Manuka honey is liquid gold when it comes to healing wounds, but it also helps heal a host of conditions and may even hold a key to killing cancer. Celeste McGovern investigates
Recently retired top English spin bowler Moeen Ali has at least one sweet story from his illustrious cricketing career to share with fans. In 2023, the allrounder sustained a nasty blister on his spinning finger during the first game in the Ashes—the equivalent of the Super Bowl for cricket—against Australia, which led him to sit out the second game.
Watching the match from their home in Norfolk, England, ardent Ali fans Susan Thompson-Craig and her husband saw how the open wound on Ali’s finger had limited him. Ms Thompson-Craig, who worked in sales for a medical-grade manuka honey company, believed if Ali put the gel made with the New Zealand honey on his finger, he would be alright. She tracked down his address, prepared a little package of honey-impregnated dressings and sent them to the cricketer, explaining how to apply them to his injury.
Mr Ali, who received the package “out of the blue,” was astonished at the kindness of this stranger but also at how quickly the honey bandages healed the weeping wound on his spinning finger.
“It has worked wonders and started healing extremely fast,” he told reporters. He returned to the game, bowled one of his best spells for England, and saw the victory over rival Australia.
The medicinal use of honey, mostly to heal wounds and clear urinary and stomach symptoms, goes back thousands of years to ancient Egypt and Greece. It has persisted across cultures and time since, although modern doctors have dismissed it.
Until recently, that is. Spurred by a growing global epidemic of infections that resist modern antibiotics, scientists have started looking back to nature for ways to combat superbugs. A stack of new research shows that honey, especially manuka honey from New Zealand and the West coast of Australia, has potent antimicrobial, anti-inflammatory, antioxidant and other properties that make it perfect for helping wounds to heal.
There’s so much science that Australia’s health watchdog approved manuka honey for wound treatment a quarter century ago. The US Food and Drug Administration followed suit in 2007, approving several honey-based wound care gels, ointments and dressings for use on diabetic foot ulcers, burns, traumatic injuries, surgical wounds, antibiotic-resistant infections and more.
Yet in 2024, despite manuka honey’s star status as “liquid gold” in the alternative health world, it’s still not used often in mainstream medicine, likely because of the misconception that there’s a lack of evidence.
Beyond the evidence for its use in healing a wide range of wounds (more on that below), in the past 10 years a flurry of research has looked at its use in a host of other diseases as well. Honey has been studied for its potential to treat brain conditions including Alzheimer’s and schizophrenia, combat various skin ailments, fight cancer and mitigate the side effects of chemotherapy.
In a recent study published this year, for example, researchers from the University of California, Los Angeles (UCLA), discovered that manuka honey may be useful in the fight against estrogen receptor–positive breast cancer. In ER-positive cancer, the hormone estrogen promotes tumor growth.
Previous research has reported the antitumor potential of honey in several cancers, including liver, breast and colorectal cancer.1 But a team of researchers under Richard Pietras, professor of medicine in the Division of Hematology-Oncology at UCLA’s David Geffen School of Medicine, took it further.
They found that consuming manuka honey alone significantly slowed the growth of established human ER-positive breast tumors in mice by 84 percent, resulting in clear shrinkage over just 42 days. The greater the concentration of honey in a treatment dose, the greater the impact on the cancer.
What’s more, the researchers found that manuka honey activated anti-cancer cellular pathways and induced apoptosis, or cancer cell death. And it did so without causing any major side effects.2
The use of honey to treat cancer seems counterintuitive since the bulk of honey is sugars, glucose and fructose, which spike blood sugar levels. This is not a good thing and is generally to be avoided in cancer.
However, honey contains more than 200 compounds, depending on the species of bee and the nectar source. The effects of these mixtures are still unknown but have been shown to sometimes trigger healing cascades in the immune system. They are antibacterial, antifungal, anti-inflammatory, and antioxidant, for starters.
