Potential of Honey in the Treatment of Wounds and Burns

Abstract

There has been a renaissance in recent times in the use of honey, an ancient and traditional wound dressing, for the treatment of wounds, burns, and skin ulcers. In the past decade there have been many reports of case studies, experiments using animal models, and randomized controlled clinical trials that provide a large body of very convincing evidence for its effectiveness, and biomedical research that explains how honey produces such good results.

As a dressing on wounds, honey provides a moist healing environment, rapidly clears infection, deodorizes, and reduces inflammation, edema, and exudation. Also, it increases the rate of healing by stimulation of angiogenesis, granulation, and epithelialization, making skin grafting unnecessary and giving excellent cosmetic results.

This is a preview of subscription content, log in to check access.

Table I
Table II
Fig. 1
Fig. 2
Table III
Fig. 3
Fig. 4

References

  1. 1.

    Zumla A., Lulat A. Honey — a remedy rediscovered. J R Soc Med 1989; 82: 384–385

    PubMed  CAS  Google Scholar 

  2. 2.

    Majno G. The healing hand. Man and wound in the ancient world. Cambridge (MA): Harvard University Press, 1975

    Google Scholar 

  3. 3.

    Forrest R.D. Early history of wound treatment. J R Soc Med 1982; 75: 198–205

    PubMed  CAS  Google Scholar 

  4. 4.

    Gunther R.T. The Greek herbal of Dioscorides. New York: Hafner, 1934. Reprinted 1959

    Google Scholar 

  5. 5.

    Ankra-Badu G.A. Sickle cell leg ulcers in Ghana. East Afr Med J 1992; 69 (7): 366–369

    PubMed  CAS  Google Scholar 

  6. 6.

    Imperato P.J., Traoré D. Traditional beliefs about measles and its treatment among the Bambara of Mali. Trop Geogr Med 1969; 21: 62–67

    PubMed  CAS  Google Scholar 

  7. 7.

    Soffer A. Chihuahuas and laetrile, chelation therapy, and honey from Boulder, Colorado [editorial]. Arch Intern Med 1976; 136: 865–866

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Honey: sweet and dangerous or panacea [editorial]? S Afr Med J 1974; 56: 2300

  9. 9.

    Condon R.E. Curious interaction of bugs and bees [editorial]. Surgery 1993; 113 (2): 234–235

    PubMed  CAS  Google Scholar 

  10. 10.

    Green A.E. Wound healing properties of honey. Br J Surg 1988; 75 (12): 1278

    Article  Google Scholar 

  11. 11.

    McInerney R.J.F. Honey — a remedy rediscovered. J R Soc Med 1990; 83: 127

    PubMed  CAS  Google Scholar 

  12. 12.

    Ndayisaba G., Bazira L., Habonimana E., et al. Clinical and bacteriological results in wounds treated with honey. J Orthop Surg 1993; 7 (2): 202–204

    Google Scholar 

  13. 13.

    Efem S.E.E. Clinical observations on the wound healing properties of honey. Br J Surg 1988; 75: 679–681

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Wood B., Rademaker M., Molan P.C. Manuka honey, a low cost leg ulcer dressing. N Z Med J 1997; 110: 107

    PubMed  CAS  Google Scholar 

  15. 15.

    Vardi A., Barzilay Z., Linder N., et al. Local application of honey for treatment of neonatal postoperative wound infection. Acta Paediatr 1998; 87 (4): 429–432

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Cavanagh D., Beazley J., Ostapowicz F. Radical operation for carcinoma of the vulva. A new approach to wound healing. J Obstet Gynaecol Br Commonw 1970; 77 (11): 1037–1040

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Bulman M.W. Honey as a surgical dressing. Middlesex Hosp J 1955; 55: 188–189

    Google Scholar 

  18. 18.

    Armon P.J. The use of honey in the treatment of infected wounds. Trop Doct 1980; 10: 91

    PubMed  CAS  Google Scholar 

  19. 19.

