Manuka honey research reveals its potential to promote wound healing

Honey has for a long time been used as a traditional remedy in the treatment of wounds, particularly for the prevention and treatment of infection. Any potential here has real significance these days, at least in part because we’re seeing the emergence of more strains of bacteria that are resistant to antibiotics. And also because chronic (long-term) wounds can be debilitating for the sufferer and a huge drain in terms of healthcare spending and resources. Apparently, chronic wounds account for up to 4 per cent of health care expenses in the developed world. That’s a lot.

One specific form of honey that is renowned in natural medicine for its curative properties is manuka honey. I was interested to see that a recent study supports its use in chronic wounds [1]. The research involved assessing the impact of manuka honey on an organism known as Streptococcus pyogenese (S. pyogenes). This bacterium is commonly found in wounds that are chronically infected.

One characteristic of S. pyogenes is that it has the ability to clump together and cause what is called a ‘biofilm’. Biofilms can form when proteins on the bacterium attached to another protein (called fibronectin) on the surface of damaged tissue cells. The biofilm that can for as a result can protect the bacterium by making it inaccessible to antibiotics.

In this recent research, manuka honey was found to reduce the expression of the proteins it uses to attach to fibronectin, thereby disrupting the formation and maintenance of the biofilm. This research provides some insight in the mechanism through which manuka honey may prevent or treat wound infections. It is perhaps also worth bearing in mind that manuka honey has been found to inhibit literally dozens of bacterial species.

This piece of research reminded me of a conversation I had with a friend. His mother-in-law was in hospital and had been diagnosed with a chronic infection in an ulcer. My friend has some interest in natural medicine, did some on-line research, through which he learned about manuka honey and its potential for assisting wound healing. He took the idea to his mother-in-law’s doctors here in the UK. The response? They flatly refused to use it, though it was not clear quite what the objection was.

Research like this recent study should help mainstream acceptance of a nature substance which appears to have genuine value in the treatment of chronically infected wounds. This will be a good thing, as more widespread use is likely to save a lot of money and a lot of suffering.


1. Maddocks SE, et al. Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two fibronectin binding proteins. Microbiology. Published online ahead of print January 31, 2012

17 Responses to Manuka honey research reveals its potential to promote wound healing

  1. Vanessa 2 February 2012 at 2:04 pm #

    I would like to say that here in England my mother was treated with manuka honey dressings over the last five years. They did seem to be successful, but after further examination of her leg wound it was found to be a rare cancer, and was not curable.

    The manuka honey dressings did reduce the wound size and redness etc. and kept infection at bay, but as it was Porocarcinoma and it couldn’t be cured.

  2. frances 2 February 2012 at 3:17 pm #

    Do you use it internally or externally?

  3. Tony Mach 2 February 2012 at 10:24 pm #

    It looks to me like honey is on par with conventional wound care. Maybe this can be improved further (as we learn how honey works in wounds on a molecular level), but currently I don’t see it as being better than conventional wound care.


    Although animal studies report accelerated healing time with the use of medical-grade honey,19,20,26 results in humans have been varied. Recently, 3 small (n = 40, each study) randomized, single-blind (examiner) controlled trial27-29 and 1 small (n = 40) randomized, nonblinded controlled trial30 demonstrated that honey may have some protective effects against radiation-induced mucositis in head and neck cancer patients undergoing therapy.In a randomized, double-blind, controlled trial, honey dressing showed no difference in healing time compared with hydrogel dressings in patients who sustained abrasions or minor lacerations.31 In a randomized, double-blind controlled trial32 and a randomized single-blind controlled trial,33 patients who sustained toenail avulsions showed no differences in mean healing times when honey was compared with paraffin gauze and iodoform gauze, respectively. A meta-analysis of these 3 studies confirmed no statistical difference in mean time to healing between honey and conventional dressing in these minor acute wounds.6In several randomized controlled trials, using honey on minor burns (superficial to partial-thickness burns) shows accelerated healing time compared with conventional dressings, such as silver sulfadiazine dressing25,34-36 and transparent polyurethane film dressing.23Figure 1 shows an example of superficial partial-thickness burns (not treated with honey). In addition, honey was found to be superior to nonconventional dressings, such as potato peels37 and amniotic membrane.38 However, the strength of these studies has been questioned because of the absence of the description of how randomization was achieved.6,39 Meta-analyses of these trials showed the use of honey to accelerate healing of minor burns compared with the previously mentioned comparators.6,39,40 In moderate burns (partial-thickness to full-thickness burns), a randomized controlled trial reported that early excision was superior to honey dressing.41 However, this study also failed to clearly state the method of randomization, which also raises questions on the strength of the study. Clinicians must consider the available evidence when selecting dressings for burn wounds.

