Dr. Dray Warns Sodium and Processed Foods Fuel Skin Disease

Dr Dray

While dietary changes like reducing sodium and increasing whole foods can significantly reduce inflammatory skin disease severity, nutrition is not an absolute cure and must not replace professional medical treatment.

AI-assisted summary of Your Diet Could Be Making Your Skin Inflammation Worse — original source. Check the original for full context.

Source published: 2026-08-25

Key ideas

Cutaneous sodium accumulation directly drives inflammatory signaling via interleukin 17 (IL-17); clinical research in JAMA Dermatology links every 1-gram increase in urinary sodium excretion to a 16% higher likelihood of active eczema flares. (2:38)
In hidradenitis suppurativa (HS), excess adipose tissue functions as an active metabolic organ secreting inflammatory mediators; losing 15% of body weight produced symptom improvements across all study responders, with over half reaching complete clearance. (9:23)
Patients should not eliminate whole fruit out of fear of dietary sugar, as fruit's intact fiber and water matrix prevents rapid blood glucose spikes and provides essential micronutrients. (15:19)
While overall dietary patterns powerfully influence cutaneous inflammation, nutrition must complement rather than replace medical therapies, as dramatic online 'diet cure' claims often stem from provisional misdiagnoses or spontaneously remitting illnesses. (18:17)

Detailed notes

## Background Published on YouTube by dermatologist Dr Dray on August 25, 2026, this video explores the relationship between nutrition and chronic inflammatory skin conditions like eczema, psoriasis, and hidradenitis suppurativa. According to the description, Dr. Dray reviews the science surrounding dietary sodium, refined carbohydrates, and processed meats while advocating for practical, nutrient-dense eating patterns rather than extreme elimination diets or abandoning medical care.

## TL;DR Dr. Dray breaks down how dietary habits influence dermatologic inflammation, explaining how cutaneous sodium accumulation drives IL-17 signaling in psoriasis and exacerbates barrier dysfunction in eczema. She highlights the inflammatory risks of refined carbohydrates, chronic insulin spikes, and processed meats, while reviewing clinical evidence on weight reduction and Mediterranean dietary patterns in managing hidradenitis suppurativa. Rather than endorsing restrictive elimination fads, she recommends a balanced foundation of vegetables, legumes, whole grains, and intact fruit alongside reduced ultra-processed food intake. Throughout the discussion, she stresses that nutrition is a valuable supportive tool to improve systemic health, not an outright substitute or miracle cure for complex diseases requiring professional medical management.

## Atmosphere & style Dr. Dray maintains a measured, pragmatic, and authoritative clinical demeanor that cuts through sensationalized internet wellness advice. The presentation feels candid and educational, balancing precise immunological concepts with relatable discussions about retraining a salt-habituated palate. Her approach combines deep empathy for patients dealing with disfiguring and painful chronic conditions with an uncompromising, evidence-based skepticism toward unverified online testimonials.

## Bulletin - [02:38](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=158s) Cutaneous sodium accumulation directly drives inflammatory signaling via interleukin 17 (IL-17); clinical research in JAMA Dermatology links every 1-gram increase in urinary sodium excretion to a 16% higher likelihood of active eczema flares. - [09:23](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=563s) In hidradenitis suppurativa (HS), excess adipose tissue functions as an active metabolic organ secreting inflammatory mediators; losing 15% of body weight produced symptom improvements across all study responders, with over half reaching complete clearance. - [15:19](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=919s) Patients should not eliminate whole fruit out of fear of dietary sugar, as fruit's intact fiber and water matrix prevents rapid blood glucose spikes and provides essential micronutrients. - [18:17](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1097s) While overall dietary patterns powerfully influence cutaneous inflammation, nutrition must complement rather than replace medical therapies, as dramatic online 'diet cure' claims often stem from provisional misdiagnoses or spontaneously remitting illnesses.

## Key takeaways - [00:00](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=0s) Dietary adjustments significantly influence chronic skin diseases, but there is no universal anti-inflammatory diet that replaces evidence-based pharmaceutical care for conditions like psoriasis, eczema, and HS. - [01:09](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=69s) Excess sodium is stored directly in the skin, where it compromises epidermal barrier function and activates IL-17 inflammatory signaling pathways central to psoriasis and eczema flares. - [02:38](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=158s) Findings in JAMA Dermatology demonstrate that each 1-gram increase in urinary sodium excretion correlates with an 11% higher eczema risk, 16% greater flare odds, and an 11% rise in disease severity. - [02:38](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=158s) The bulk of damaging sodium intake comes from ultra-processed convenience foods, fast food, and commercial sauces rather than salt added during home cooking. - [04:32](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=272s) Historical dietary guidelines demonizing fat prompted food manufacturers to substitute refined sugars and starches, fueling modern epidemics of insulin resistance and systemic inflammation. - [04:32](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=272s) Demonizing all carbohydrates is misguided; nutrient-dense whole foods such as legumes, whole grains, and starchy tubers support metabolic health and fight inflammation. - [07:54](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=474s) Processed meats expose the body to polycyclic aromatic hydrocarbons and advanced glycation end products (AGEs), which can be mitigated by choosing fresh cuts, gentle cooking, and acidic marinades. - [09:23](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=563s) Hidradenitis suppurativa is aggravated by excess adipose tissue both through mechanical friction in skin folds and through the active secretion of systemic inflammatory mediators. - [09:23](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=563s) A clinical study showed that achieving a 15% reduction in total body weight significantly reduced HS symptoms, yielding total clearance in more than half of participants before permanent scarring occurred. - [11:38](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=698s) Adhering to a Mediterranean-style dietary pattern is linked to milder HS symptoms, whereas extreme elimination diets targeting dairy or brewer's yeast lack broad clinical backing. - [12:55](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=775s) An actionable anti-inflammatory diet centers on eating vegetables at every meal, consuming daily legumes, and replacing refined white flour with whole grains such as quinoa, oats, and wild rice. - [12:55](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=775s) Whole potatoes, cassava, and plantains are healthy and satiating when boiled, baked, or steamed, and should not be avoided due to associations with fried junk food. - [15:19](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=919s) Whole fruits like apples and bananas contain sugars bound within an intact fiber and water matrix, providing steady energy and antioxidants without sharp glycemic spikes. - [16:01](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=961s) Retraining taste buds away from hyper-palatable, high-sodium processed foods typically takes about two weeks, after which natural flavors become substantially more satisfying. - [18:17](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1097s) Testimonials claiming diet alone cured an incurable autoimmune or inflammatory disease often overlook misdiagnoses, fluctuating lab markers, or conditions that spontaneously remitted on their own.

## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=0s) Diet, Expectations, and Chronic Skin Inflammation

Dr. Dray opens by addressing a recurring question from her comment section: can the food choices you make worsen skin inflammation and exacerbate underlying dermatological conditions? While dietary patterns can significantly influence skin health, Dr. Dray emphasizes that the reality is far more nuanced than simple internet rules like "Eat this. Never eat that." There is no universal "anti-inflammatory diet" capable of curing every skin ailment, and setting realistic expectations is crucial.

She pushes back directly against online influencers who promise that dietary changes alone can cure complex diseases. While nutritional adjustments make a tangible difference, they rarely eliminate the root condition entirely. For chronic inflammatory disorders such as psoriasis, hidradenitis suppurativa (HS), and atopic dermatitis (eczema), medical management remains essential. Diet should never be viewed as an outright substitute for established, evidence-based pharmaceutical therapies.