Manuka honey is produced by Apis mellifera honeybees from the flowers of the manuka tea tree Leptospermum scoparium. It contains trace amounts of minerals, proteins, enzymes that catalyze reactions, fatty acids, polyphenols and flavonoids.
Its unique and star component is an unusually high level of a molecule called methylglyoxal (MGO), which correlates with its potent antibacterial activity.3 The higher the MGO rating, the greater the antimicrobial action of the honey.
Besides this, manuka honey has been shown to get macrophages moving. These are the white blood cells of the immune system that engulf and digest pathogens, including cancer cells, microbes, foreign substances and cellular debris. The honey also sets off other defense cascades, calling in immune system players that fight infection and heal tissue.4
On top of all these properties, manuka honey also has phytoestrogenic properties. It binds estrogen receptors, which may explain some of its potency against ER-positive breast cancer.5
Whatever the cellular magic behind it, the UCLA researchers are convinced manuka honey can aid the fight against cancer. “Our findings confirm that MH has potent anticancer properties through different mechanisms,” they conclude. They suggest using manuka honey as a supplement or even an alternative to cancer drugs, which destroy good cells along with cancerous ones.
Manuka honey’s star performance to date is in wound healing, however, where it has already established a phenomenal track record and an evidence base of science to back it, though it’s still massively underused by mainstream medicine.
With the rise of antibiotic-resistant infections, that may soon change. There are more than 38 million patients worldwide with chronic wounds, from diabetic ulcers and surgical wounds to burns and pressure sores.
These are an economic weight on healthcare systems on their own, but with the additional and growing threat of superbugs that resist drug treatments, the fee is staggering. In the UK alone, treatment of chronic wounds costs the National Health Service £8.3 billion ($10.9 billion) per year.6
The World Health Organization describes the epidemic of superbug infections as a “global public health emergency that requires concerted efforts by all stakeholders.” And a 2024 study published in The Lancet predicts that by 2050 the toll of superbug infections could rise as high as 39 million deaths per year—one every three minutes.7
Manuka honey’s antibiotic potency is indisputable.8 It’s also been shown to be highly effective against a broad spectrum of antibiotic-resistant bacteria.9
While manuka honey has become the frontrunner and benchmark, most other honeys studied have similar potent antibacterial properties. This is mostly attributed to their substantial hydrogen peroxide content, which is much lower in manuka honey.
Other properties contribute to their antimicrobial artillery, including defensin-1, a protein made in the salivary glands of bees. There’s also their acidity; their sugar content, which pulls water out of bacterial cells;10 and their assortment of phenols and flavonoids, which may help them to bust up biofilms, the garrisons bacteria build around themselves.11
One study compared 14 Algerian honeys to manuka honey and found little difference in their performance against antibiotic-resistant superbugs known to infect burn wounds. All of the honeys were potent destroyers of the bacteria.
“This study proposes honey as an extremely promising treatment against multidrug-resistant bacteria from burn infections,” the authors conclude.12
Manuka’s activity has also been attributed to its unique methylglyoxal content, measured by its MGO rating, and its ability, depending on the bacterial species, to alter a bacterium’s shape and DNA, affecting its reproduction.13 The complexity of its assault on bacteria means even superbugs are highly unlikely to become resistant to it.14
As a wound dressing, honey is ideal. It moisturizes injured tissue and soothes inflammation while fighting a host of microbes. It is anti-inflammatory and triggers tissue-healing pathways. And it can be washed away without sticking or growing into wounds, which trumps the most common highly absorbent cotton or collagen bandages.
A number of case reports in the medical literature bear out honey’s astonishing wound-healing capacity:
Necrosis. A baby born at Rush University Medical Center in Houston, Texas, at just under 24 weeks gestation developed multiple wounds that were treated with Medihoney, a sterilized manuka honey product. His toes, which had become black with necrosis and were in danger of being amputated, were completely restored by the treatment.15
MRSA infection. A 12-year-old boy at the Children’s Hospital Medical Centre in Germany had undergone surgery to remove an abdominal lymphoma. It left an open drainage site on his abdomen.
