Changing what I ate became one of the biggest turning points in my PPP recovery.
Before PPP, I ate what I considered a completely normal diet. Bread, pasta, dairy, sugar, convenience food and the occasional glass of wine were simply food. I did not think of them in relation to my skin.
Then I became ill, and eventually I began questioning things I had never thought to question before.
Nobody treating my PPP had asked me what I was eating.
My medical appointments were understandably focused on the skin in front of them. I was prescribed topical treatments and was told about medical options, but food, digestion and lifestyle were not part of the conversation.
By that point I had reached the stage where I wanted to understand everything I could potentially influence. I had already begun looking beyond the visible rash at stress, antibiotics, infections, gut health and the wider state of my body. Food became the most obvious thing I was exposing myself to every single day.
I could not control everything that had happened before I developed PPP. I could control what I put on my plate the next morning.
I made the diet much simpler before I tried to make it more interesting.
I wanted to remove the foods I suspected most strongly and create a cleaner baseline from which I could observe my skin. During the strict part of my recovery, these were the major changes.
Gluten
Refined sugar
Dairy
Alcohol
Highly processed food
Margarine and highly refined cooking oils
This was not meant to be my diet forever. It was an elimination phase designed to make patterns easier to see.
Gluten became my strongest individual dietary trigger.
Gluten was the first major food group I removed. Soon after making the change, my skin actually flared. At the time I interpreted that as my body adjusting to the new diet.
Today I would phrase that more carefully. I know the flare happened after I stopped eating gluten, but I cannot know what caused that short-term worsening. PPP naturally waxed and waned, and I was changing several things in my life during the same period.
What mattered was what happened over the following weeks. I stayed consistent. The flare settled. The pattern of new pustules began to change, and eventually gluten became one of the foods for which I noticed the clearest repeatable relationship with my own symptoms.
A Swedish study of 123 people with PPP found markers of gluten sensitivity in a subset of patients, and 7 of the 123 participants had coeliac disease.
Among participants with relevant antibodies who followed a gluten-free diet, the researchers reported total or almost total clearing of the skin lesions together with normalisation of the antibodies. This was not a large randomised dietary trial, but it is meaningful evidence that gluten can matter in a subgroup of people with PPP.
Mostly simple food that looked like food.
Once I stopped building meals around bread, pasta and convenience foods, the question became surprisingly simple: what could I put on the plate that was nutrient-dense, minimally processed and made me feel well?
Vegetables, lots of them
Leafy greens, broccoli, cauliflower, cabbage, carrots, beetroot, courgette, cucumber, celery and sweet potatoes became normal everyday food rather than a small side portion.
Good-quality protein
Fish and other simple protein sources helped make meals satisfying without relying on bread, pasta or highly processed substitutes.
Omega-3 rich fish
Salmon, sardines, mackerel and other oily fish became foods I actively included rather than something I happened to eat occasionally.
Healthy fats
Olive oil, avocado, nuts and seeds became part of the basic structure of my meals.
Berries and less-sweet fruit
Berries, apples and other whole fruit gave me something naturally sweet without returning to the refined sugar I had removed.
Green juices
Green juice was part of my routine because it gave me an easy way to increase the amount and variety of vegetables I was consuming. I never needed it to be a miracle detox drink for it to be useful.
Vegetables + protein + healthy fat became my default.
That basic formula removed a lot of decision-making. I did not need a special “PPP recipe” every time I was hungry. I needed real food I tolerated and could prepare consistently.
Simple was one of the reasons I could keep doing it.
Gluten stood out most strongly, but it was not the only change.
Refined sugar
I removed sweets, cakes, biscuits, sugary drinks and the refined foods that had made sugar an everyday rather than occasional part of my diet.
Dairy
I removed dairy during the elimination period. Later I was able to experiment with reintroduction and learn that my tolerance was not as black-and-white as it was with gluten.
Alcohol
During the active healing period I stopped drinking alcohol. I wanted the recovery phase to be as uncomplicated as I could reasonably make it.
I was not looking for one good day. I was looking for the pattern to change.
PPP naturally goes through better and worse periods, so I did not want to mistake one quiet week for proof that I had found the answer. I kept going and watched what happened to the cycles.
I began seeing fewer new pustules. The outbreaks became less aggressive. The skin had more time to heal between cycles. Other parts of my health were changing too, and the direction felt different from the endless flare-after-flare pattern I had been trapped in.
Diet was not the only thing I changed. I was also working on stress, digestion, sleep, nutrients and the wider lifestyle framework I have described throughout Well-Healed.
But if you ask me which change gave me one of the clearest practical starting points, my answer is still food.
I still think the gut matters. I just explain it differently now.
When I first began writing about PPP, I sometimes described a damaged or “leaky” gut as if it were the established underlying cause of the disease. PPP research does not allow us to say that.
My view of digestive health itself has not become less important. The gut is a major immune interface, nutrition depends on digestion and absorption, and my own digestive health changed during the same period that I rebuilt my diet.
I do not need one unproven gut theory to explain every case of PPP in order to believe that looking after digestion and eating nourishing food are worthwhile parts of a whole-health approach.