[01:09](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=69s) The Overlooked Impact of High-Sodium Diets and IL-17

While public health discussions regarding high-salt diets almost exclusively center on cardiovascular health and hypertension, Dr. Dray points out an underappreciated biological mechanism: the human body can store excess sodium directly in the skin. This localized sodium accumulation has profound effects on cutaneous immunology, activating specific immune cell types and driving inflammatory signaling cascades.

Most notably, high cutaneous sodium promotes pathways involving interleukin 17 (IL-17). This cytokine is a central driver in the pathogenesis of psoriasis, so much so that several modern targeted psoriasis medications are specifically designed as IL-17 inhibitors. Furthermore, elevated sodium intake can directly compromise the integrity of the skin barrier, leading to dryness, rough texture, and localized irritation. In diseases that already feature baseline epidermal barrier dysfunction—such as acne, rosacea, and eczema—a high-sodium diet serves as a secondary physiological insult, rendering disease management significantly harder to achieve.

```mermaid flowchart TD accTitle: Sodium Impact on Skin Inflammation and Barrier accDescr: Visual summary of how dietary sodium accumulates in skin tissue and triggers immune and barrier dysfunction.

subgraph INTAKE["Dietary Intake"] A["High-Sodium Intake\n(Ultra-Processed Foods)"] end

subgraph ACCUMULATION["Cutaneous Storage"] B["Excess Sodium Deposited in Skin"] end

subgraph PATHWAYS["Cutaneous Consequences"] C["Immune Activation\n(Upregulates IL-17)"] D["Skin Barrier Disruption\n(Dryness & Irritation)"] end

subgraph CLINICAL["Clinical Manifestations"] E["Psoriasis & Eczema Flares"] F["Worsening Acne, Rosacea & Atopic Dermatitis"] end

A --> B B --> C B --> D C --> E D --> F ```

[02:38](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=158s) Sodium Research in Eczema and Hidden Sources in Ultra-Processed Foods

Emerging human clinical data reinforces this link between sodium and dermatological disease. Dr. Dray highlights a large study published in *JAMA Dermatology* investigating urinary sodium excretion and eczema. The findings revealed that every 1-gram increase in sodium excretion was associated with: - An 11% increase in the risk of an eczema diagnosis - A 16% higher likelihood of experiencing an active eczema flare-up - An 11% increase in overall disease severity

While this epidemiological association does not prove direct causation or justify entirely eliminating sodium from the diet, it aligns with basic science showing that sodium alters barrier function and immune reactivity.

Crucially, Dr. Dray clarifies that when she discusses a high-salt diet, she is not referring to home cooks using a pinch of table salt while seasoning a skillet. The overwhelming majority of excess sodium in modern diets comes from ultra-processed convenience foods, fast food, restaurant dishes, canned soups, shelf-stable packaged bread, sauces, and cured meats. These convenience items deliver massive doses of sodium alongside refined carbohydrates, added sugars, and unhealthy fats—a dietary combination that continually fuels chronic systemic inflammation.

[04:32](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=272s) Refined Carbohydrates, Insulin Resistance, and the Low-Fat History Lesson

Refined carbohydrates and added dietary sugars represent another major dietary driver of chronic cutaneous inflammation. In the United States, consumption of ultra-processed grain products—including sweetened breakfast cereals, packaged pastries, Pop-Tarts, desserts, white bread, and fast food—is extraordinarily high. These foods trigger steep spikes in blood glucose and subsequent surges in insulin. Over time, chronically elevated insulin promotes insulin resistance, weight gain, and widespread systemic inflammation.

To explain how the food landscape reached this point, Dr. Dray provides a historical critique of dietary guidelines. Decades ago, public health institutions singled out dietary fat as the primary nutritional enemy. The commercial food industry capitalized on this advice by flooding grocery stores with heavily marketed "fat-free" and "low-fat" products. To preserve flavor and texture once fat was removed, manufacturers substituted massive amounts of refined sugar and processed starch. Consumers assumed these foods were inherently healthy and ate them in unlimited quantities, driving daily caloric intakes skyward.

Paired with increasingly sedentary lifestyles, this macronutrient swap catalyzed modern epidemics of obesity, diabetes, and metabolic dysfunction. Dr. Dray warns against falling into the opposite trap today by demonizing all carbohydrates: - Isolating a single macronutrient as the sole root of disease is fundamentally flawed. - When consumers fear all carbohydrates, they often replace them with equally processed, calorie-dense foods loaded with excess sodium and poor-quality fats. - Nutrient-dense carbohydrates found in whole foods—such as beans, legumes, whole grains, and starchy vegetables—are protective and should form the foundation of a healthy diet.

[07:54](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=474s) Processed Meats, Carcinogens, and Advanced Glycation End Products

Processed meats—such as deli slices, bacon, hot dogs, sausages, and smoked meats—pose a dual threat to skin health and systemic longevity. Beyond packing enormous quantities of sodium into relatively small servings, they expose the body to toxic chemical compounds formed during industrial curing and high-temperature processing. Heavily charred and smoked meats contain polycyclic aromatic hydrocarbons, which are established carcinogens that elevate long-term cancer risks.

For anyone attempting to lower their chronic inflammatory burden, Dr. Dray strongly advises minimizing or completely cutting out processed meats. For individuals who choose to consume meat regularly: - Purchase fresh cuts and prepare them at home rather than consuming pre-packaged, ready-to-eat products. - Utilize gentler cooking methods like stewing or braising rather than high-heat charring. - Marinate meats using vinegar- or acid-based marinades, which significantly lowers the formation of inflammatory advanced glycation end products (AGEs).

[08:53](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=533s) Hidradenitis Suppurativa: Pathology and the Dietary Connection

Dr. Dray introduces hidradenitis suppurativa (HS) as a prime clinical example of how metabolic dysregulation, inflammation, and dietary factors intersect. HS is a debilitating, chronic inflammatory skin disease marked by the development of intensely painful nodules, deep abscesses, and boils in intertriginous zones (skin folds). Common presentation sites include: - The axillae (underarms) - Inframammary folds (under the breasts in women) - Abdominal skin folds - The groin and intergluteal cleft (between the buttocks)

Over time, recurrent inflammatory lesions rupture and progress to form epithelialized sinus tracts—interconnected subcutaneous tunnels beneath the skin that continuously fill with inflammatory exudate, purulent fluid, and pus, underscoring the critical need to understand how diet interacts with the disease process.

[09:23](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=563s) Hidradenitis Suppurativa: The Burden of Disease, Adipose Tissue, and Weight Loss

Hidradenitis suppurativa (HS) is a devastating condition where painful lesions fill with pus, drain, become severely inflamed, and eventually heal into dense scar tissue. Beyond the immense physical agony, it is profoundly disfiguring and takes a heavy psychological toll on patients, straining interpersonal and romantic relationships and gutting their overall quality of life. As the disease progresses, progressive scarring can severely restrict physical mobility, causing the condition to "really, really, really start to creep in in so many different ways to their daily life." While there is no single medically validated "HS-approved diet" guaranteed to cure the disorder, clinical research demonstrates a meaningful link between overall dietary patterns and symptom severity.

The most potent clinical finding in this space links weight reduction in individuals carrying excess weight or obesity to marked drops in disease severity. This connection operates on two distinct levels: mechanical friction and systemic biochemistry. Mechanically, excess adiposity expands redundant skin folds, generating persistent friction as dense tissues constantly rub together—a direct physical trigger for flares. Biochemically, body fat is far more dangerous than simple dead weight. Rather than functioning as an "inert storage organ" for surplus calories, excess adipose tissue behaves as an active metabolic organ, constantly churning out inflammatory mediators that fuel systemic inflammation across the body.

