Palmoplantar Pustulosis Diet: What to Eat and What to Avoid
When I was first diagnosed with palmoplantar pustulosis, no doctor mentioned diet. Not once. And yet, changing what I ate turned out to be one of the most powerful steps in my recovery.
I am not claiming that diet alone will cure PPP. But I can tell you from my own 15 years of experience, and from the thousands of patients I have connected with through my support community, that what you eat has a direct and significant effect on inflammation, flare-up frequency, and skin healing in PPP.
This page covers the dietary framework that helped me reach remission, and the key principles behind it.
I am not claiming that diet alone will cure PPP. But I can tell you from my own 15 years of experience, and from the thousands of patients I have connected with through my support community, that what you eat has a direct and significant effect on inflammation, flare-up frequency, and skin healing in PPP.
This page covers the dietary framework that helped me reach remission, and the key principles behind it.
Why Does Diet Affect Palmoplantar Pustulosis?
PPP is an immune-mediated inflammatory condition. The immune system becomes dysregulated and attacks the skin, creating the characteristic pustules and inflammation.
Diet affects PPP through several mechanisms:
Diet affects PPP through several mechanisms:
- Gut health and the microbiome directly influence immune function. A disrupted gut barrier ('leaky gut') can allow inflammatory compounds into the bloodstream, triggering immune responses throughout the body, including in the skin.
- Certain foods are inherently pro-inflammatory (sugar, refined grains, vegetable oils) and drive the inflammatory pathways active in PPP.
- Nutritional deficiencies, particularly in vitamin D, zinc, and omega-3 fatty acids, impair the body's natural regulatory mechanisms.
- Food sensitivities (gluten, dairy) can trigger localised immune reactions that worsen PPP flare-ups in susceptible individuals.
The Anti-Inflammatory PPP Diet: What to Eat
Fatty fish and omega-3 rich foods
Omega-3 fatty acids are among the most researched natural anti-inflammatories. I ate fatty fish 3–4 times per week:
- Salmon (wild-caught where possible)
- Sardines and mackerel
- Herring and anchovies
- Flaxseeds and chia seeds (plant-based omega-3)
- Walnuts
Vegetables, especially leafy greens and cruciferous
Vegetables are the foundation of any anti-inflammatory diet. I prioritised:
- Spinach, kale, rocket, and Swiss chard
- Broccoli, cauliflower, Brussels sprouts, and cabbage
- Sweet potatoes and carrots (rich in beta-carotene)
- Beetroot (anti-inflammatory and supports liver detox)
- Courgette, cucumber, and celery
Fermented foods for gut health
Rebuilding a healthy gut microbiome was central to my recovery. I incorporated fermented foods daily:
- Sauerkraut and kimchi (unpasteurised)
- Natural live yogurt (I reintroduced dairy slowly, it was only an issue for me in large quantities)
- Kefir
- Miso (in moderation, it is high in sodium)
- Kombucha
Herbs and spices with anti-inflammatory properties
- Turmeric with black pepper (enhances absorption)
- Ginger, in teas, soups, and cooking
- Garlic, also prebiotic, supporting gut bacteria
- Rosemary, oregano, and thyme
Fruits
I focused on lower-sugar fruits and berries rich in antioxidants:
- Blueberries, raspberries, and blackberries
- Pomegranate
- Avocado (also rich in healthy fats)
- Apples (in moderation)
Healthy fats
- Extra-virgin olive oil as the primary cooking fat
- Avocado oil for higher-heat cooking
- Coconut oil (in moderation)
- Raw nuts and seeds (not roasted in vegetable oil)
What to Avoid: Foods That Trigger PPP Flare-Ups
Gluten
Gluten was my single biggest dietary trigger. Within days of eating gluten-containing foods, my skin would worsen noticeably. While not every PPP patient has a gluten sensitivity, the link between gluten, gut permeability, and autoimmune conditions is well-documented.
Foods to eliminate or significantly reduce:
Foods to eliminate or significantly reduce:
- Wheat bread, pasta, and baked goods
- Rye, barley, and spelt
- Most breakfast cereals
- Beer and malt-based drinks
- Many sauces, soups, and processed foods contain hidden gluten, read labels carefully
Refined sugar
Sugar drives inflammation directly and feeds dysbiotic gut bacteria. I eliminated:
- Sweets, chocolate, cakes, and biscuits
- Fruit juices and fizzy drinks
- White bread, white rice, and other refined carbohydrates
- Most breakfast cereals and flavoured yogurts
Dairy (particularly in the early phase)
Dairy was a moderate trigger for me. I eliminated it fully during my initial recovery phase, then reintroduced it slowly. Many PPP patients find that hard cheeses and butter cause fewer problems than milk or soft cheeses. Listen to your own body.
Alcohol
Alcohol is pro-inflammatory, disrupts gut bacteria, depletes zinc and other key nutrients, and impairs liver function. I eliminated it entirely during my recovery period.
Vegetable oils high in omega-6
An imbalance between omega-6 and omega-3 fatty acids drives inflammation. I replaced:
- Sunflower oil, corn oil, soybean oil, and margarine
- With: olive oil, coconut oil, and avocado oil
Processed and ultra-processed foods
Ready meals, fast food, crisps, and packaged snacks typically contain a combination of the above: refined flour, sugar, seed oils, additives, and preservatives, a perfect storm for PPP inflammation.
Practical Tips: How to Make These Changes Stick
- Don't try to change everything at once. Start by removing your top two or three suspected triggers, then adjust from there.
- Keep a food and symptom diary. Track what you eat and note any flare-up patterns. Within a few weeks, patterns often become visible.
- Meal prep is your friend. When healthy food is ready in the fridge, you are less likely to reach for processed alternatives.
- Focus on what you are adding, not just what you are removing. An abundance mindset makes the transition sustainable.
- Be patient. Dietary changes typically take 6–12 weeks to show measurable effects on skin inflammation.
My Free Diet Booklet
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I have created a free booklet that outlines exactly which foods to eat and which to avoid while healing from PPP. Enter your email here to receive it.
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Diet is not a magic cure for PPP.
But it is one of the most powerful tools available to you, completely within your control,
with no side effects, and cumulative in its benefits over time.