    Bergman A., Yanai J., Weiss J., et al. Acceleration of wound healing by topical application of honey. An animal model. Am J Surg 1983; 145: 374–376

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Hutton D.J. Treatment of pressure sores. Nurs Times 1966; 62 (46): 1533–1534

    PubMed  CAS  Google Scholar 

  21. 21.

    Phuapradit W., Saropala N. Topical application of honey in treatment of abdominal wound disruption. Aust N Z J Obstet Gynaecol 1992; 32 (4): 381–384

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Dunford C., Cooper R.A., Molan P.C. Using honey as a dressing for infected skin lesions. Nurs Times 2000; 96 (NTPLUS 14): 7–9

    PubMed  CAS  Google Scholar 

  23. 23.

    Subrahmanyam M. Topical application of honey in treatment of burns. Br J Surg 1991; 78 (4): 497–498

    PubMed  Article  CAS  Google Scholar 

  24. 24.

    Subrahmanyam M. Honey impregnated gauze versus polyurethane film (OpSite®) in the treatment of burns — a prospective randomised study. Br J Plast Surg 1993; 46 (4): 322–323

    PubMed  Article  CAS  Google Scholar 

  25. 25.

    Subrahmanyam M. Honey dressing versus boiled potato peel in the treatment of burns: a prospective randomized study. Burns 1996; 22 (6): 491–493

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Burlando F. Sull’azione terapeutica del miele nelle ustioni. Minerva Dermatol 1978; 113: 699–706

    Google Scholar 

  27. 27.

    Blomfield R. Honey for decubitus ulcers. J Am Med Assoc 1973; 224 (6): 905

    Article  Google Scholar 

  28. 28.

    Subrahmanyam M. A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. Burns 1998; 24 (2): 157–161

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Subrahmanyam M. Honey-impregnated gauze versus amniotic membrane in the treatment of burns. Burns 1994; 20 (4): 331–333

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Adesunkanmi K., Oyelami O.A. The pattern and outcome of burn injuries at Wesley Guild Hospital, Ilesha, Nigeria: a review of 156 cases. J Trop Med Hyg 1994; 97 (2): 108–112

    PubMed  CAS  Google Scholar 

  31. 31.

    Efem S.E.E. Recent advances in the management of Fournier’s gangrene: preliminary observations. Surgery 1993; 113 (2): 200–204

    PubMed  CAS  Google Scholar 

  32. 32.

    Hejase M.J., E. S.J., Bihrle R., et al. Genital Fournier’s gangrene: experience with 38 patients. Urology 1996; 47 (5): 734–739

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Somerfield S.D. Honey and healing. J R Soc Med 1991; 84 (3): 179

    PubMed  CAS  Google Scholar 

  34. 34.

    Tovey F.I. Honey and healing. J R Soc Med 1991; 84 (7): 447

    PubMed  CAS  Google Scholar 

  35. 35.

    Harris S. Honey for the treatment of superficial wounds: a case report and review. Primary Intention (Aust J Wound Manage) 1994; 2 (4): 18–23

    Google Scholar 

  36. 36.

    Bloomfield E. Old remedies. J R Coll Gen Pract 1976; 26: 576

    Google Scholar 

  37. 37.

    Braniki F.J. Surgery in Western Kenya. Ann R Coll Surg Engl 1981; 63: 348–352

    Google Scholar 

  38. 38.

    Molan P.C. A brief review of honey as a clinical dressing. Primary Intention (Aust J Wound Manage) 1998; 6 (4): 148–158

    Google Scholar 

  39. 39.

    Kumar A., Sharma V.K., Singh H.P., et al. Efficacy of some indigenous drugs in tissue repair in buffaloes. Indian Vet J 1993; 70 (1): 42–44

    CAS  Google Scholar 

  40. 40.