```mermaid flowchart TD accTitle: Mechanisms linking excess body fat to hidradenitis suppurativa severity accDescr: Diagram showing how excess adipose tissue leads to HS flares via mechanical friction and biochemical inflammatory mediators.

subgraph Tissue["Excess Adipose Tissue"] A["Increased Body Fat"] end

subgraph Pathways["Pathways of Disease Exacerbation"] B["Redundant Skin Folds & Friction"] C["Metabolically Active Secretion of Inflammatory Mediators"] end

subgraph Outcome["Clinical Impact"] D["Worsened HS Flares, Tunneling & Scarring"] end

A --> B A --> C B --> D C --> D ```

In one small clinical study, patients who lost 15% of their total body weight experienced noticeable symptom reductions, with more than half achieving complete disease clearance. Losing excess body weight is especially pivotal early in the disease process before chronic tunnels and permanent scar tracts develop. However, HS is an intricate, multifactorial inflammatory disorder, and excess weight is not its sole cause.

- Excess adipose tissue continuously releases inflammatory mediators rather than merely acting as an inert calorie depot. - Losing 15% of body weight in a small study led to symptom improvement across all responding participants, with over 50% achieving total clearance. - Weight loss is most protective in early HS stages before irreversible tunneling and extensive fibrotic scarring take root.

---

[11:38](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=698s) Mediterranean Diet, Dairy, and Brewer's Yeast Elimination

Preliminary research indicates that dietary quality directly correlates with HS flare frequency and severity. Patients who follow a Mediterranean-style dietary pattern—prioritizing legumes, whole fruits, vegetables, whole grains, seafood, and olive oil while minimizing red meat—tend to report milder symptoms and fewer active flares. Similarly, small investigations have evaluated lowering dietary sugar and eliminating brewer's yeast, which appears to act as an individual trigger for certain patients.

Despite these findings, caution is essential when interpreting small elimination trials. In one study of 47 patients with HS, eliminating dairy resulted in an 83% reduction in flare frequency, and another tiny study reported improvements after cutting out brewer's yeast. However, because these sample sizes are very small, they do not justify broad, universal medical mandates. Strict elimination diets are seductive to patients who are suffering deeply, but Dr. Dray advises against jumping into extreme dietary restrictions without solid, broad-based clinical evidence.

---

[12:55](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=775s) A Realistic Anti-Inflammatory Framework: Veggies, Legumes, and Minimally Processed Carbs

When building an evidence-based diet to manage inflammatory skin diseases and enhance general skin health, the emphasis must remain on the overall dietary pattern rather than demonizing single foods. Lasting change comes from consistency over time, not rigid perfection. The cornerstone recommendation is to consume vegetables every single day, ideally at every meal. While eating vegetables at breakfast, lunch, and dinner might sound somewhat intense or "unhinged" to the average person, it is the most reliable strategy to flood the body with anti-inflammatory compounds, dietary fiber, and surface-protecting antioxidants. Dietary fiber directly nourishes the gut microbiome, exerting beneficial downstream effects on systemic immune regulation.

In addition to vegetables, incorporating legumes—such as beans, lentils, and chickpeas—daily provides an exceptional combination of plant protein, complex carbohydrates, and fiber. Dr. Dray encourages people to stop fearing carbohydrates and instead swap refined options like standard white bread for minimally processed whole grains, including oats, quinoa, brown rice, wild rice, red rice, and black rice.

Potatoes and other starchy tubers (such as cassava and plantains) frequently suffer from an unfair reputation due to epidemiological studies linking potato products to adverse health outcomes. Dr. Dray explains that potatoes are merely "guilty by association" because they are predominantly consumed as fried, heavily salted, and ultra-processed junk snacks often laden with industrial oils or sugary coatings. Prepared via baking, boiling, steaming, or mashing, whole potatoes are deeply satiating, highly nutritious, and entirely compatible with an anti-inflammatory lifestyle.

- **Vegetables:** Target daily consumption at every meal to boost fiber, gut microbiome health, and antioxidant reserves. - **Legumes:** Eat beans, chickpeas, or lentils daily for nutrient-dense plant protein and complex carbohydrates. - **Whole Grains:** Replace refined white flour products with quinoa, oats, brown rice, red rice, black rice, and wild rice. - **Preparation Matters:** Keep starchy root vegetables like potatoes, plantains, and cassava in the diet by choosing baking, boiling, or steaming over deep-frying.

---

[15:19](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=919s) Why You Shouldn't Fear Whole Fruit

Patients frequently misapply warnings about high-glycemic diets, glycemic load, and advanced glycation end products (AGEs) by completely eliminating fruit from their plates. Dr. Dray warns that cutting out whole fruit is a misguided overcorrection: "No, no. You need to keep that in there."

While fruits like apples and bananas certainly contain naturally occurring sugars, that sugar is physically packaged within a matrix of intact dietary fiber, water, and micronutrients. This structural matrix slows down digestion and glucose absorption, preventing the rapid blood glucose spikes caused by refined sugars. Whole fruit supports sustainable energy metabolism and provides vital systemic micronutrients, making a few daily servings an excellent choice for individuals managing inflammatory skin issues.

---

[16:01](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=961s) Hidden Sodium, Cardiovascular Creep, and Retraining the Palate

Managing sodium intake is critical, particularly the massive doses hidden in ultra-processed convenience foods and restaurant meals. High sodium does not immediately make a person feel sick, creating a false sense of security while blood pressure silently climbs year after year. Dr. Dray paints a realistic picture of the long-term medical consequences: a patient reaches their 40s, receives a hypertension diagnosis at a routine checkup, gets prescribed a pill, and returns a year later only to need a second prescription added on. Each additional medication carries potential side effects, recurring financial costs, and frequent monitoring visits—making early lifestyle intervention in young adulthood far more preferable.

The primary culprit is rarely the dash of salt used to season home-cooked food. Instead, the bulk of sodium intake stems from quick-prep convenience foods, fast food, processed deli meats, canned soups, snack foods, and commercial restaurant sauces. Because people drastically underestimate their consumption, Dr. Dray suggests using a diet tracking app for a couple of days to calculate true baseline numbers.

Reducing sodium is notoriously difficult at first because the palate adapts to hyper-palatable, heavily salted foods. In the first few days of cutting back, everything tastes intensely bland, leading people to think, "Oh my gosh, I can't live like this." However, after toughing it out for roughly two weeks, taste buds naturally reset. Once acclimated, food tastes dramatically better, natural flavors emerge, and meals become far more deeply satiating. Ultimately, while dialing in nutrition powerfully supports inflammatory skin management, Dr. Dray emphasizes that diet alone is rarely an absolute cure, and medical therapy remains essential.

[18:17](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1097s) Scrutinizing Online "Diet Cure" Testimonials and Misdiagnoses

Dr. Dray addresses the pervasive online stories where individuals claim they achieved complete remission solely by swapping or radically changing their diet. The typical narrative follows a familiar trajectory: a patient is given a chronic diagnosis that supposedly demands lifelong medication, chooses not to listen to the doctors, changes what they eat, and returns to find all lab markers normalized and the disease permanently gone. While Dr. Dray readily acknowledges that remarkable recoveries do happen in isolated cases, she stresses that no clinician can reliably predict who will experience that kind of outcome. More importantly, viewers must remember that "there are two sides to every story" when evaluating these dramatic personal testimonies.