The research is smaller than I wish it were, but diet has been studied directly in PPP.
Gluten sensitivity in a PPP subgroup
Researchers studied 123 PPP patients. Twenty-two had IgA antibodies against gliadin, and seven participants had coeliac disease. Antibody-positive participants who adhered to a gluten-free diet were reported to have total or nearly total clearing of their skin lesions.
Dietary patterns and PPP severity
A dietary survey comparing Japanese adults with PPP to healthy controls found differences in BMI and several dietary measures. Higher sodium intake and higher BMI were correlated with greater PPP severity. Because this was observational, it cannot show that changing those factors will improve PPP, but it demonstrates that diet and metabolic factors deserve further study.
A 2011 review of PPP management also highlighted gluten sensitivity as potentially important in selected patients. That wording still feels right to me: selected patients. The useful question is not whether every person with PPP must eat exactly as I did. It is whether food is one of the modifiable pieces worth investigating in your own case.
I would be strict enough to learn something, but not frightened of food.
When you are desperate to heal, it is easy to turn a food list into a set of absolute rules and become afraid that one imperfect meal has ruined everything. I do not think that mindset helps.
I would still begin with a clear elimination period. I would still remove the foods I most strongly suspected. But I would keep a diary, look for repeatable patterns, reintroduce where appropriate and remember that the goal is not the smallest possible diet.
The goal is to discover the broadest nourishing diet your own body does well on.
Start simple. Stay consistent. Pay attention.
Start simple
Whole food, vegetables, protein and healthy fats gave me a much clearer baseline than constantly changing supplements and complicated recipes.
Stay consistent
I needed enough time to observe trends rather than judging the diet by what my skin did over forty-eight hours.
Pay attention
Your useful answer is the repeatable pattern in your own body, not the loudest food rule you read online.
Food gave me a way to participate in my own recovery every single day.
That is one of the reasons I remain such a strong believer in natural healing when it is safe and realistic. A nourishing diet does not belong only to the treatment of one skin disease. It supports the whole person.
I could not guarantee what my dermatologist would prescribe next or how my skin would behave tomorrow. I could decide what I bought, cooked and ate today. That sense of agency mattered enormously.
Medicine can have a place when it is needed. But I would still want the foundations of my health working for me at the same time.
I did not change my diet because food had become my enemy. I changed it because food was one of the most powerful things I could choose for my health every day.
My PPP diet FAQ.
What did you stop eating when healing your PPP?
My main elimination foods were gluten, refined sugar, dairy, alcohol and highly processed foods. I also changed the fats I cooked with and focused heavily on whole, nutrient-dense food.
What was your strongest food trigger?
Gluten became the clearest individual dietary trigger for me. I could identify a much more repeatable relationship with gluten than with most other foods I tested.
Does everyone with PPP need to avoid gluten?
I would not assume that every person with PPP responds to gluten as I do. However, PPP research has identified gluten sensitivity and coeliac disease in a subset of patients, with improvement on a gluten-free diet reported among antibody-positive participants. If coeliac disease is a possibility, testing is best done before starting a strict gluten-free diet because removing gluten can affect the test results.
How quickly did your PPP improve after changing your diet?
I began noticing meaningful changes over the following weeks rather than overnight. My wider recovery took roughly three months, during which diet was combined with stress reduction, gut-health work, nutrient support and other lifestyle changes.
Did you stay on the strict diet forever?
No. The strict phase was a tool for learning. I later reintroduced foods and developed a much more individual long-term way of eating based on what I had learned about my own tolerance.
Where can I see the full PPP food framework?
My main Palmoplantar Pustulosis Diet page explains the food framework in detail and also includes access to my free Healing Diets comparison guide.
Use my experience as a starting point, not as a cage.
My main PPP Diet page shows the food categories I prioritised, the foods I temporarily removed, how to keep a symptom diary and how to approach reintroduction without staying unnecessarily restrictive.
The diet mattered enormously. The book explains everything I did around it.
How to Treat Palmoplantar Pustulosis Naturally contains the fuller version of my recovery process, including the food framework, possible triggers, supplements, gut health, stress, symptom relief and the 90-day structure I used while trying to put all the pieces together.
I wrote it because I wanted other people with PPP to have the practical roadmap I had been searching for when I was at my worst.
The other pieces of my PPP recovery.
Sources used for this 2026 update.
- Michaëlsson G, Kristjánsson G, Pihl Lundin I, Hagforsen E. Palmoplantar pustulosis and gluten sensitivity: a study of serum antibodies against gliadin and tissue transglutaminase, the duodenal mucosa and effects of gluten-free diet. Br J Dermatol. 2007. View the gluten study .
- Serizawa N, et al. Dietary habits in Japanese patients with palmoplantar pustulosis. J Dermatol. 2021. View the dietary habits study .
- Mrowietz U, van de Kerkhof PCM. Management of palmoplantar pustulosis: do we need to change? Br J Dermatol. 2011. View the PPP management review .
- British Association of Dermatologists. Palmoplantar pustulosis patient information leaflet. Read the BAD guidance .