    Oryan A., Zaker S.R. Effects of topical application of honey on cutaneous wound healing in rabbits. J Vet Med Ser A 1998; 45 (3): 181–188

    Article  CAS  Google Scholar 

  41. 41.

    Gupta S.K., Singh H., Varshney A.C., et al. Therapeutic efficacy of honey in infected wounds in buffaloes. Indian J Anim Sci 1992; 62 (6): 521–523

    Google Scholar 

  42. 42.

    Subrahmanyam M. Early tangential excision and skin grafting of moderate burns is superior to honey dressing: a prospective randomised trial. Burns 1999; 25 (8): 729–731

    PubMed  Article  CAS  Google Scholar 

  43. 43.

    White J.W. Composition of honey. In: Crane E., editor. Honey: a comprehensive survey. London: Heinemann, 1975: 157–206

    Google Scholar 

  44. 44.

    Frankel S., Robinson G.E., Berenbaum M.R. Antioxidant capacity and correlated characteristics of 14 unifloral honeys. J Apic Res 1998; 37 (1): 27–31

    CAS  Google Scholar 

  45. 45.

    Molan P.C. The antibacterial activity of honey. 1. The nature of the antibacterial activity. Bee World 1992; 73 (1): 5–28

    Google Scholar 

  46. 46.

    Allen K.L., Molan P.C., Reid G.M. A survey of the antibacterial activity of some New Zealand honeys. J Pharm Pharmacol 1991; 43 (12): 817–822

    PubMed  Article  CAS  Google Scholar 

  47. 47.

    Chirife J., Herszage L., Joseph A., et al. In vitro study of bacterial growth inhibition in concentrated sugar solutions: microbiological basis for the use of sugar in treating infected wounds. Antimicrob Agents Chemother 1983; 23 (5): 766–773

    PubMed  Article  CAS  Google Scholar 

  48. 48.

    Kaufman T., Levin M., Hurwitz D.J. The effect of topical hyperalimentation on wound healing rate and granulation tissue formation of experimental deep second degree burns in guinea-pigs. Burns 1984; 10 (4): 252–256

    Article  CAS  Google Scholar 

  49. 49.

    Bose B. Honey or sugar in treatment of infected wounds? Lancet 1982 Apr; I (24): 963

    Article  Google Scholar 

  50. 50.

    Keast-Butler J. Honey for necrotic malignant breast ulcers. Lancet 1980 Oct; II (11): 809

    Article  Google Scholar 

  51. 51.

    Mossel D.A.A. Honey for necrotic breast ulcers. Lancet 1980 Nov; II (15): 1091

    Article  Google Scholar 

  52. 52.

    Molan P.C. The antibacterial activity of honey. 2. Variation in the potency of the antibacterial activity. Bee World 1992; 73 (2): 59–76

    Google Scholar 

  53. 53.

    Willix D.J., Molan P.C., Harfoot C.J. A comparison of the sensitivity of wound-infecting species of bacteria to the antibacterial activity of manuka honey and other honey. J Appl Bacteriol 1992; 73: 388–394

    PubMed  Article  CAS  Google Scholar 

  54. 54.

    Cooper R.A., Molan P.C., Harding K.G. Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds. J R Soc Med 1999; 92: 283–285

    PubMed  CAS  Google Scholar 

  55. 55.

    Cooper R.A., Molan P.C. The use of honey as an antiseptic in managing Pseudomonas infection. J Wound Care 1999; 8 (4): 161–164

    PubMed  CAS  Google Scholar 

  56. 56.

    Abuharfeil N., Al-Oran R., Abo-Shehada M. The effect of bee honey on the proliferative activity of human B- and T-lymphocytes and the activity of phagocytes. Food Agric Immunol 1999; 11: 169–177

    Article  CAS  Google Scholar 

  57. 57.