Behind many of these supposed miracle cures lies the complicated reality of medical diagnostics. Many individuals receive an initial or provisional diagnosis based on preliminary laboratory work that later normalizes on its own, meaning they never truly had the chronic condition to begin with. Many inflammatory and autoimmune conditions can be mimicked by transient illnesses known to spontaneously remit without any medical intervention. For instance, specific blood markers associated with autoimmune conditions can turn positive and prompt evaluations for systemic diseases like lupus, yet those same markers can temporarily elevate under a variety of unrelated, benign circumstances.

Because autoimmune and inflammatory diagnoses can be notoriously difficult to establish, Dr. Dray maintains a healthy skepticism whenever someone insists their diet cured an incurable illness. She questions whether the patient had the disease in the first place or simply had a condition that naturally ran its course and resolved. While patients understandably bristle at hearing explanations that feel dismissive—fearing it implies the issue was "all in your head" or "just went away on its own"—she urges viewers to keep an element of suspicion in mind regarding misdiagnosis when hearing anecdotal claims online.

```mermaid flowchart TD accTitle: Pitfalls of Anecdotal Dietary Cures accDescr: Flowchart illustrating medical realities behind anecdotal dietary cure stories. A["Online Testimony: 'Diet Cured My Disease'"] --> B{"Underlying Medical Reality"} B --> C["Genuine response (rare & unpredictable)"] B --> D["Provisional lab abnormalities that self-normalized"] B --> E["Unrelated illness with spontaneous remission"] B --> F["Misdiagnosis triggered by transient autoimmune markers"] ```

- **Unpredictable Outcomes:** Even if dietary intervention coincides with symptom resolution in specific individuals, clinicians cannot forecast who might experience such a response. - **Diagnostic Complexities:** Blood markers for conditions such as lupus frequently fluctuate and can present false alarms during temporary, unrelated physiological stresses. - **The Role of Natural History:** Many skin and systemic conditions fluctuate naturally or resolve spontaneously, leading patients to incorrectly credit dietary changes made at the same time.

[20:01](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1201s) Diet as a Window into Internal Health and Sign-Off

Despite urging caution against relying on diet alone to treat complex diseases, Dr. Dray reinforces that nutrition remains undeniably foundational to health and dermatologic wellness. The skin functions as a direct "window to what is going on internally," reflecting systemic metabolic health, gut function, and inflammation. She closes the discussion by encouraging viewers to share their thoughts and lingering questions in the comments regarding specific foods, nutritional patterns, and their roles in either helping or harming the skin. She bids farewell with her signature sign-off, reminding her audience to give the video a thumbs up, share it with friends, and remember the essentials: "sunscreen and subscribe."

## Notable quotes > [00:00](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=0s) Eat this. Never eat that. — Dr. Dray

> [09:23](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=563s) really, really, really start to creep in in so many different ways to their daily life. — Dr. Dray

> [09:23](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=563s) inert storage organ — Dr. Dray

> [12:55](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=775s) unhinged — Dr. Dray

> [12:55](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=775s) guilty by association — Dr. Dray

> [15:19](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=919s) No, no. You need to keep that in there. — Dr. Dray

> [16:01](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=961s) Oh my gosh, I can't live like this. — Dr. Dray

> [18:17](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1097s) there are two sides to every story — Dr. Dray

> [18:17](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1097s) all in your head — Dr. Dray

> [18:17](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1097s) just went away on its own — Dr. Dray

> [20:01](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1201s) window to what is going on internally — Dr. Dray

> [20:01](https://www.youtube.com/watch?v=kwdfMqF6SSk&t=1201s) sunscreen and subscribe. — Dr. Dray

## Mentioned Dr. Dray, JAMA Dermatology, Pop-Tarts, IL-17, Amazon, Liketoknowit, Instagram, Pinterest, Facebook, Twitter, TikTok

## Video description Can your diet make inflammation worse? Dermatologist Dr. Dray explains how dietary patterns may influence inflammatory skin diseases including eczema, psoriasis, and hidradenitis suppurativa (HS), and what the research actually tells us about food, inflammation, and skin health.

This video takes a closer look at the connection between sodium and inflammatory skin disease, including research linking higher sodium intake with increased eczema risk, active flares, and disease severity. Dr. Dray also discusses sugar and refined carbohydrates, processed and red meat, metabolic health, weight loss and hidradenitis suppurativa, and the evidence surrounding Mediterranean and plant-based diets.

Rather than promoting an extreme "anti-inflammatory diet" or restrictive elimination diet, Dr. Dray discusses practical ways to build a more nourishing dietary pattern, including eating vegetables frequently, incorporating legumes, choosing whole grains and minimally processed starches, eating whole fruit, limiting added sugar and refined carbohydrates, reducing processed meats, and paying attention to sodium intake.

In this video:

00:00 Can your diet make inflammation worse? 01:09 High-salt diets and inflammatory skin disease 04:32 Sugar, refined carbohydrates and inflammation 07:54 Red meat, processed meat and inflammation 08:53 Hidradenitis suppurativa and diet 12:53 What should someone with inflammatory skin disease actually eat? 15:17 Why you shouldn't fear whole fruit 16:01 Sodium and processed foods 18:01 Final takeaways

Dr. Dray also explains why diet should be viewed as one part of managing inflammatory skin disease, rather than a replacement for appropriate medical treatment. Eczema, psoriasis, and hidradenitis suppurativa are complex inflammatory conditions, and dietary changes should not be used in place of care from a qualified healthcare professional.

Topics covered: inflammatory skin disease, diet and inflammation, eczema diet, psoriasis diet, hidradenitis suppurativa diet, HS diet, sodium and eczema, salt and inflammation, sugar and inflammation, processed foods, red meat and inflammation, Mediterranean diet, plant-based diet, metabolic health, nutrition and skin health, food and skin inflammation.

#Inflammation #Eczema #Psoriasis #HidradenitisSuppurativa #DietAndSkin #SkinHealth #Dermatologist

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[Source](https://www.youtube.com/watch?v=kwdfMqF6SSk)

中文简报

Dray医生警告高钠及加工食品会加剧皮肤疾病尽管减少钠摄入和增加天然全食物等饮食改变可显著降低炎症性皮肤病的严重程度，但营养并非绝对的根治手段，绝不能替代专业医疗。 Dray医生详细解析了饮食习惯如何影响皮肤炎症，阐明了皮肤钠蓄积如何驱动银屑病中的IL-17信号传导，并加剧湿疹的屏障功能障碍。她强调了精制碳水化合物、慢性胰岛素激增和加工肉类的致炎风险，同时回顾了减轻体重与地中海饮食模式在管理化脓性汗腺炎方面的临床证据。相比于盲目推崇限制性的排除饮食风潮，她建议以蔬菜、豆类、全谷物和完整水果为均衡基础，同时减少超加工食品的摄入。在整个讨论中，她反复强调，营养是改善全身健康的宝贵辅助工具，但对于需要专业医疗管理的复杂疾病而言，它绝非直接的替代品或奇迹疗法。皮肤钠蓄积会通过白细胞介素17（IL-17）直接驱动炎症信号；《JAMA Dermatology》的一项临床研究显示，尿钠排泄量每增加1克，湿疹活动性发作的可能性就会增加16%。 (2:38) 在化脓性汗腺炎（HS）中，过量脂肪组织会作为活性代谢器官分泌炎症介质；减重15%可使所有产生应答的研究参与者症状改善，其中超过半数达到了皮损完全清除。 (9:23) 患者不应因恐惧膳食中的糖分而杜绝完整水果，因为水果完整的纤维与水分基质能防止血糖快速飙升，并提供必需的微量营养素。 (15:19) 尽管整体膳食模式对皮肤炎症有很大影响，但营养必须辅佐而非替代药物治疗，因为网络上夸大其词的“饮食根治”说法往往源于暂时的误诊或自限性疾病的自发缓解。 (18:17)

Reading summary

