Honey has been appreciated as food since the dawn of history, and undoubtedly long before. Its medicinal use is also ancient. The Greek physician Hippocrates recommended topical application of honey for infected wounds and ulcers of the lips; Roman physicians used honey as an oral medication for constipation, diarrhea, upset stomach, sore throat and coughs.
Honey consists largely of fructose and glucose, two related forms of sugar. Its sugar concentration is high enough to kill microorganisms in the same manner as the sugar in jams and jellies. This would appear to be the primary basis for honey's most studied use: as a topical application to treat or prevent infection.
In some controlled trials, honey has shown some promise for treating abcesses,3, diabetic foot ulcers,19 venous leg ulcers,21,26, pressure ulcers (bedsores)26minor abrasions,17 and post-operative wound infections,7 as well as for preventing infections following surgery 9 and catheter infections in people undergoing hemodialysis.10
In most of these studies, honey was not used alone but combined with standard treatments, such as oral or topical antibiotics or surgical debridement (removal of dead tissue). Not all studies show clear benefit, however. One trial found that antibacterial honey (Medihoney) did not significantly improve wound healing in 105 patients mostly suffering from leg ulcers.20 Conversely, topical honey improved healing time compared to saline gauze and silver sulfadiazine in 2 trials of 140 patients with skin ulcers or burns.25
The best evidence is probably for the acute treatment of minor burns,4-6,18,26 though the studies supporting this use remain inconclusive. Sugar paste too has shown promise as a wound treatment. However, some evidence hints that honey may be more effective than concentrated sugar.1 If true, this suggests that additional non-sugar constituents of honey provide benefit. It is often stated in honey-related literature that honey produces hydrogen peroxide, and that this explains additional benefit. However, there is no evidence that honey produces sufficient hydrogen peroxide to have any meaningful effect. Another theory is that honey might stimulate healing.2
Honey has also been studied as a potential treatment for nighttime cough.23,24 In one study, 130 children aged 2-17 with runny nose and cough were randomized to receive nightly doses of buckwheat honey, artificial honey-flavored cough medicine (dextromethorphan), or no treatment.23 On a parent-rated symptom scale, honey was found to be the most helpful in reducing nighttime cough and improving sleep in children with upper respiratory infection. Adding to these positive results, another study randomized 139 children aged 2-5 years old with upper respiratory infection to 1 of 4 treatment groups: honey, dextromethorphan, diphenhydramine (eg, Benadryl), or no treatment.24 Standard care, such as acetaminophen and nose drops, was also given to all children as needed. While improvement was seen in all of the groups, children receiving honey had the fewest episodes of nighttime cough and slept better compared to children in the other groups.
Oral consumption of honey might have a slight laxative effect.14 Honey taken by mouth might also increase the body's ability to metabolize alcohol, thereby limiting intoxication and more rapidly reducing alcohol blood levels.12 Finally, one study hints that honey might improve cholesterol profile and blood sugar levels.13
A small study of 40 patients suggests topical honey may help prevent development of oral mucositis (painful inflammation of mucus membranes in the mouth) in patients having radiochemotherapy for head and neck cancer.22
When used topically to treat burns, honey is generally applied either directly to the wound in a thin coat, or in the form of a honey-soaked dressing.
Oral dosages of honey for medicinal purposes range from 1 to 5 tablespoons several times daily.
As a widely consumed food, honey is believed to be quite safe. However, infants younger than 12 months should not consume honey, due to the risk of infant botulism.
Honey may contain slight amounts of pollen. However, it appears that allergy to honey is uncommon among pollen-allergic people.16
Efem SE, Udoh KT, Iwara CI. The antimicrobial spectrum of honey and its clinical significance. Infection. 1992;20:227-9.
Molan PC. Potential of honey in the treatment of wounds and burns. Am J Clin Dermatol. 2001;2:13-9.
