Throughout history, honey has been used for medicinal purposes with the use of Honey as a wound dressing being one of the most persistent therapeutic uses over time. Ancient Egyptians were among the first beekeepers being well established around 3100 BC. Papyrus records depicting a surgical textbook, from possibly 2500 BC, indicate that honey was used extensively in Egyptian medicine and was a common ingredient in many wound dressings described. Honey provides a moist wound healing environment which promotes healing and honey’s antibacterial properties help prevent and clear infection. Often in historical texts, the type and location of the honey was specified, thus indicating that the people were well aware of the medicinal properties of honey from particular floral sources.

In modern times, after the advent and proliferation of modern antibiotic (western) medicine, the use of honey in Wound Care largely fell out of favor. However, more recently there has been a rapid spread of bacterial strains which are resistant to antibiotics used in clinical practice. It is now common to have bacteria strains, so called “super bugs”, that are resistant to all commonly used antibacterial drugs. This situation has created renewed interest in using honey as a wound care agent and helped spawn extensive research and use of Manuka honey in registered wound care products.

Nutritional Value

Honey contains a wide range of nutrients including minerals, vitamins and amino acids. It has been reported that wounds heal faster if a nutrient mixture is applied topically to cells in the wound bed. Honey can promote healing to the wound bed by supplying glucose. One example is that the glucose allows macrophages to gain energy through glycolysis in the absence of oxygen (due to damaged tissues where oxygen supply is often poor).

Antibacterial Properties

Honey has been shown to have the ability to manage wound infections even in situations where conventional antibiotics and antiseptics have failed. Honey has also been shown to be effective against so called “super bugs” such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE).

Osmotic Action

Honey has high osmotic action, attracting water molecules from cells.  In a wound, the osmotic action of honey causes an outflow of lymph which is beneficial to the healing process. This outflow provides improved supply of nutrients to the surface of the wound and provides a moist wound environment, without promoting bacterial growth.

Acidity of Honey

It has been observed that wounds heal faster in an acidic environment, and conversely an alkaline pH is associated with wounds that are not healing.  Honey is moderately acidic with a pH level typically between 3.2 and 4.5, which when applied to a wound acidifies the wound bed. One of the reasons that an acidic environment is friendly to wound healing is that the amount of oxygen released through capillaries increases from 25% for a normal pH level to over 50% in a lower pH environment.

Anti-oxidant Activity

Honey contains a high level of antioxidants. Some studies, in which oxidative stress was measured, concluded that the control of free radicals due to the anti-oxidant action of honey was the way in which honey initiates healing in burns.

Anti-inflammatory Action

In a wound, a short-lived state of inflammation is necessary to initiate the healing process.

However, when inflammation persists, it may cause damage and either slow down or prevent healing.  Persistent inflammation may be triggered by events such as bacteria present and the presence of slough in wounds.  Honey has both antibacterial action and helps to remove slough from wounds, both contributing to reduce inflammation.