Dermatologist Dr. Dray explains that while dietary patterns significantly influence cutaneous inflammation and barrier function, nutrition serves as an adjunct to medical therapy rather than an outright cure for chronic skin conditions. Cutaneous Sodium Accumulation and Barrier Dysfunction (1:09) Excess dietary sodium can deposit directly into skin tissue, where it alters cutaneous immunology and provokes inflammatory cascades. Specifically, elevated sodium upregulates interleukin 17 (IL-17), an inflammatory cytokine central to the pathology of psoriasis and targeted by modern biologic drugs. High sodium accumulation also impairs the skin barrier, driving dryness and irritation that compounds baseline barrier dysfunction in acne, rosacea, and eczema. Dr. Dray highlights a large study published in JAMA Dermatology demonstrating that every 1-gram increase in urinary sodium excretion was associated with an 11% rise in eczema diagnosis risk, a 16% greater likelihood of active flares, and an 11% increase in disease severity. She clarifies that this risk is driven not by table salt used in home cooking, but by ultra-processed convenience foods, fast food, cured meats, and restaurant fare that deliver high sodium alongside refined carbohydrates and unhealthy fats. Refined Carbohydrates, Processed Meats, and Glycation (4:32) Diets rich in ultra-processed grain products and added sugars generate steep spikes in blood glucose and insulin, ultimately fostering insulin resistance and systemic inflammation. Dr. Dray links this pattern to historical public health guidelines that demonized dietary fat, prompting food manufacturers to replace fat with refined carbohydrates and starches. She warns against repeating this mistake by eliminating all carbohydrates, pointing out that whole-food carbohydrates like legumes and whole grains protect metabolic health. Processed meats like bacon, hot dogs, and deli slices introduce heavy sodium loads alongside polycyclic aromatic hydrocarbons formed during industrial curing and high-heat smoking. Dr. Dray advises reducing or eliminating processed meats. For those preparing fresh meats at home, she recommends gentler cooking methods like stewing or braising, as well as acid- or vinegar-based marinades to suppress the formation of inflammatory advanced glycation end products (AGEs). Adiposity and Friction in Hidradenitis Suppurativa (9:23) Hidradenitis suppurativa (HS) exemplifies the intersection of metabolic dysregulation and dermatologic disease, manifesting as painful nodules, abscesses, and draining subcutaneous sinus tracts in skin folds. Excess adipose tissue exacerbates the condition through two distinct mechanisms: physical friction generated by redundant skin folds rubbing together, and biochemical signaling from body fat acting as an active metabolic organ that continuously secretes systemic inflammatory mediators. In one small clinical study, patients who lost 15% of their body weight experienced marked symptom reductions, with more than half achieving complete disease clearance before irreversible scarring developed. Preliminary trials also associate Mediterranean diets with lower flare rates. However, while small trials noted an 83% flare reduction after eliminating dairy in 47 patients and improvements from removing brewer's yeast, Dr. Dray cautions that limited sample sizes do not justify universal, restrictive elimination diets. A Practical Framework of Unrefined Plant Foods (12:55) Rather than relying on restrictive elimination protocols, Dr. Dray advocates an anti-inflammatory baseline centered on eating vegetables at every meal to deliver fiber, antioxidants, and gut microbiome support. She recommends pairing vegetables with daily legumes like beans, chickpeas, and lentils, as well as unrefined whole grains including oats, quinoa, and brown, red, black, or wild rice. Starchy roots like potatoes, plantains, and cassava remain nutritious when baked, boiled, or steamed rather than consumed as fried, salted convenience snacks. Dr. Dray explicitly advises against eliminating whole fruit over fears of sugar and glycation. Intact fruit fibers and water buffer naturally occurring sugars, preventing the rapid glucose spikes caused by refined sugars while supplying essential micronutrients. Finally, she notes that lowering sodium from processed foods often makes meals taste bland initially, but the palate typically resets after roughly two weeks of consistency. Dr. Dray emphasizes that while online testimonials often credit radical dietary changes with curing incurable conditions, these accounts frequently reflect misdiagnoses, self-normalizing lab markers, or transient illnesses that spontaneously remit. Although the skin acts as an internal window into metabolic and gut health, nutritional interventions must complement, rather than substitute for, evidence-based dermatological care.

Source quotes

[0:00] Dr. Dray: Eat this. Never eat that. [9:23] Dr. Dray: really, really, really start to creep in in so many different ways to their daily life. [9:23] Dr. Dray: inert storage organ [12:55] Dr. Dray: unhinged [12:55] Dr. Dray: guilty by association [15:19] Dr. Dray: No, no. You need to keep that in there. [16:01] Dr. Dray: Oh my gosh, I can't live like this. [18:17] Dr. Dray: there are two sides to every story [18:17] Dr. Dray: all in your head [18:17] Dr. Dray: just went away on its own [20:01] Dr. Dray: window to what is going on internally [20:01] Dr. Dray: sunscreen and subscribe.

Original transcript

[0:00] Well, hey guys. Welcome back. If you're [0:01] new here, I'm Dr. Dre. I'm a [0:03] board-certified dermatologist. Today, [0:05] I'm going to address a topic that comes [0:07] up a lot in the comments section. Can [0:09] the foods that you eat worsen skin [0:11] inflammation and make certain skin [0:13] conditions worse? More specifically, [0:15] we're going to touch on dietary choices [0:17] that can negatively and positively [0:19] influence a variety of skin issues. The [0:22] answer is a lot more complicated than [0:24] simply saying, "Eat this. Never eat [0:26] that." There's no single [0:28] anti-inflammatory diet that's going to [0:30] cure every single skin disease. [0:32] Furthermore, for the most part, with [0:34] some rare exceptions, while diet changes [0:37] can make a huge difference, absolutely. [0:39] Let's set realistic expectations. In [0:41] many cases, they don't totally cure the [0:44] disease. You still need some form of [0:47] ongoing medication management. Because a [0:49] lot of people online will sell you on [0:51] diet advice that if you just follow it, [0:53] you can cure every single ailment under [0:56] the sun. And that is misleading. Diet [0:58] should not be pursued solely as a [1:00] replacement for established medical [1:02] therapies, especially for chronic [1:04] inflammatory skin conditions like [1:05] psoriasis, hidradenitis suppurativa, and [1:08] atopic dermatitis. I want to touch on [1:10] something that often gets overlooked, [1:12] and that is the interesting role that [1:15] high-sodium diets have on worsening skin [1:17] conditions. Most of the time, when [1:19] you're talking about the harms of a [1:21] high-salt diet, what enters the [1:23] conversation is the adverse effects on [1:25] the cardiovascular system, high blood [1:27] pressure. Sodium doesn't just affect [1:29] your cardiovascular system, however. [1:30] Research suggests that the body can [1:32] actually store excess sodium in your [1:35] skin. And that excess sodium can [1:36] actually impact the immune system in [1:38] your skin. When sodium accumulates in [1:40] your skin, it can activate certain [1:42] inflammatory cell types and promote [1:44] certain inflammatory pathways, [1:46] especially inflammatory pathways that [1:48] include interleukin 17, otherwise known [1:50] as IL-17. This is particularly [1:52] interesting because IL-17 is a key key [1:56] player in certain inflammatory skin [1:58] conditions such as psoriasis. And there [2:00] are actual psoriasis medications that [2:02] target IL-17 specifically. There's also [2:04] evidence that high sodium diets can be [2:07] disruptive for your skin