimmune conditions. Discover the foods that help fight inflammation and the ones that fuel it — all backed by research from leading medical institutions.

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Blood Sugar Management

Diabetic Diet

Managing blood sugar through diet is one of the most powerful tools for controlling diabetes. Focus on low-glycemic foods, balanced macronutrients, and fiber-rich choices to maintain stable glucose levels and reduce complications.

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📊 Note on Glycemic Index: The Glycemic Index (GI) rates foods 0-100 based on how quickly they raise blood sugar. Low GI (55 or less) foods are preferred. Focus on whole, unprocessed foods and pair carbohydrates with protein, fat, or fiber to slow glucose absorption.
Metabolic Health

Metabolic Syndrome Diet

Metabolic syndrome is diagnosed when 3 or more of these 5 criteria are present: elevated waist circumference, high triglycerides, low HDL cholesterol, high blood pressure, and elevated fasting blood sugar. Diet is one of the most effective interventions.

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💡 DASH & Mediterranean Diets: Both the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean diets are strongly recommended for metabolic syndrome. They emphasize fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting sodium, processed foods, and added sugars.
Comprehensive Guide

Hidradenitis Suppurativa

A Comprehensive Guide to Treatment & Management

Hidradenitis Suppurativa is a chronic inflammatory skin condition causing painful lumps, abscesses, and tunnels under the skin, typically in areas where skin rubs together (armpits, groin, buttocks, under breasts). While there is no cure, a combination of medical treatments, dietary changes, lifestyle modifications, and home remedies can significantly reduce flare-ups and improve quality of life.

Hurley Staging System

HS severity is classified into three stages

Stage I (Mild)

Single or multiple abscesses without sinus tracts or scarring

Stage II (Moderate)

Recurrent abscesses with sinus tracts and scarring, widely separated lesions

Stage III (Severe)

Diffuse or interconnected sinus tracts and abscesses across entire area

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Medical Treatments

Professional treatments organized by category — always consult your dermatologist

Applied directly to affected skin areas to reduce bacteria and inflammation.
Topical Clindamycin Antibiotic gel/lotion applied to mild lesions to fight infection
Topical Gentamicin Antibiotic for reducing bacterial load on affected areas
Topical Resorcinol (15%) Chemical peeling agent with anti-inflammatory and keratolytic properties; reduces pain and lesion size
Benzoyl Peroxide Wash Antibacterial wash to help prevent bacterial buildup
Antiseptic Washes (Chlorhexidine) Reduce surface bacteria and help prevent secondary infections
Zinc Oxide Cream Topical zinc to reduce inflammation and protect skin
Prescribed for moderate HS to control bacterial infection and reduce inflammation systemically.
Doxycycline (100mg 1-2x daily) First-line tetracycline antibiotic with anti-inflammatory properties
Minocycline (100mg 1-2x daily) Tetracycline alternative for patients who cannot tolerate doxycycline
Clindamycin + Rifampin combination Dual antibiotic therapy for moderate-severe cases; typically prescribed for 10-12 weeks
Tetracycline (500mg 2x daily) Broad-spectrum antibiotic for HS management
Metronidazole Additional antibiotic option for complex cases
Trimethoprim-Sulfamethoxazole Alternative antibiotic for resistant infections
Advanced immunomodulatory medications that target specific inflammatory pathways. For moderate-to-severe HS that hasn't responded to antibiotics.
Adalimumab (Humira) FDA-approved TNF-alpha inhibitor; most established biologic for HS
Secukinumab (Cosentyx) IL-17A inhibitor recently approved for HS treatment
Infliximab (Remicade) TNF-alpha inhibitor used off-label for severe cases
Ustekinumab (Stelara) IL-12/23 inhibitor used for refractory HS
Anakinra (Kineret) IL-1 receptor antagonist for severe HS
Canakinumab (Ilaris) IL-1 beta inhibitor for severe, treatment-resistant HS
Bimekizumab (Bimzelx) Dual IL-17A and IL-17F inhibitor showing promising results
Address hormonal factors that may contribute to HS flares, particularly effective in female patients.
Spironolactone Anti-androgen that reduces the need for antibiotics and helps control flares
Combined Oral Contraceptives Estrogen-containing birth control pills can improve mild HS in women
Finasteride 5-alpha reductase inhibitor used off-label for HS
Metformin Insulin sensitizer that may help HS patients with insulin resistance
Additional prescription options for managing HS symptoms and inflammation.
Oral Retinoids (Acitretin) Normalizes skin cell production; improvement seen after 2 months
Isotretinoin Used for acne-like HS presentations (not for pregnant/breastfeeding)
Dapsone Anti-inflammatory agent for HS management
Colchicine Anti-inflammatory traditionally used for gout; helps some HS patients
Corticosteroids (Prednisone) Short-term use for severe flares to quickly reduce inflammation
Intralesional Steroid Injections (Kenalog) Triamcinolone injected directly into lesions to reduce swelling and pain
Cyclosporine Immunosuppressant for severe, refractory cases
Pain Management Medications NSAIDs, acetaminophen, or prescription pain relief as needed
Interventional procedures ranging from minor office procedures to extensive surgical reconstruction for advanced disease.
Incision & Drainage Short-term relief for painful abscesses; sores often recur
Deroofing (Unroofing) Removal of the roof of sinus tracts to promote healing; good for isolated lesions
Punch Debridement Limited unroofing of single inflamed bumps
CO₂ Laser Therapy Vaporizes sinus tracts; lesions unlikely to return after treatment
Nd:YAG Laser Hair follicle and bacterial load reduction for early-stage HS
Laser Hair Removal Helps prevent HS in early stages by reducing hair follicle inflammation
Excision of Individual Lesions Targeted removal for localized disease
Wide Surgical Excision Removal of all affected tissue for severe cases; may require skin grafting
Photodynamic Therapy Light-based treatment that targets affected tissues
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Diet Management

