Table 1.

Overview of published clinical studies regarding diet and hidradenitis suppurativa

Diet/supplement studied	HS study population	Key findings	Reference (first author, year)
Mediterranean diet (MD)	41 treatment-naïve patients, 41 control subjects (case–control, cross-sectional)	HS patients had lower adherence to the MD	Barrea, 2019 [11]
	221 patients (cross-sectional)	Higher adherence to a MD was associated with lower disease activity	Fuentes, 2022 [12]
	35 patients, and 35 matched healthy subjects	Mediterranean diet adherence did not correlate with HS disease severity	Velluzzi, 2022 [14]
Low carbohydrate/low dairy	40 patients (retrospective cohort)	7/40 patients had considerably improved HS on a low dairy/low carbohydrate diet	Kurzen, 2019 [15]
	47 patients in a personal dairy-free series	83% of 47 patients undergoing a dairy-free diet had improved symptoms	Danby, 2015 [16]
	770 patients in anonymous Facebook survey-based study	Of 237 patients, 50.6% reported dairy and 51.1% reported various carbs as symptom exacerbating foods	Fernandez, 2020 [13]
High fat diet	770 patients in anonymous Facebook survey-based study	Of 237 patients, 42.2% identified high fat foods as symptom-exacerbating	Fernandez, 2020 [13]
Brewer’s yeast-free diet	12 post-operative patients with IgG reaction to brewer’s yeast and wheat	Brewer’s yeast-free diet for 12 months caused immediate symptom stabilization and lesion regression in all patients	Cannistra, 2013 [24]
	37 patients following a brewer’s and baker’s yeast exclusion diet	Among 37 patients following a yeast-exclusion diet, 70% reported symptom improvement	Aboud, 2020 [25]
Zinc	22 patients treated with 90 mg zinc gluconate per day	Of 22 patients, 8 had a complete remission, and 14 with partial remissions	Brocard, 2007 [27]
	66 patients treated with combination 90 mg zinc gluconate per day and 2% topical triclosan twice daily	Significant reduction in severity of disease severity, erythema and inflammatory nodules	Hessam, 2016 [28]
	122 patients and 122 controls with serum zinc measured	Low serum zinc found to be more prevalent in HS patients, and associated with severe HS	Poveda, 2018 [29]
	92 patients treated with zinc and nicotinamide maintenance treatment	Treated patients experienced a significant reduction in acute flares, and longer disease-free survival	Molinelli, 2020 [30]
Vitamin D	16 patients with serum vitamin D measured	Patients had a poor vitamin D status, with 10 having < 30 nmol/L and 2 having < 50 nmol/L	Kelly, 2014 [35]
	14 patients supplemented with vitamin D	Vitamin D supplementation significantly reduced number of nodules at 6 months	Guillet, 2015 [36]
	250 patients, measuring serum vitamin D at diagnosis before HS treatment	Inverse correlation between vitamin D levels and C-reactive protein	Moltrasio, 2021 [42]
	110 patients, 110 matched controls with serum vitamin D measured	Patients with HS were more likely to have vitamin D deficiency compared to healthy controls	Seetan, 2022 [37]
Homocysteine/vitamin B12	26 patients, 26 healthy controls, measuring serum homocysteine	Higher prevalence of hyperhomocysteinemia in HS patients vs controls	Marasca, 2019 [43]
	2 patients with HS and inflammatory bowel disease (IBD) + 10 IBD patients with various suppurative dermatoses	High-dose vitamin B12 prevented recurrence of suppuration in 2 patients with HS and IBD. In 10 additional IBD patients, 6/10 benefitted from high-dose vitamin B12	Mortimore, 2010 [44]

HS hidradenitis suppurativa, IBD irritable bowel disease, IgG immunoglobulin G, MD Mediterranean diet