barrier. [2:09] Ultimately, this can not only lead to an [2:11] increased susceptibility to dryness, [2:13] irritation, rough skin texture. By [2:15] itself, it can result in an increased [2:17] tendency towards skin irritation, local [2:20] skin inflammation, and worsening of [2:21] underlying skin conditions like acne, [2:23] rosacea, atopic dermatitis, all of which [2:26] at baseline have an impaired barrier. [2:28] But if you go ahead and couple that with [2:30] a super high salt diet, that extra [2:32] insult to the barrier might just be what [2:34] is making your disease process very [2:36] difficult to control. We now have some [2:38] human data that really, really, really [2:40] start to shed some light on the harms of [2:42] high salt diets for skin disease. A [2:44] recent large study published in JAMA [2:46] Dermatology showed that for every 1 g [2:49] increase in sodium excretion, this was [2:51] associated with an 11% increase in the [2:54] risk of an eczema diagnosis. Also, with [2:56] an associated 16% higher likelihood of [2:59] having an active eczema flare-up and an [3:02] 11% increase in overall disease [3:05] severity. Of course, this doesn't prove [3:07] that eating a high salt diet causes [3:09] eczema, and it is by no means a [3:11] recommendation that if you have eczema, [3:13] you should try and eliminate sodium. But [3:15] it's an interesting association that [3:17] fits what we're we're learning about the [3:19] science of how high salt diets impact [3:21] skin biology, barrier function, and [3:23] inflammatory pathways. You need to scan [3:25] in chronic inflammatory skin conditions. [3:27] Here's where I think the high sodium [3:29] link also becomes particularly relevant. [3:32] When I talk about a high salt diet, I'm [3:34] not talking about somebody who just [3:35] likes to season their food with table [3:37] salt at the table or while they're [3:39] cooking. The dietary sodium that [3:41] contributes to high sodium isn't coming [3:44] from you seasoning your own food for the [3:46] most part. Where it creeps in is [3:48] ultra-processed convenience foods, fast [3:50] food, and restaurant meals, deli meats, [3:53] packaged meats, sauces, soups, canned [3:56] goods, snack foods, even bread that you [3:59] buy on the shelf. Shelf stable bread is [4:02] another one that can get pretty high in [4:04] the salt content. Not only are these [4:06] foods high in added sodium, but they [4:08] also are high in refined carbohydrates, [4:11] processed sugar. They often are high in [4:13] unhealthy fats, all of which don't bode [4:15] well for inflammation. And when we're [4:17] talking about dietary choices, I'm not [4:19] talking about here and there, maybe a [4:21] couple of times a week eat a convenience [4:23] snack or whatever. I'm talking about [4:25] your day consists every single day of [4:28] ultra-processed, ready-made convenience [4:31] foods. This is not rare. Another area [4:33] where we have a considerable amount of [4:35] research suggesting an association with [4:38] diet and chronic skin inflammation is [4:40] when it comes to the conversation around [4:42] added dietary sugars, particularly [4:44] excess consumption of refined sugars and [4:46] refined carbohydrate. This is especially [4:47] important because at least in the United [4:50] States, Americans consume a very high [4:52] burden of ultra-processed, refined [4:54] carbohydrate. When I speak of [4:55] ultra-processed, refined carbohydrate, [4:57] I'm talking about sugar-sweetened [4:59] packaged snacks, sweetened cereals, [5:01] desserts, Pop-Tarts, pastries, snack [5:04] foods, fast foods, highly highly [5:06] processed grain products like white [5:08] bread. These foods can lead to a rapid [5:10] increase in blood glucose and insulin. [5:12] Chronically high levels of insulin as a [5:14] result over time can have some [5:16] devastating effects for your overall [5:17] health as well as inflammation and body [5:19] weight. So, this becomes particularly [5:20] relevant for inflammatory skin diseases. [5:23] This is where I think it's very [5:24] important to focus on the history of [5:27] dietary recommendations and dietary [5:29] advice, and where things started to go [5:31] awry, and we started seeing a rise in [5:34] insulin resistance, diabetes, and [5:35] obesity. For decades, Americans were [5:37] told that dietary fat was the main [5:40] source of problems that should be [5:42] minimized avoided. The problem? Well, [5:45] the food industry got a hold of that [5:47] information and went wild with it. As a [5:49] result, they produced an enormous number [5:51] of {quote} low-fat or fat-free products. [5:54] But, what happened here is that when [5:56] they removed the fats, they replaced the [5:59] fats with refined sugars, refined [6:01] carbohydrate. In other words, people [6:03] were eating just as much, in many cases [6:06] however, even more calories because it's [6:08] not as though these were low-calorie, [6:10] low-fat foods. Oftentimes, people would [6:13] think the key was just to eat fat-free [6:16] and low-fat and that they could have as [6:17] many servings as they wanted. That [6:19] resulted in a substantial increase in [6:21] daily calorie consumption, which no [6:23] matter how you build the macronutrients, [6:26] the laws of thermodynamics, they don't [6:28] lie. If you keep increasing your [6:29] calories, eventually you're either going [6:31] to gain weight or it's going to be very [6:33] difficult for you to lose weight without [6:35] increasing your activity levels. Guess [6:37] what? Most people around those times [6:39] started to become even more sedentary. [6:41] So, this is like the perfect storm for [6:43] obesity, diabetes, insulin resistance, [6:46] all the metabolic problems that we see [6:48] today. So, the history lesson here is [6:50] that we need to be careful, hey, [6:51] focusing solely on one macronutrient and [6:54] centering all the dietary advice around [6:56] that, and B, we really, really, really [6:58] need to be vigilant when it comes to the [7:00] food industry because they will take [7:03] health claims and use them to market [7:05] otherwise unhealthy, high-calorie foods. [7:07] And so, the results of ignoring the [7:09] overall profile and quality of the food, [7:11] it really can backfire. And that [7:13] translates to how we think about [7:15] inflammatory skin conditions and the [7:16] role for diet here. It's not really [7:18] going to be just one macronutrient that [7:21] is the key. Avoid this, the disease will [7:23] go away. Absolutely not. It's not even [7:25] one type of food. For example, if people [7:27] are now led to fear carbohydrates [7:29] because of the fat-free backlash, well, [7:31] as a result, they might swap over to [7:34] equally as ultra-processed, high-calorie [7:36] foods that now have a bunch of high [7:38] salt, high sodium, overall just poor [7:41] nutrient quality. I'm a big advocate, as [7:43] much as possible, focusing your meals, [7:46] your daily food consumption around whole [7:49] foods, whole grains, beans, legumes. [7:51] These carbohydrates are not the enemy. [7:54] Another category I think that really [7:56] deserves a lot of attention is processed [7:58] meats. Deli meat, smoked meat, hot dogs, [8:00] bacon, sausage, and other processed [8:03] meats can contribute substantially to [8:06] dietary sodium in a given day. These [8:08] types of foods also have a ton of other [8:10] compounds in them specifically that [8:12] contribute to overall inflammation and a [8:14] lot of serious adverse effects your [8:16] health. For example, heavily charred [8:18] meats or smoked meats contain a high [8:20] burden of polyaromatic hydrocarbons. [8:23] These are carcinogens and play a role in [8:25] cancer risk. So, when someone is trying [8:27] to reduce their overall inflammatory [8:29] burden and looking to make some diet [8:32] swaps, I highly encourage reducing, [8:35] minimizing, eliminating the consumption [8:37] of