Okeniyi JA, Olubanjo OO, Ogunlesi TA et al. Comparison of Healing of Incised Abscess Wounds with Honey and EUSOL Dressing. J Altern Complement Med. 2005;11:511-3.
Subrahmanyam M. Honey-impregnated gauze versus amniotic membrane in the treatment of burns. Burns. 1994;20:331-3.
Subrahmanyam M. A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. Burns. 1998;24:157-61.
Subrahmanyam M. Honey impregnated gauze versus polyurethane film (OpSite) in the treatment of burns--a prospective randomised study. Br J Plast Surg. 1993;46:322-3.
Al-Waili NS, Saloom KY. Effects of topical honey on post-operative wound infections due to gram positive and gram negative bacteria following caesarean sections and hysterectomies. Eur J Med Res. 1999;4:126-30.
McIntosh CD, Thomson CE. Honey dressing versus paraffin tulle gras following toenail surgery. J Wound Care. 2006;15:133-6.
Johnson DW, van Eps C, Mudge DW et al. Randomized, Controlled Trial of Topical Exit-Site Application of Honey (Medihoney) versus Mupirocin for the Prevention of Catheter-Associated Infections in Hemodialysis Patients. J Am Soc Nephrol. 2005 Mar 23 [Epub ahead of print]
English HK, Pack AR, Molan PC. The effects of manuka honey on plaque and gingivitis: a pilot study. J Int Acad Periodontol. 2004;6:63-7.
Onyesom I. Honey-induced stimulation of blood ethanol elimination and its influence on serum triacylglycerol and blood pressure in man. Ann Nutr Metab. 2005;49:319-24.
Al-Waili NS. Natural honey lowers plasma glucose, C-reactive protein, homocysteine, and blood lipids in healthy, diabetic, and hyperlipidemic subjects: comparison with dextrose and sucrose. J Med Food. 2004;7:100-7.
Ladas SD, Haritos DN, Raptis SA. Honey may have a laxative effect on normal subjects because of incomplete fructose absorption. Am J Clin Nutr. 1996;62:1212-5.
Rajan TV, Tennen H, Lindquist RL et al. Effect of ingestion of honey on symptoms of rhinoconjunctivitis. Ann Allergy Asthma Immunol. 2002;88:198-203.
Kiistala R, Hannuksela M, Makinen-Kiljunen S et al. Honey allergy is rare in patients sensitive to pollens. Allergy. 1996;50:844-7.
Ingle R, Levin J, Polinder K. Wound healing with honey - a randomised controlled trial. S Afr Med J. 2006;96:831-5.
Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2008;CD005083.
Shukrimi A, Sulaiman AR, Halim AY, et al. A comparative study between honey and povidone iodine as dressing solution for Wagner type II diabetic foot ulcers. Med J Malaysia. 2008;63:44-46.
Robson V, Dodd S, Thomas S. Standardized antibacterial honey (Medihoney) with standard therapy in wound care: randomized clinical trial. : J Adv Nurs. 2009;65:565-575.
Gethin G, Cowman S. Manuka honey vs. hydrogel--a prospective, open label, multicentre, randomised controlled trial to compare desloughing efficacy and healing outcomes in venous ulcers. J Clin Nurs. 2009;18:466-74.
Rashad UM, Al-Gezawy SM, El-Gezawy E, Azzaz AN. Honey as topical prophylaxis against radiochemotherapy-induced mucositis in head and neck cancer. J Laryngol Otol. 2009;123:223.
Shadkam MN, Mozaffari-Khosravi H, Mozayan MR. A comparison of the effect of honey, dextromethorphan, and diphenhydramine on nightly cough and sleep quality in children and their parents. J Altern Complement Med. 2010;16(7):787-793.
Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM Jr. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med. 2007 Dec;161(12):1140-6.
Jull AB, Walker N, et al. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2013;2:CD005083.
Jull AB, Cullum N, et al. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2015;3:CD005083.
Last reviewed December 2015 by EBSCO CAM Review Board
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