    Figure 1
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    As stated earlier, many chronic wounds have their origins from circulatory compromise. Because topical agents do not adequately address the underlying circulatory compromise, it is not surprising that there is little evidence that supports the use of many products currently used.Two randomized, open-label, controlled trials were reported on the use of honey on venous leg ulcers. In the larger study, honey-impregnated dressing did not significantly improve venous leg ulcers compared with conventional dressing at 12 weeks.42 Compression was used in both groups. In the second trial, honey dressing was compared with hydrogel in sloughy venous ulcers. At 12 weeks, honey was found to have a slightly higher rate of healing (44%) versus hydrogel (33%).43 The method of randomization was reported in both studies. A meta-analysis based on these 2 studies concluded that there is no statistical difference in healing between honey and conventional dressing in venous leg ulcers.6In a poor-quality randomized controlled trial, honey dressing compared with saline-soaked dressing was found to accelerate healing in Stages I and II pressure ulcers.44 In another, poor-quality trial, honey was found to accelerate healing in Stage II or III pressure ulcers.45 In yet another randomized controlled trial of poor quality, honey dressing was found to be equivocal to iodine dressing in Wagner type II diabetic foot ulcers.46 The method of randomization was not described for any of these previously mentioned studies, which raises questions on their strength.

  4. Tony Mach 2 February 2012 at 10:47 pm #

    And please note “use of medical-grade honey” in the link I provided. In the example you provided I think they were right to refuse a treatment:
    a) they had no experience in doing
    c) didn’t have any knowledge of efficiency or dangers of that treatment
    c) wouldn’t have had proper material anyway

    If you are in the wilderness and don’t have proper material at hand, honey might be a excellent substitute for conventional wound care, but in clinical setting I would prefer the staff to stick to what they know.

    BTW: You seem to be OK with “Ah, what the heck, let’s just try it!” as long as it is “natural”. Now in an emergency where nothing else is at hand, this might be worthwhile (or it might make things worth). In a proper study, to find out modes of action and efficency, this might be very worthwhile. But in a clinical setting? No sir, that is *not* OK. You could argue with the same attitude: Ah, what the heck, take a random pharmaceutical! After all, it is *known* to help for something!

    As long as it is not proven that something is helpful in treating a certain condition (and I see no evolutionary reason why honey should have evolved to be helpful in wound care), one can advocate for its research, but advocating for its use is quackery. So sorry, “his mother-in-law’s doctors here in the UK” did the right thing.

  5. Dr John Briffa 2 February 2012 at 10:55 pm #

    Tony Mach

    Rather than flatly refuse to use it, do you think there’s an argument for the doctors going away, having a look at the research, and then perhaps exploring the potential in this approach? I actually didn’t say that the doctors should have used manuka honey, but it seems the suggestion was not even given due consideration. My sense is the could have done better for this patient.

  6. Liz Smith 3 February 2012 at 5:19 pm #

    I will always try something alternative first but before administering it I get my friend to test me by Kinesiology. If my body ‘says’ Yes, I use it, if it says no I don’t use it. I test all cosmetics, shampoos, for laureth sulfates and parabens, even foods for aspartame etc. Shame the medics don’t incorporate Kinesiology – my body knows what it wants or does not want.

  7. Feona 3 February 2012 at 8:00 pm #

    It’s astonishing how often orthodox medics flatly refuse to use complementary treatments which have been used for decades, if not centuries. During the 1980s I was Executive Secretary of the Research Council for Complementary Medicine, which pushed very hard to encourage research and trialling for many alternative therapies, including plant-based ones such as this. No chance – they couldn’t be patented, so there was no fortune to be made from them. Instead, they were denigrated and mocked by the pharmaceutical industry and the orthodox medical establishment. Every time I see a ‘discovery’ like this appearing, I can’t help a wry smile.

  8. Liz Smith 4 February 2012 at 2:49 am #

    During 1971-4 I was studying Food & Nutrition and we had contact with Surrey University who were doing research on honey for medical use on operation scars that would not heal. The lecturer told us that it was known in Roman times so it was not new at all. A homeopathic lecturer at the same session explained that honey was excellent for using on scars. I do not recall if the special Manuka honey was available at that time. I wonder how suitable honey from Melaleuca Alternifolia – Tea Tree – would be?