processed meats. going to continue to [8:39] eat meat on a regular basis, I suggest [8:41] preparing it yourself. And ideally, [8:43] you're going to be stewing it and [8:44] considering incorporating vinegar-based [8:47] marinades to reduce other inflammatory [8:49] things, namely advanced glycation end [8:51] products, which I have videos discussing [8:53] at length. Another inflammatory skin [8:55] condition that provides some important [8:57] clues when we study the disease and how [9:00] diet influences it as to how different [9:02] dietary choices lead to skin [9:04] inflammation is going to be hidradenitis [9:06] suppurativa. This is a chronic [9:07] inflammatory skin condition where you [9:09] develop these painful nodules, boils in [9:12] the skin folds, namely under the arms, [9:14] under the breasts in women, in the [9:15] abdominal skin folds, between the [9:16] buttocks. These form sinus tracts [9:19] beneath the skin, basically tunnels, [9:21] tubes under the skin. They fill with [9:23] pus, they drain, they're incredibly [9:25] inflamed, and they eventually scar down. [9:27] This is incredibly painful condition to [9:29] deal with, not to mention it is [9:31] disfiguring and really has a negative [9:34] impact on someone's interpersonal [9:35] relationships, romantically speaking, [9:38] definitely, as well as just their [9:39] overall quality of life. They really, [9:41] really suffer with this condition, and [9:43] the scarring can limit mobility over [9:45] time, and really, really, really start [9:47] to creep in in so many different ways to [9:49] their daily life. While we don't have a [9:51] single HS-approved diet, like eat this [9:53] way and your HS will clear up, there are [9:55] a lot of interesting studies looking at [9:57] dietary patterns and their influence on [9:59] hidradenitis suppurativa overall [10:01] severity. One of the strongest signals [10:03] that we have seen is [10:05] association with a decrease in disease [10:06] severity when people with overweight or [10:08] obesity began to lose weight. Several [10:10] small studies suggest that weight loss [10:12] can reduce hidradenitis suppurativa [10:15] severity. Not only does that make sense [10:17] given the fact that the greater the [10:18] excess in body fat, unwanted body fat, [10:21] the more redundancy in the skin folds [10:23] you're going to have. That's going to [10:25] create a source of friction. Simply the [10:27] mechanical excess of skin and fat and [10:31] dense tissue rubbing together, that is [10:33] going to precipitate more disease. But, [10:35] here is where the real inflammatory [10:37] insult lies, and that is the excess [10:39] adipose tissue itself. Excess adipose [10:41] tissue is not merely this inert storage [10:44] organ where you deposit excess calories [10:47] to use later. It's actually a [10:49] metabolically active tissue releasing a [10:52] variety of inflammatory mediators that [10:54] drive underlying inflammatory processes [10:57] and contribute to overall health [10:59] problems. One small study showed that [11:01] patients who lost 15% of their body [11:03] weight experienced at least some [11:05] reduction in their hidradenitis [11:07] suppurativa with over half of them [11:09] experiencing complete clearance. Yeah, [11:11] that's right. Simply dropping your body [11:14] fat, your excess body weight, it can [11:16] help clear your disease. This is [11:17] especially important earlier on in [11:20] disease flare-ups before those tunnels [11:22] and scars have formed. That's not to say [11:24] that hidradenitis suppurativa is only [11:26] caused by excess body fat. It's a [11:28] complex inflammatory disease with a [11:30] variety of underlying things that come [11:32] together and lead to the disease. But, [11:34] this is something where the diet [11:36] definitely can play a role. There's some [11:38] preliminary evidence regarding the [11:40] Mediterranean diet. This is just a [11:42] dietary pattern of eating that [11:44] emphasizes legumes, whole fruits, [11:46] vegetables, whole grains, and the [11:47] addition of olive oil, as well as [11:50] limiting red meats. It also encourages [11:53] some inclusion of seafood and fish. [11:55] Small studies have suggested that people [11:57] who eat more like this, we'll say, with [12:01] hidradenitis suppurativa have less [12:03] severe disease. They may have fewer [12:05] flares, in other words. As well as [12:06] studies looking at the role for sugar [12:08] reduction and avoiding brewer's yeast, [12:10] which seems to be a culprit for some [12:12] people, actually. These studies are [12:14] generally small and preliminary, so not [12:16] enough to really say, "Oh, yeah, if we [12:18] encourage patients to eat this way, [12:19] it'll always be in their best interest." [12:21] One small study suggested that 47 [12:24] patients with hidradenitis suppurativa, [12:26] when they eliminated dairy from their [12:27] diet, 83% of them experienced a [12:30] reduction in the number of HS flares. [12:31] The same is true for the brewer's yeast [12:33] connection. A tiny study showed [12:35] improvement in hidradenitis suppurativa [12:37] when brewer's yeast was completely [12:39] eliminated from the diet. But, the [12:40] sample size in this study was far too [12:42] small to make generalized [12:44] recommendations. In other words, if you [12:45] have hidradenitis suppurativa, I don't [12:47] recommend you go out and do these [12:49] complete elimination diets, and I know [12:51] that can be tempting to do, especially [12:53] when you're really suffering. So, what [12:55] should someone with an inflammatory skin [12:56] condition or just looking to improve [12:58] overall skin health, what should they be [13:00] aiming to eat? Like, where can we begin [13:02] to make some changes that make sense and [13:05] are evidence-based, bearing in mind that [13:07] they're not necessarily going to cure [13:08] all of our skin issues. I want you guys [13:11] to focus on the overall pattern of [13:13] eating. It's not about eliminating a [13:14] particular food or never ever eating a [13:16] certain thing. It is about what you do [13:18] the majority of the time. I recommend [13:20] everyone to eat vegetables every single [13:22] day, ideally at every meal. And I know [13:24] this sounds unhinged, but you got to [13:26] start somewhere, and that's one of the [13:27] best ways to increase the [13:29] anti-inflammatory components of your [13:31] diet, increase dietary fiber which [13:33] directly fuels a healthy gut microbiome [13:35] which impacts downstream of that [13:37] inflammation and provides your skin the [13:40] antioxidants necessary to combat [13:42] environmental aggressors at the surface. [13:44] I also recommend incorporating legumes [13:47] every single day. Beans, lentils, [13:49] chickpeas, these are incredibly [13:51] nutritious sources of protein, fiber, [13:54] carbohydrate and I also encourage people [13:56] to experiment with incorporating [13:58] different whole grains. Like instead of [14:01] going for the white bread all the time, [14:03] try and go for a grain, oats, quinoa, [14:05] brown rice, other varieties of rice like [14:07] wild rice, black rice, red rice. You [14:09] don't need to be afraid of [14:10] carbohydrates. The goal should be to [14:12] choose minimally processed carbohydrates [14:15] whenever and wherever possible. That [14:16] also includes starchy vegetables like [14:19] potatoes. Some studies suggest that [14:21] potato product consumption is associated [14:23] with some pretty negative health [14:25] effects. Don't let that finding make you [14:27] fear potatoes. They're kind of guilty by [14:30] association because they are used in a [14:32] variety of delicious junk food snacks [14:35] accompanied by a ton of fat. They're [14:37] usually fried in oils and a lot of [14:40] sodium, two things which yeah, not so [14:43] great. And sometimes they also have a [14:45] lot of sugar coating