Honey In Wound Care

Published on February 20, 2020

Honey can be applied to many different types of wounds

If you’re interested in bees and beekeeping, you’ve probably frequently enjoyed honey. What’s better than taking a huge bite out of fresh comb or swapping honey for sugar in your favorite recipes? Seeing your bees create honey out of nectar is one of the many joys of beekeeping, but there are many uses for honey besides the culinary. Today, we talk about one of its oldest applications: wound care.

Before I became a writer for Beepods, I was a nurse by trade. In fact, I was a Certified Wound, Ostomy, and Continence Nurse (CWOCN). Technically, I still am. I frequently used honey as a wound treatment for my patients and I saw results. In fact, when I used honey to treat wounds, it was the treatment that started the most conversations with my patients.

“Can I eat it?”

“I didn’t know you could put honey on wounds.”

“My mom used to give me tea and honey when I was sick. Does it work the same way?”

When I left nursing, honey didn’t leave my life. I still read about it a lot, I use it at home, and I helped compile and write recipes for our eBook, Recipes and Remedies: Using Honey and Other Bee Products to Sweeten Your Life. I do miss wound care from time to time and what better way to tap into that nostalgia than to share a blog with all of you about the history, the science, and the cultural value of honey as a wound care treatment.

The History of Honey In Wound Care

Honey is one of the oldest wound treatments in existence. Many cultures throughout history used honey for medicinal purposes including the Greeks, the Romans, the Egyptians, and many other civilizations. It’s actually difficult to find a culture that didn’t use honey in some capacity. Go ahead. Try to find one!

One of the earliest references to honey as a wound care treatment is in the Edwin Smith papyrus, which is one of the oldest surgical texts in existence, dating back to 1600-2200 BC. The treatment? Honey and oil-soaked linen bandages for a head wound.

Honey continued to be used throughout history, even as a common treatment during the Civil War. Nurses and physicians from both sides used honey to help maintain a moist wound bed and treat any infections. These are also reasons why honey continues to be used regularly in wound care today.

How Honey Helps Treat Wounds

Honey has some unique properties that make it a great option for wound care. It has a high osmolarity, which means it helps draw fluid out of the wound bed, keeping the wound moist, but not too moist. It’s kind of like the story of Goldilocks and the Three Bears. It keeps it just right.

One of the main goals of a wound care nurse is to maintain the appropriate moisture balance in a wound so it can heal properly and honey helps us do this.

Additionally, honey is acidic. It has a pH of 3.2-4.5 on average, which helps the body create the tissue infrastructure it needs to repair a wound. Take a deep breath. We are about to get sciency:

When somebody sustains a wound, the body repairs the injured area by rebuilding healthy tissue on top of it so you don’t have an open wound forever. This new tissue starts as a matrix.
Proteases are enzymes that help break down damaged pieces of this matrix during the body’s repair process.
Sometimes, the proteases are too abundant and this throws off the balance between building and breakdown; the proteases start breaking down undamaged parts of this matrix, stalling its progress.
The acidic nature of honey helps suppress the unbalanced protease activity so your body can keep healing.

Cool, huh?

Honey Stops Bacteria

Bees transform nectar into healing honey

It gets cooler. Honey contains a lot of sugar in the form of glucose, fructose, and sucrose. You might think since bacteria love sugar (who doesn’t?), the honey would increase the chance of infection, but it actually doesn’t. If the moisture balance in the wound is ideal, the sugars in honey draw water out of bacteria cells, preventing their growth.

Plus, honey has demonstrated broad-spectrum action against bacteria. What this means is honey works to destroy many different types of bacteria. I’m not going to list them out because there are a lot and their names are long and complicated. This ain’t a spelling bee. This is about honey bees and the healing substance they produce: honey! The bees have a lot to do with the antibacterial properties of honey.

When bees forage, they add glucose oxide to the nectar and this creates hydrogen peroxide. It’s not exactly the stuff in that brown bottle everybody has tucked away in their medicine cabinet; it’s actually much weaker, but still effectively kills bacteria.

Hot tip from a wound nurse: Hydrogen peroxide, the stuff you buy in the bottle, is not great for wounds. Why? Hydrogen peroxide is cytotoxic. It kills cells. Bacteria cells. Your cells, too. While it can help to clean a wound right after you sustain it, it will harm your own cells in addition to bacteria cells, preventing you from healing.

The hydrogen peroxide in honey is in a concentration that is not harmful to your own cells, just the bacteria.

