Hidradenitis Supportiva: what is it and how to approach nutrition care

Posted on April 16, 2024

Hidradenitis Supportiva (HA) or acne inversus, appears to be an immune-mediated hereditary condition in which lesions form on the skin resulting in abscesses or scars. Influenced by smoking, weight, and hormones (more prevalent in women), this condition typically manifests between puberty and menopause and is painful and unsightly. Lesions, which can last for months, form due to the hair follicle plugging and rupturing, attracting inflammatory cytokines to the affected region. Common regions affected by this condition include the axilla, inner highs, buttocks, pubic area, and inguinal areas. (1)

Researchers have indicated that this condition may be autoimmune in nature due to the subsequent antibody development. Diet and lifestyle strongly influence autoimmunity and for HA the following may be beneficial:

1. Conformation to the Mediterranean Dietary Pattern

a. Vegetables >2 servings per day

b. Fruits > 3 servings per day

c. Legumes > 3 servings per week

d. Fish > 3 servings per week

e. A diet high in oils such as extra virgin olive oil.

2. Specific nutrients

a. Vitamin D – target around 40 ng/mL

b. Vitamin A – sufficiency via cod liver oil or via supplementation

c. Zinc

i. 25mg or more daily

ii. Cleanser with pyrithione zinc shampoo

d. Iron – check anemia via Hemoglobin, Hematocrit, MCV

e. B12 – biweekly 1000mcg

3. Avoidance of the following

a. Dairy

b. Brewer’s yeast (Saccharomyces cerevisiae)

i. https://www.celiac.com/forums/topic/110239-looking-for-the-list-of-foods-containing-brewer%E2%80%99s-yeasts/

c. Smoking and nicotine

Maintaining weight balance is beneficial for this condition. Please speak with our in-house nutritionist if you are suffering from HA and need assistance in dietary strategies and lifestyle approaches.

(1) https://www.ncbi.nlm.nih.gov/books/NBK534867/

(2) https://pubmed.ncbi.nlm.nih.gov/37325281/

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8840467/