The Hidden Link Between Candida Overgrowth and Hidradenitis Suppurativa (HS)

If you’re living with hidradenitis suppurativa (HS), you know how frustrating and painful this inflammatory skin condition can be. But what if part of the puzzle lies not just on the surface of your skin—but in your gut? Many people with HS also struggle with candida overgrowth, a type of fungal imbalance that can quietly fuel inflammation from the inside out.

In this article, we’ll explore the connection between candida overgrowth and HS, how to recognize the signs, why those with HS may be more prone to it, and how diet and medication may play a role.

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What Is Hidradenitis Suppurativa?

Hidradenitis suppurativa is a chronic inflammatory skin condition that causes painful nodules, abscesses, tunnels (sinus tracts), and scarring—often in areas like the armpits, groin, and under the breasts – however, it cam impact anywhere on the body there is a hair follicle. HS is not contagious or caused by poor hygiene. It is now widely understood to be an immune-mediated disease with ties to inflammation, hormonal imbalances, metabolic dysfunction, and gut health.

What Is Candida Overgrowth?

Candida is a type of yeast that naturally lives in our digestive tract, mouth, and skin. In a healthy body, it’s kept in balance by beneficial bacteria and a well-functioning immune system. But when candida grows unchecked—due to factors like antibiotics, high sugar intake, or chronic stress—it can lead to an overgrowth, sometimes called intestinal candidiasis or systemic candida.

Common Symptoms of Candida Overgrowth

Candida overgrowth can affect both gut health and systemic function. While symptoms can vary, here are some common signs to watch for:

Persistent fatigue or brain fog
Bloating, gas, or constipation
Recurring yeast infections or urinary tract infections
White coating on the tongue
Intense sugar or carbohydrate cravings
Itchy skin or rashes
Joint pain or skin flare-ups (especially in HS-prone areas)
Mood swings, irritability, or anxiety

Candida overgrowth doesn’t just stay in the gut—it can contribute to full-body inflammation and immune dysregulation, both of which are relevant to HS.

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How Candida Overgrowth Can Worsen HS Symptoms

When candida grows out of control, it can compromise the intestinal barrier (“leaky gut”), triggering immune reactions, inflammation, and skin flare-ups. For someone with HS—already dealing with an overactive immune response and systemic inflammation—candida can pour fuel on the fire.

Candida also releases byproducts like acetaldehyde, which can further disrupt hormonal balance, insulin sensitivity, and even neurotransmitters that impact mood and pain sensitivity. “Fungal infections are also associated with worsening and delaying the healing process of chronic wounds, commonly involving poor clinical outcomes (Mandras, et al., 2022). The most frequently isolated pathogenic fungi and opportunistic pathogenic fungi mainly include Candida species and filamentous fungi. (1).

In many cases, HS flares may worsen when candida overgrowth is present due to the additional burden on the immune system and increase in pro-inflammatory markers.

Why People with HS May Be More Prone to Candida Overgrowth

Several factors make those with HS more susceptible to candida issues:

Frequent Antibiotic Use
Long-term or repeated antibiotics (often prescribed for HS flares or infections) wipe out beneficial gut bacteria that keep candida in check.
Immune-Modulating Medications
TNF blockers (like Humira or Remicade) reduce inflammation by suppressing immune activity, which can create an opportunity for opportunistic microbes like candida to thrive.
Blood Sugar Imbalances
Many people with HS have underlying insulin resistance, prediabetes, or PCOS. High blood sugar feeds yeast—candida thrives in a glucose-rich environment.
Hormonal Imbalances and Stress
Disruptions in estrogen, progesterone, and cortisol (all common in HS) can impact gut health and immune surveillance, creating a favorable terrain for candida overgrowth.

The Dietary Connection: Sugar, Cravings & Insulin Resistance

Candida feeds on sugar. When overgrowth occurs, it often drives intense cravings for sugar and carbs—creating a cycle that’s hard to break.

This is especially relevant for people with HS, who may already struggle with metabolic health and insulin resistance. Elevated insulin levels not only feed candida but can also exacerbate HS flares by promoting inflammation and androgen dominance.

If you’re on medications like TNF blockers or antibiotics, managing your diet becomes even more critical. These treatments can reduce inflammation and improve quality of life, but they also increase the need for dietary support to keep your microbiome balanced and your immune system resilient.

This is not a call to avoid medication—but rather a reminder that pairing your treatment with dietary support can dramatically improve your outcomes and reduce potential side effects like candida overgrowth.

Do I Have Candida? Self-Check Questions

While proper testing (like stool tests or organic acids tests) can offer clarity, here’s a quick checklist to help you assess whether candida overgrowth might be part of your picture:

Do you experience intense sugar or carb cravings, especially in the evening?
Have you had frequent rounds of antibiotics or immunosuppressants?
Do you have chronic digestive issues like bloating or constipation?
Have you noticed recurring skin rashes, itching, or yeast infections?
Do you feel foggy, tired, or irritable without clear reason?
Is there a white coating on your tongue in the morning?
Do your HS flares worsen with high-sugar foods or stress?

If you answered yes to several of these, candida could be worth exploring with a nutritionist or functional health provider.

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Candida & HS: Diet Changes to Get Started

Here are some foundational dietary steps to support candida balance and reduce HS-related inflammation:

❌ Avoid added sugars, fruit juices, refined grains, YEASTY foods and alcohol
✅ Focus on non-starchy vegetables, leafy greens, and clean protein
✅ Include anti-fungal foods like garlic, coconut oil, and oregano
✅ Support gut health with fermented foods (if tolerated) or probiotics
✅ Stabilize blood sugar with balanced meals and protein at every meal
✅ Drink plenty of water and use electrolytes to support detox pathways

These steps not only help starve excess yeast but also reduce systemic inflammation—an important win for anyone managing HS. For more guidance on nutrition for HS, check out this article and my cookbooks.

Final Thoughts

Candida overgrowth and hidradenitis suppurativa share a deep, hidden connection—one that runs through the gut, the immune system, and your hormonal balance. If you’re on medication for HS, managing your diet is not just helpful—it’s essential.

By addressing candida through nutrition and lifestyle, many people find relief not just from digestive issues and fatigue—but from skin flares too.

If you’re ready to dive deeper into a holistic HS healing plan, I’d love to support you. Work with me 1:1 here.