More Than Just Hydrogen Peroxide

Manuka honey, a common source of medical-grade honey, contains a component called methylglyoxal, which seems to stop bacteria in its tracks independent of the hydrogen peroxide. It’s some special stuff and it’s the source of one of the most commonly used medical-grade honey in the US.

Also, you can thank your bees for contributing the aptly named defensin-1 to honey, which is an antibacterial protein.

These are the components we’ve isolated and have determined to contribute to the antibacterial properties of honey so far. There could be more!

So, Can I Just Put Honey in My Wound?

The medical-grade honey I used to put in people’s wounds is not the same thing as what you buy in the store. It’s been sterilized. Please don’t put it on your toast.

Through researching this blog, I learned how they actually sterilize it and it’s pretty neat. Laboratories use gamma irradiation to remove any bacteria spores so it’s safe to use in your wounds. You can heat raw honey to 120 degrees for about 10 minutes for a similar effect, but it does reduce some of its beneficial properties.

The reason the honey is sterilized before human use is to eliminate any Clostridium botulinum spores. Yes, that’s botulism. Their possible presence in raw honey is also the reason why doctors recommend you do not give infants under the age of one any raw honey; their immune systems can’t handle the spores yet.

There’s a catch. There are actually no case studies available noting wound infections caused by raw honey. Yep. No case studies from thousands of years of use of honey, prior to the availability of gamma irradiation, of anybody contracting botulism from raw honey in a wound.

That doesn’t mean it isn’t possible. It just means the risk is quite small. Yet, modern medicine aims to minimize risk as much as possible and that’s something to keep in mind when exploring the many applications of honey.

Wound Care is Complex

When I worked in wound care, everything was driven by evidence-based practices. This is important! If we have not researched a possible treatment, how can we recommend it for a patient or tell them it will help? However, research is flawed and part of the reason honey is not used liberally and across-the-board is because there is not a breadth of research to support its use.

There is some promising research on its use for partial-thickness (through the layers of skin) burns and radiation-related wounds, but many of the studies on honey as a wound care treatment are poorly designed.

Plus, every single person, like every single bee colony, is different. It’s difficult to compare study outcomes when you have 40 study subjects and no two people are exactly the same in terms of health history, genetics, gender, comorbidities, or pain threshold. What works for one may not work for another. That’s not even getting into all the different types of wounds a person could possibly have, all of which have different causes.

Furthermore, honey may be an effective surface treatment for a wound, but if somebody has circulatory issues contributing to the wound, it may not heal because of that underlying etiology, not because honey failed as a treatment. Wound care looks at the whole person and has be a holistic approach in order to achieve each patient’s healing goals. It’s not really honey’s fault all the time.

And not everybody can afford the constraints of modern-day science.

Honey Will Continue to Be Used In Wound Care

Honey isn’t going anywhere – it’s part of wound care

The truth is this: honey has been used by humans for thousands of years as an effective wound care treatment. I’ve personally seen it help heal wounds many times. Even though the science isn’t perfect and we need to design higher quality experiments to definitively prove honey’s efficacy, we know honey is beneficial.

There are many benefits of using honey as a wound care treatment. To start with, it’s cost-effective. Wound care treatments can add up. Fast. Using honey, even in its raw form, can be a great way to help patients in need.

In fact, it is frequently used by medical providers in developing countries, where they don’t have access to the fancier wound dressings, but do have access to honey from local apiaries. Beekeeping is still very much a part of life for many cultures in the world. The need to treat patients overrides the need for extensive scientific study before action.

People Trust Honey

Honey is also trusted and recognizable. It may be more palatable for patients, who are fearful and in pain, to use a substance they have in their cupboard at home. In fact, they may have positive associations with it from their parents giving them a spoonful when they were sick as a child. These positive associations, this belief, can help with the healing process just as much as what’s happening on a cellular level.

Traditional and folk medicine practitioners frequently use honey as part of their treatments. In rural areas and in developing countries where this may be the only source of care, this sticky, sweet substance from bees does a whole lot of good.

People trust their local healers. If they have a good rapport with them, people tend to have better outcomes and if their providers believe in honey as a treatment, this fact alone can help people heal.

Finally, if you have a connection with bees and with the art of beekeeping, using the honey to treat wounds, coughs, or just to sweeten their day can bring meaning to your life.

Disclaimer: This blog has not been evaluated by the Food and Drug Administration. These statements are not intended to diagnose, treat, cure, or prevent any disease.

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Caitlin Knudsen

Caitlin Knudsen is a content writer for Beepods with a passion for lifelong learning and psychology. She is an avid gardener, grower of houseplants, and does recipe development and food photography in her spare time.