My journey from painful flares to long-term freedom

Palmoplantar Pustulosis Remission

More than fifteen years ago, I changed the way I ate, managed stress, supported my digestion, slept and cared for my body. Within months, my PPP stopped returning, and I have remained free from a significant flare ever since.

My experience is not unique. Over the years, I have heard from many people in the PPP community who also describe reaching remission after identifying personal triggers and making meaningful lifestyle changes.

This page is about what became possible when I stopped treating each outbreak as an isolated skin problem and began changing the wider conditions that were keeping my body under pressure.

Read my remission story See the changes I made

Written by Åsa Kärrman · Author and PPP patient advocate · Last updated August 11, 2026

1 Listen Notice patterns, symptoms and possible personal triggers
2 Change Test practical shifts in food, stress, sleep and daily habits
3 Heal Give the body time and the conditions it needs to recover
My central message: PPP may be chronic, but chronic does not always mean constantly active. Long-term remission is possible.
Åsa Kärrman, author and palmoplantar pustulosis patient advocate
My personal experience

I was told I would have to learn to live with PPP. I decided to look deeper.

At my worst, the pain made walking difficult and affected almost every part of daily life. After being misdiagnosed several times, I finally received a PPP diagnosis, but very few answers about why it had happened or what I could do beyond managing the symptoms.

I began researching inflammation, food sensitivities, digestive health, stress, sleep, nutrient status and environmental triggers. I then made several lifestyle changes at the same time.

Within approximately three months, the cycle of new pustules stopped. My skin healed, my pain disappeared and ordinary life returned. More than fifteen years later, I still have not experienced another significant flare.

I changed several things together because I no longer saw food, digestion, nutrients, sleep and stress as separate issues. The combined effect stopped the cycle of new outbreaks and allowed my skin to heal.
My book is built around one central idea: managing symptoms is not always the end of the road. Understanding the patterns behind your flares can change the direction of your health.
What remission means to me

Remission is more than temporarily suppressing visible symptoms.

It means reaching a sustained period in which the disease is no longer actively controlling your skin, your movement or your life. The skin clears, the pain settles and new pustules stop appearing.

Clear skin

No recurring crops of pustules, active inflammation or painful fissures.

Recovered function

Walking, working, sleeping and using your hands no longer revolve around pain.

Long-term stability

The improvement continues over time rather than lasting only while a short treatment is being used.

Remission is a real outcome

Fifteen years without a significant flare is not temporary improvement.

It is a fundamentally different life. My skin healed, the pain stopped, normal movement returned and PPP ceased to dictate my choices.

I still respect the signals my body gives me, but I no longer live as though another severe outbreak is inevitable.

The changes behind my remission

I did not wait for one perfect treatment. I changed the environment my body was living in.

These were the main areas I explored. I did not view them as separate tricks, but as connected parts of the same healing process.

My experience

Removing foods that appeared to trigger inflammation

I removed gluten, sugar and dairy and later explored other foods through an elimination process. My symptoms improved as my diet became simpler and less inflammatory for me. I describe that part of my journey in more detail in The Diet That Healed My Palmoplantar Pustulosis.

My experience

Supporting digestive health

I focused on probiotics, fermented foods, digestive support and nutrient-dense meals. This became an important part of how I viewed immune balance and recovery.

My experience

Correcting nutritional gaps

I paid closer attention to vitamin D, zinc and other nutrients that support general health and immune function.

My experience

Looking for patterns instead of isolated symptoms

I stopped viewing each pustule as a separate skin problem and began asking what was happening in my body before each flare. That shift in thinking is also the focus of Behavioural Change and Palmoplantar Pustulosis.

My experience

Giving change enough time

I did not expect one meal or one supplement to transform my skin. I stayed consistent long enough to see whether the overall pattern changed.

These were the areas that mattered most in my recovery. Your strongest triggers may be different, which is why careful observation and gradual testing matter more than copying another person's protocol exactly.

What I have learned from the PPP community

My story is personal, but the pattern is not limited to me.

Through my books, website and support community, I have heard from many people who describe meaningful improvement or remission after changing several aspects of their lifestyle. These stories do not prove that the same approach will work for everyone, but they are an important part of why I continue to write about remission and individual triggers.

Different triggers

One person may identify gluten, another stress, smoking, infection, alcohol, medication or a combination of factors.

Overlapping foundations

The details differ, but food quality, digestive health, sleep, stress, infections, nutrient status and consistency appear repeatedly.

No universal formula

Lifestyle-led remission is not about forcing everyone into the same rigid diet. It is about identifying the combination of factors that keeps your own symptoms active and changing what is within your reach.

Related reading

Explore remission, stress and treatment choices in more detail.