them as well. But [14:48] baked or boiled, mashed, steamed, these [14:51] these ways of preparation, they really [14:53] allow for you to eat the potato with all [14:56] of its health benefits and not [14:58] necessarily worry so much about this [15:00] problem with adverse health effects. [15:02] Potatoes themselves are not a junk food. [15:04] They're very nutritious and actually [15:06] very satiating. Same thing with [15:08] plantains, cassava. So again, it's not [15:11] necessarily about focusing on a [15:12] macronutrient but focusing on the food [15:15] quality. The overall food and how that [15:17] food is prepared. I also want to remind [15:19] you guys not to be afraid of whole [15:20] fruit. A lot of people hear the [15:21] conversation around high glycemic diets [15:24] and inflammation in the skin, glycemic [15:26] load, advanced glycation end products, [15:28] and they think, "Okay, I'm going to [15:29] eliminate sugar wherever possible, [15:32] including from whole fruit." It's like, [15:34] "No, no. You need to keep that in [15:36] there." Apples, yes, they contain sugar. [15:38] Yes, a banana contains sugar. But guess [15:40] what? It's also accompanied by fiber, [15:42] micronutrients, and those components [15:45] together help your body process the [15:47] sugars and metabolize them in such a way [15:49] that it doesn't have this tremendously [15:51] negative effect on your blood sugar. And [15:53] you know, it is not only good for energy [15:56] usage long term, but also provides you [15:58] with a variety of health benefits. I [16:00] suggest a few servings of fruit a day. [16:02] Highly, highly recommend watching the [16:04] salt intake, particularly from ultra [16:06] processed convenience foods. Admittedly, [16:08] this is an adjustment. A lot of people [16:10] A, are completely unaware of how much [16:12] sodium they are taking in, and they [16:14] don't think that it matters because it [16:16] doesn't necessarily make you feel ill, [16:18] but over time it can cause your blood [16:20] pressure to slowly creep up and creep up [16:22] year after year after year. So, that by [16:23] the time you get into your 40s and you [16:25] go in for your annual exam, your [16:27] doctor's going to be like, "That blood [16:28] pressure, we need to put you on a [16:30] medication." And you're going to be [16:31] like, and you're like, "Okay." So, you [16:32] take the medication. Guess what? A year [16:34] later, well, the medication is not [16:36] enough to control the blood pressure, we [16:38] got to add another one. Each medication [16:40] they have to add comes with side [16:41] effects, not to mention cost, time of [16:43] going in there all the time and having [16:45] your blood pressure monitored. Pay [16:46] attention to the sodium today. If you're [16:48] really young in particular, it does make [16:50] a difference. And again, I'm not really [16:52] talking about people who use salt in [16:54] cooking to season their food. It's [16:56] coming from those restaurant meals, [16:57] especially the convenience restaurant [16:59] meals, like quick prep meals, deli [17:01] meats, sauces, soups, snack foods, fast [17:04] foods. Try and prepare some of your own [17:05] sauces. It It It really does not have to [17:07] be a labor-intensive thing. But one of [17:09] the reasons why it's so hard to get a [17:10] handle of is not only are you probably [17:12] not aware of how much sodium you're [17:14] taking in on a daily basis. In other [17:16] words, you might need to track your [17:17] diet, uh, the foods that you're eating [17:19] in one of the these diet tracking apps [17:21] for a couple of days, so you really get [17:23] a sense of how much you're taking in. It [17:25] also is not fun to cut your salt down, [17:28] taste-wise, because your taste buds [17:30] become so accustomed to the high salt. [17:33] You actually start to not taste other [17:36] things particularly well. And so, what [17:38] happens is when someone reduces their [17:40] sodium intake, everything tastes super [17:42] bland. And they're like, "Oh my gosh, I [17:44] can't live like this." But if you tough [17:45] it out for a couple of weeks, your taste [17:47] buds acclimate. And all of a sudden, the [17:48] food that you're eating is going to [17:50] taste a lot better. And you're going to [17:51] be like, "Wow, I never realized how much [17:53] I liked this particular food. Now that [17:55] I've cut back on the salt to a more [17:57] reasonable level, I can actually taste [18:00] my food." And it makes it a lot more [18:01] satiating. Diet definitely can [18:03] potentially influence the overall [18:05] trajectory of your given disease [18:07] process. Changing your diet can make a [18:09] huge difference. That being said, diet [18:11] alone should not be the sole approach, [18:14] because it's going to be the rare [18:15] circumstance where somebody is able to [18:17] completely get their disease under [18:19] control by swapping out their diet or [18:21] switching their diet. A lot of times, [18:23] you'll hear personal anecdotes online. I [18:25] was diagnosed with this disease that I [18:28] was told is going to be chronic. It [18:30] would require medication forever. And I [18:32] didn't listen to the doctors. Instead, I [18:34] changed my diet. When I went back to the [18:36] doctor, all my markers had normalized. [18:39] And I've stayed on this diet, and the [18:40] disease has never come back. And I do [18:42] believe that that happens in certain [18:44] cases. The problem is, hey, I can't [18:46] predict if and when that'll happen to [18:48] anyone. The other thing that you need to [18:50] keep in mind when you're hearing these [18:51] testimonies, is that there are two sides [18:54] to every story. And a lot of times, [18:56] someone may be given a provisional [18:58] diagnosis of something based on [19:00] laboratory work, but over time, the [19:02] laboratory work ends up normalizing. And [19:05] they never actually had the disease to [19:06] begin with. Maybe they had a disease [19:08] that was different and in a temporary [19:11] state, and that is known to [19:12] spontaneously resolve. That certainly [19:14] happens. There are certain blood markers [19:16] of autoimmune disease, for example, that [19:18] become positive, and they trigger the [19:21] evaluation for things like lupus. [19:24] However, those things can be elevated [19:27] temporarily in a variety of other [19:29] circumstances. So, in other words, these [19:31] can be challenging diagnoses to make, [19:33] and so I often question when someone [19:35] says their disease was cured, did they [19:36] ever have the disease to begin with, or [19:38] did they have a disease that is known to [19:40] spontaneously remit without any [19:42] treatment? People hate to hear that [19:43] because they don't want to be told that, [19:45] "It's all in your head. It's just went [19:47] away on its own." I understand, but if [19:49] you're listening to someone give that [19:50] testimony, you always need to have that [19:52] little um element of suspicion in the [19:55] back of your head, like, did they really [19:56] have the disease, per se, or were they [19:58] misdiagnosed? That does happen. That [20:01] really does happen. But, diet, without a [20:02] doubt, is so important for our health [20:05] and for the health of our skin, of [20:06] course, because your skin, it is a [20:08] window to what is going on internally. [20:10] All right, y'all. I really hope you [20:11] enjoyed today's video, and that it was [20:12] informative. Let me know in the comments [20:14] what other questions do you guys have [20:16] with regards to diet, different foods, [20:18] and their role in helping or harming the [20:21] skin. I hope you all enjoyed this one. [20:22] If so, give it a thumbs up, share it [20:24] with your friends, and as always, don't [20:25] forget, sunscreen and subscribe. I'll [20:27] talk to you guys tomorrow. Bye. [20:43] >> [music]