An anti-inflammatory diet, particularly the Mediterranean diet, has been shown to reduce HS severity and flare frequency.

🥬 Foods to Embrace

Wild salmonSardinesMackerelAnchoviesHerringTroutWalnutsFlaxseedsChia seedsHemp seedsSeaweedAlgae oil
BlueberriesStrawberriesRaspberriesBlackberriesCherries (tart)PomegranateOrangesGrapesKiwiPapayaMangoPineappleWatermelonApples
SpinachKaleSwiss chardCollard greensBroccoliBrussels sproutsCauliflowerBell peppersSweet potatoesCarrotsBeetsAsparagusArtichokesZucchiniTomatoesOnionsGarlic
Pumpkin seedsCashewsChickpeasLentilsQuinoaOatsGrass-fed beef (lean, moderate)TurkeyCrabLobsterShiitake mushrooms
Turmeric (with black pepper)GingerCinnamonGarlicRosemaryOreganoClovesCayenne (small amounts)
Extra virgin olive oilAvocadosCoconut oil (virgin)Nuts (almonds, walnuts, pecans)SeedsOlives
Plain yogurt (low-fat)KefirSauerkrautKimchiMisoKombuchaTempeh
Brown riceQuinoaOats (steel-cut)BuckwheatMilletWild riceBarley
Citrus fruits (Vitamin C)Bell peppers (Vitamin C)Sweet potatoes (Vitamin A)Almonds (Vitamin E)Sunflower seeds (Vitamin E)Fortified foods (Vitamin D)Eggs (Vitamin D)Mushrooms (Vitamin D)
Green tea (EGCG)Turmeric teaGinger teaChamomile teaPeppermint tea

⚠️ Foods to Avoid

These foods are known to trigger or worsen HS flares through inflammatory pathways, hormonal disruption, or gut dysbiosis.

Saturated fat content triggers inflammatory pathways; dairy hormones may stimulate follicular occlusion
Whole milkIce creamButterHeavy creamFull-fat cheeseCream cheeseSour cream
Spike insulin levels leading to inflammation; may increase IGF hormones that worsen cysts
White sugarCandySodaFruit juicePastriesCookiesCakeDoughnutsSweetened cerealsSyrup
70% symptom improvement reported when excluded; 87% recurrence when reintroduced (2020 study)
BeerBread (yeast-leavened)WineFermented alcoholic beveragesSome nutritional supplementsPizza doughPretzels
Rapid blood sugar spikes increase systemic inflammation
White breadWhite pastaWhite riceCrackersChipsBiscuitsInstant noodlesProcessed cereals
High in trans fats, AGEs, and omega-6 fatty acids that fuel inflammation
French friesFried chickenFast foodFrozen dinnersPackaged snacksHot dogsDeli meatsBaconSausage
Some HS patients report flares with nightshade vegetables (individual sensitivity — keep a food diary)
TomatoesPotatoes (white)EggplantBell peppersChili peppers
High-fat diets induce gut dysbiosis and increase inflammatory cytokines; 42% of HS patients report worsening symptoms
Fatty red meatPork bellyRibsFried foodsMargarineShortening
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Home Remedies