    Van Wart H.E., Birkedal-Hansen H. The cystein switch: a principle of regulation of metalloproteinase activity with potential applicability to the entire matrix metalloproteinase gene family. Proc Nat Acad Sci U S A 1990; 87 (14): 5578–5582

    Article  Google Scholar 

  58. 58.

    Flohé L, Beckmann R., Giertz H., et al. Oxygen-centred free radicals as mediators of inflammation. In: Sies H., editor. Oxidative stress. London, Orlando: Academic Press, 1985: 403–435

    Google Scholar 

  59. 59.

    Kaufman T., Eichenlaub E.H., Angel M.F., et al. Topical acidification promotes healing of experimental deep partial thickness skin burns: a randomised double-blind preliminary study. Burns 1985; 12: 84–90

    Article  CAS  Google Scholar 

  60. 60.

    Kaufman T., Neuman R.A., Weinberg A. Is postburn dermal ischaemia enhanced by oxygen free radicals? Burns 1989; 15 (5): 291–294

    PubMed  Article  CAS  Google Scholar 

  61. 61.

    Tanaka H., Hanumadass M., Matsuda H., et al. Hemodynamic effects of delayed initiation of antioxidant therapy (beginning two hours after burn) in extensive third-degree burns. J Burn Care Rehabil 1995; 16 (6): 610–615

    PubMed  Article  CAS  Google Scholar 

  62. 62.

    Murrell G.A.C., Francis M.J.O., Bromley L. Modulation of fibroblast proliferation by oxygen free radicals. Biochem J 1990; 265: 659–665

    PubMed  CAS  Google Scholar 

  63. 63.

    Tur E., Bolton L., Constantine B.E. Topical hydrogen peroxide treatment of ischemic ulcers in the guinea pig: blood recruitment in multiple skin sites. J Am Acad Dermatol 1995; 33 (2 Pt 1): 217–221

    PubMed  Article  CAS  Google Scholar 

  64. 64.

    Chung L.Y., Schmidt R.J., Andrews A.M., et al. A study of hydrogen peroxide generation by, and antioxidant activity of, Granuflex? (DuoDERM?) Hydrocolloid Granules and some other hydrogel/hydrocolloid wound management materials. Br J Dermatol 1993; 129 (2): 145–153

    PubMed  Article  CAS  Google Scholar 

  65. 65.

    Postmes T., Vandeputte J. Recombinant growth factors or honey? Burns 1999; 25 (7): 676–678

    PubMed  CAS  Google Scholar 

  66. 66.

    Aristotle. Historia animalium. In: Smith J.A., Ross W.D., editors. The works of Aristotle (350 BC). Vol IV. Oxford, UK: Oxford University, 1910

    Google Scholar 

  67. 67.

    Molan P.C., Allen K.L. The effect of gamma-irradiation on the antibacterial activity of honey. J Pharm Pharmacol 1996; 48: 1206–1209

    PubMed  Article  CAS  Google Scholar 

  68. 68.

    Postmes T., van den Bogaard A.E., Hazen M. The sterilization of honey with cobalt 60 gamma radiation: a study of honey spiked with Clostridium botulinum and Bacillus subtilis. Experentia (Basel) 1995; 51: 986–989

    Article  Google Scholar 

Download references

Acknowledgements

The advice of Julie Betts, Wound Resource Nurse, Community Health, Health Waikato Ltd., New Zealand, and Val Robson, Clinical Nurse Specialist Leg Ulcer Care, University Hospital Aintree, Liverpool, England, on the practical aspects of the clinical usage of honey is gratefully acknowledged. Photographs were provided by Julie Betts.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Associate Professor Peter C. Molan.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Molan, P.C. Potential of Honey in the Treatment of Wounds and Burns. Am J Clin Dermatol 2, 13–19 (2001). https://doi.org/10.2165/00128071-200102010-00003

Download citation

Keywords

  • Amniotic Membrane
  • Fusidic Acid
  • Clostridium Botulinum
  • Rapid Healing
  • Manuka Honey