These articles expand on the themes that became most important during my own recovery: personal triggers, behaviour, stress and the different paths people may take toward symptom control or remission.

Stress and Palmoplantar Pustulosis How I think about the flare-stress cycle and why stress became one of my most important personal triggers. Behavioural Change and PPP Why long-term habits, mindset and consistency became part of my approach alongside diet. Natural Healing vs Biologics My personal treatment decision, what I learned and why different people may make different choices. Is Natural Healing Possible? A closer look at the question of natural recovery and what remission can realistically mean.
Personal recovery stories

Other people have found their own paths forward too.

These are individual experiences, not treatment instructions. I share them because first-hand stories can offer perspective and hope when you are living through a difficult flare.

Michelle's Recovery Story Michelle's experience of changing her diet and lifestyle after developing PPP. Sophie's Recovery Story A severe case, a difficult treatment journey and Sophie's experience of reaching remission. Janine's PPP Journey Janine's personal story of recovery after years of living with palmoplantar pustulosis.
Remission is not only clear skin. It is getting your ordinary life back.

Walking without calculating every step. Holding a cup without pain. Planning a journey without wondering whether your feet will cope. Going days, weeks and eventually years without thinking about your skin.

What changed after my skin healed

The greatest result was not cosmetic. It was freedom.

Physical freedom

  • No new pustules or painful fissures
  • Walking and standing became normal again
  • I could use my hands without protecting every movement
  • Sleep was no longer interrupted by pain or itching
  • My skin stopped dictating what I could do

Mental freedom

  • I stopped waiting for the next flare
  • Food choices became informed rather than fearful
  • I trusted my body again
  • I could plan work, travel and family life normally
  • PPP became part of my history rather than my daily identity
What I still do today

I no longer live on a strict protocol, but I have not forgotten what my body taught me.

1

I protect my stress levels

Stress remains the trigger I respect most. I notice early signs of overload and prioritise sleep, boundaries and recovery.

2

I return to the basics when needed

My diet is less restrictive than it was during recovery, but I know which foods and habits make me feel less well.

3

I choose sustainability over perfection

Long-term health is not about performing a flawless protocol. It is about returning consistently to the habits that support you.

Remission should create a bigger life, not a smaller one.

The purpose of changing your lifestyle is not to become afraid of food, stress or ordinary life. It is to understand your body well enough that you can live more freely.

If symptoms begin to return

A small setback is information, not proof that remission has failed.

A new spot or brief period of irritation does not erase years of progress. It is information. It may point to renewed stress, disrupted sleep, infection, medication, food changes or another factor worth reviewing.

Questions I would ask myself

  • Has my stress level increased?
  • Have sleep and recovery changed?
  • Have I recently taken antibiotics or another new medicine?
  • Have old food patterns gradually returned?
  • Am I dealing with an infection or another physical strain?

Practical next steps

  • Photograph the change and track its progression
  • Return to the foundations that previously helped
  • Review recent medicines, infections, stress and exposures
  • Change one or two things at a time so patterns remain visible
  • Seek appropriate care if symptoms spread rapidly or feel different
Continue your own investigation

Start with the area that feels most relevant to you.

What Is PPP? Understand the condition, symptoms, diagnosis and treatment options. PPP Diet Read how I used food elimination and reintroduction to explore my triggers. PPP Pictures See active flares, fissures, peeling and healing at different stages. PPP FAQ Answers about triggers, remission, diet, gut health and support. PPP Support Connect with others who understand the physical and emotional impact. All PPP Resources Browse the complete collection of guides, articles and practical tools.
The complete remission journey

How to Treat Palmoplantar Pustulosis Naturally

The book tells the full story of how I went from painful active disease to long-term remission. It explains the areas I researched, the changes I tested and the practical framework I used to understand my own body.

It is written for people who want more than a list of symptoms and medications, people who want to investigate why their PPP may be active and what they can do to support healing.

Learn about the book View paperback
Experience, patterns and research

Lived experience can reveal questions that short clinical studies do not answer.

This page brings together my own long-term remission, patterns repeatedly shared within the PPP community and published information about the condition. Each source contributes a different part of the picture.

  1. British Association of Dermatologists. Palmoplantar pustulosis. Read the patient guidance .
  2. Heidemeyer K, et al. Palmoplantar Pustulosis: A Systematic Review of Risk Factors and Therapies. Read the systematic review .
  3. DermNet. Palmoplantar pustulosis. Read the clinical summary .
Use this information thoughtfully: Let it help you recognise patterns, ask better questions and make more informed choices. Do not stop prescribed medication without discussing it with the person who prescribed it, and seek appropriate care for rapidly worsening, widespread or unusual symptoms.