Natural approaches that may complement medical treatment — always discuss with your doctor

Apply warm, moist compress for 10-15 minutes to help drain painful lumps and reduce swelling. Use clean cloth each time.
Pure aloe vera gel (no additives) applied directly soothes inflammation, reduces pain, and provides antiseptic benefits.
Mix a few drops with carrier oil (coconut, jojoba). Has antimicrobial and anti-inflammatory properties.
Mix 1 tbsp turmeric + ½ tbsp coconut oil. Apply to affected area for 15 minutes. Anti-inflammatory and antimicrobial.
Raw honey applied topically provides antimicrobial, healing, and anti-inflammatory benefits. Can combine with turmeric.
Oral zinc supplements (30-90mg daily) can help reduce inflammation. Consult doctor for dosing.
Applied with cotton ball to reduce bacteria, redness, and inflammation. Can combine with aloe or turmeric.
⅓ tsp household bleach per quart of warm water. Soak 10 minutes, shower after. Consult dermatologist first.
Diluted ACV applied to lesions may help with bacterial control and pH balance.
Add 1-2 cups Epsom salt to warm bath. Helps draw out infection and reduce pain.
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Lifestyle Tips

Daily habits that can help reduce flares and improve quality of life

👕 Clothing

Wear loose-fitting, breathable fabrics (cotton, moisture-wicking) to minimize friction in affected areas

⚖️ Weight Management

Maintaining a healthy weight reduces skin friction and lowers IGF hormones that stimulate cyst growth

🚭 Smoking Cessation

Smoking is a major risk factor — nicotine promotes follicular plugging and worsens HS severity

🧘 Stress Management

Chronic stress triggers inflammatory cascades; practice mindfulness, meditation, yoga, or deep breathing

🧴 Gentle Skin Care

Use fragrance-free, gentle cleansers. Avoid harsh scrubbing. Pat skin dry instead of rubbing.

🩹 Wound Care

Keep draining lesions clean with gentle cleansing and appropriate bandaging. Change dressings regularly.

🏃 Exercise

Regular moderate exercise reduces inflammation, but shower immediately after and wear moisture-wicking clothes

😴 Sleep Hygiene

Adequate sleep (7-9 hours) is essential for immune regulation and reducing inflammatory markers

🌡️ Heat Management

Avoid excessive heat and humidity when possible; these can trigger flares

🤝 Support Networks

Connect with HS communities and support groups — chronic conditions benefit from emotional support

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Supplements

Nutritional supplements that may support HS management — consult your healthcare provider for personalized dosing

Zinc (30-90mg/day)

Reduces inflammation and supports immune function

Vitamin D (1000-4000 IU/day)

Many HS patients are deficient; supports immune regulation

Vitamin C (500-1000mg/day)

Antioxidant support and wound healing

Turmeric/Curcumin (500-1000mg/day)

Potent anti-inflammatory; take with black pepper for absorption

Omega-3 Fish Oil (2-3g/day)

Reduces inflammatory markers EPA and DHA

Probiotics

Support gut microbiome health which influences systemic inflammation

Vitamin B12

Supports skin health and cellular repair

Evening Primrose Oil

Contains GLA which may help reduce inflammation

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Sources & References

Peer-reviewed research and trusted medical institutions

📄 Mayo Clinic 📄 Cleveland Clinic - HS Diet 📄 Cleveland Clinic - Home Remedies 📄 Healthline - HS Diet 📄 Healthline - Natural Treatments 📄 Canadian HS Foundation 📄 NIH - Dietary Factors and HS 📄 Journal of Integrative Dermatology
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All Sources & References