  9. roy 4 February 2012 at 3:37 pm #

    Hi Dr Briffa,
    there was a news bulitin the back end of last year ? a male nurse from africa or the carabian i think came to work in the uk, and telivised that his father had used honey all the time for wounds and cuts, in his home country and that he hiself swore by the use of honey, and if the NHS used it it would save the NHS millions , PS its the firt thing i use on cuts myself .

  10. Kristine 5 February 2012 at 7:01 pm #

    My mother had heart surgery several years ago and the wound was treated with Manuka Honey, this was in New Zealand and it did the job. I use the honey mixed up with Apple Cider Vinegar and garlic, its a great tonic and I find that I don’t get colds anymore.

  11. jake3_14 5 February 2012 at 8:14 pm #

    I have to agree with Tony March on this issue. The science on this issue is scanty, and a clinical setting is no place to play around with folk remedies.

  12. Donald Tiso 7 February 2012 at 3:07 am #

    presumably Tony Mach hasn’t seen this research ? a treatment that is effective against multi antibiotic resistant bacteria is one of the things doctors have been crying out for .
    presumably jake never uses Asprin or anything else that has it’s roots in “folk medicine” , thank god my GP is open minded enough to realise what is important is whether the treatment WORKS , not whether it’s “folk” or “conventional”.

  13. Jill H 7 February 2012 at 7:11 pm #

    Native peoples were schooled in an encyclopedic knowledge of the plants, the animals, the weather, the geology and every aspect of the natural world in which they were grounded. Science is simply knowledge acquired by study. It is nothing more and nothing less. Perhaps we need to dig more deeply into ‘folk remedies’ which I would translate as almost forgotten ‘wisdom’. Maybe some of the greatest scientific discoveries of all time have been made by scientists that are aware of the limitations of their craft and search for clues – collect information and ask the questions ‘Why? and What? and If?

  14. jake3_14 9 February 2012 at 2:04 am #

    Mr. Tiso, you offer a press release of a study sponsored by the company whose product is under investigation. Where’s the study abstract? Where’s the peer review? What methods were used? Was there a control group? Was the study double-blind? Provide these details, and then we can begin to discuss whether the study itself was worthwhile science.

  15. Jill H 10 February 2012 at 6:37 am #

    The University of Wales would appear to be carrying out extensive research
    Further interesting research

    And it is being trialled with good success at the wildlife hospital I work at. Following is a case report

    ” A weaner male Elephant seal that presented on 4 OCT 2010 with
    a massive shark bite wound to the left thorax and axilla. At our initial
    evaluation we sedated the animal, took some radiographs and thoroughly
    evaluated the wounds. The good news- no vital structures were
    damaged. The chest wall is intact and there is no evidence of joint
    involvement. The bad news is the massive soft tissue trauma left a lot
    of skin and muscle without a blood supply and it was in various stages
    of dying when we first looked at the animal. So we were faced with making a plan for open wound
    treatment- aggressive topical cleansing, removal of dead tissue and
    application of some sort of antimicrobial, antiseptic ointment. That’s
    when we thought of honey.

    Honey has gained recent popularity in both human and veterinary
    medicine as a wound treatment due largely to its natural healing
    properties. It has very high sugar content and as a result binds water
    molecules strongly. Honey also contains a variety of compounds that may enhance the
    tissue response to infection and inflammation. It’s relatively
    inexpensive [in fact much less expensive than most topical antibiotic
    ointments] and evidence suggests it is just as effective. So we
    decided to try. Every other day or so we’ve been cleaning up the wound
    and applying a generous layer of honey to it. Now – I am not sure if
    it is the honey or tincture of time, could be either or both, but
    The wounds are healing quite nicely indeed! ”

    Just to report the animal made a complete recovery and was released back to the ocean

  16. jake3_14 10 February 2012 at 7:43 pm #

    Jill H., Thanks for the references. These are indeed interesting.

  17. Linda 28 February 2012 at 12:48 am #

    A few years back I had robot assisted laparoscopic surgery for hysterectomy / oopherectomy for uterine cancer. An infection developed that opened up one of the wounds to about an inch and a half wide, seemed an inch or more deep and oozing pus, etc. Since I am gravely allergic to some antibiotics, I took matters into my own hands, opened up a fresh jar of Trader Joe’s honey and applied it then bandaged it. Reapplied and changed dressing each day and it looked better each day. Took only 4 days to completely resolve and close up, additional time of course, for complete healing into a small scar. Took the cancer into my own hands as well, with many natural approaches and doctor found a very small site of cancer left even though symptoms had been there for months prior to diagnosis and diagnosis was 4 months prior to surgery – adenocarcinoma of the uterus. Alive still and now eating paleo + some dairy, to much general benefit.

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