What to do About Recurring Boils, AKA Hidradenitis Supprativa

Medical “science” strikes out again. (Please note that I am talking about my own personal experience, and not handing out advice. Follow me or don’t, but don’t blame or credit me for your outcome. This is about my journey, and your causes may be completely different! But what I’ve done is absolutely worth a try if you’re suffering. In case you’re not interested in my story, I’ll put the spoiler up here: stop eating grains, especially wheat, and seed oils, and maybe nightshades and dairy.)

Have you ever heard of hidradenitis suppurativa? It’s a fancy word for boils. You get them under your arms, on your buttocks, under your breasts. If you do a web search, you’ll be told that HS results from infected hair follicles, hormones, skin rubbing together, uncleanliness, or genetics. Smoking and being overweight makes it worse. It’s supposedly rare, and supposedly incurable. The advanced stages of HS often have surgeons flaying the skin off their patients to try and improve the situation. Antibiotics don’t help, because there’s no infection. People–even doctors who should know better– often erroneously attribute it to poor hygiene. It’s debilitating. It’s embarrassing, painful, and ugly, and I wouldn’t wish it on anybody.

When I was in my early twenties, I started getting HS boils, and it was a constant bother until just a few years ago. I lived about seventeen years with these things, and it was non-stop, no remission, no matter what I tried. I was not overweight at the time that I developed the condition, and the boils persisted even when I quit smoking, so these two things, for me, seem to have little to do with it. Nothing seemed to cause it, and nothing seemed to help. I’d never had a bacterially-infected boil, nor did antibiotics ever do anything but upset my stomach. I’d had surgery suggested to me, but no way was I doing that. That sounded worse than the disease itself.

It never occurred to me that it was specific foods causing it, and no doctor ever suggested it to me.

It is purely accidental that I haven’t had a single boil in the last four years. If I hadn’t gotten gestational diabetes and then decided to live the rest of my life on a very low carb diet, I’d still be having trouble sitting down. The scars will always be with me, but I don’t even mind wearing sleeveless shirts anymore.

When I was pregnant with my first child, I had a particularly bad boil, and ended up in the ER with it. The doctor who was taking care of me asked, “Do you by any chance have Crohn’s disease? We see this in these patients pretty frequently.” He seemed to think that it was because of the diarrhea that accompanies that disease being an irritant to the skin. It didn’t apply to my situation, but I never forgot what he said. It was a clue. I knew even then that it wasn’t because of skin irritation or infection, but something internal, maybe autoimmune (or autoinflammatory, whatever). I now think that people with Crohn’s are at least partly food-inflamed in much the same way I was. If I knew anybody with Crohn’s, I’d evangelize them about the carnivore diet.

A while back, one of the leading internet carnivore/keto lifestyle doctors posted a video about HS, and how to deal with it, and his solution was (of course) a ketogenic diet and weight loss. When you’ve got a hammer–and a fine hammer it is!–everything’s a nail. Dr. Berry gives a confident, firm, and wrong answer.

I embedded the video because I do like his advice on diet, and you should follow it for plenty of reasons. But it’s not insulin-resistance. At least, it wasn’t for me. Your mileage may, of course, vary.

Certainly, my HS did get better at the same time I went keto. Kelly Hogan tells the same story. But I think Dr. Berry is wrong about the reason for that. It’s not insulin resistance that causes HS. Getting your blood sugar under control will likely not clear up the whole mess, though it will help a little.

I’ve had HS long before I got fat, and I didn’t get better when I lost weight while still eating triggering foods. Now that I’m off the grains and seed oils, no amount of mere sugar can trigger it. I know, because I’ve experimented with it to see. I can eat honey and fruit all day long, and I’m fine.┬áNow, insulin resistance will contribute to inflammation body-wide, just as the good doctor says, so people with HS or any other illness do need to get themselves healthy. This means you absolutely need to lose weight. Fat exacerbates the problem, the same way it exacerbates every other health problem. It does make it worse. I’m not saying to stay fat.

Do not stay fat!

But I don’t think insulin resistance causes HS. For me, HS is a severe, almost instantaneous reaction to certain foods, not insulin resistance. My approach to a ketogenic diet just happened to eliminate the foods that were causing my HS.

One great thing about adhering to a carnivore diet is that you can do controlled experiments on yourself to see what symptoms any given food might cause. I have carefully added back several different foods for the sake of seeing what I can get away with, and to my surprise, I found that, for me, grains (wheat, corn, rice, etc.) and seed oils are the only triggers for this condition. Even a tiny crumb of something made with wheat will set off bleeding, swelling, and itching in my scars. I once went to a BBQ place and there was a stray crumb from the breading of fried okra on my plate. I didn’t even swallow it! I spit it out as soon as I tasted it. Or maybe I swallowed some without realizing it. Anyway, I didn’t think anything else of it until a few hours later when the itching started. Seed oils on my meat at a restaurant will do the same as grains. It’s not even worth eating out anymore, I have to be so careful. I suspect nightshades and dairy could be a problem for some people, but they don’t seem to cause this particular symptom in me.

Whatever it is that caused my HS in the beginning (I think it was ultimately due to a medical procedure I had when I was 18), I don’t have boils now, as long as I stay away from grains and seed oils.

You can call it remission, if you like. I’m not healed. I’ll still get painful boils if I start eating those foods again. But as far as I’m concerned, that’s as good as a cure. With all due respect to the doctor, while a keto/carnivore approach that excludes grains and seed oils may help, I don’t think it’s for the reasons he gives. In fact, you might be metabolically healthy like I was for several of my first years with this disease, and be just fine with your carbs. If so, you could start by eliminating the most likely triggering foods: grains, seed oils, and possibly nightshades, and dairy.

If you have HS, I’d love to hear about your experience, and whether you’ve found foods to be your trigger, either by email or on social media. You can find me on Gab, MeWe, and SG.