His wound became infected with methicillin-resistant Staphylococcus aureus (MRSA). After 12 days of treatment with a local antiseptic (octenidin), the infection hadn’t improved. Then the doctors tried an Australian Medihoney, and the wound was free of bacteria within just two days.16
Reopened wound. A 55-year-old man had benign tumors on his penis surgically removed. Afterward he suffered the complication of wound “dehiscence,” meaning the surgical incisions reopened, leaving his organ painfully bare of skin.
A skin graft was unsuccessful. Manuka honey, specifically Activon, was applied, and the man was well enough to resume sexual activity within about three months and avoided a reconstructive surgery.17
Congenital defect. A baby was born with a large aplasia cutis congenita—an area of the scalp where the skin had not formed, leaving an open wound. There is no medical consensus on how to treat such wounds, but complications such as life-threatening infections occur in 20 to 50 percent of cases.
In this case, at Cohen Children’s Medical Center of New York, the baby was treated with only manuka honey twice daily for eight weeks, after which ordinary nonstick dressings were used, with complete healing.18
Diabetic foot ulcer. Another case report described the at-home treatment of a severe diabetic foot ulcer during the Covid-19 lockdowns. The patient took antibiotics and applied a medical-grade honey-based wound dressing by following instructions their doctor provided online and over the phone. They achieved complete healing within four weeks and avoided having the dead tissue removed by an orthopedic surgeon.19
Given its power to help heal severe external wounds and treat their infections, it’s not surprising that manuka honey has been found to help heal mouth ulcers as well, including those caused by chemotherapy. It may impact the gut microbiome favorably20 and combat H. pylori, the bacteria underlying some gut ulcers.21
Recently manuka honey was shown to have promise for treating gastroesophageal reflux disease (GERD). In one 2023 study, patients with GERD either consumed 5 g of manuka honey (MGO rating 400+) three times a day for four weeks or took a placebo.
The researchers found improvement on endoscopy and cell examination in 73.3 percent of patients who took manuka honey but in only 20 percent of the placebo group. By the study’s end, 100 percent of the manuka honey patients reported improvement in their symptoms, while only 40 percent of the placebo group did.22
About 40 percent of chemotherapy patients suffer oral mucositis, painful mouth lesions, and damage to their gastrointestinal lining as side effects of the drugs. Mouth lesions can become deep and can interfere with talking and swallowing.
The drugs to treat oral mucositis are not very effective, so some researchers have looked to honey for help. A 2019 review of the literature on honey to treat oral mucositis examined 17 randomized controlled trials involving 1,265 patients.
It found that honey helped to both heal and prevent the mouth sores, and “pure, natural” honey worked best. The Chinese researchers recommended it as a frontline treatment alongside cancer chemotherapy to prevent and treat this side effect.23
One interesting clinical trial divided 75 adult cancer patients with mouth lesions from chemotherapy into three groups. One group received 20 doses of 8 mg betamethasone solution, another received 300 g of honey plus 20 g of instant coffee and a third group received 300 g of honey.
All the participants were told to sip 10 mL of their treatment, then swallow it every three hours for a week. The honey-plus-coffee group was the winner, with clearly reduced and healed oral mucositis lesions, followed by the honey group. The steroid group came in last.24
Unfortunately, that study didn’t identify the type of honey it used, but some people have described improvements after chemotherapy when taking manuka honey.
“After I went through chemotherapy, my insides were a train wreck,” @JOERANSTRAIGHT commented on social media. “There was no answer or cure for something similar to IBS [irritable bowel syndrome] . . . I could not eat any vegetables because it was something that went right through me no matter which type of vegetable it was.”
About two months earlier, he had started taking a spoonful of raw manuka honey every morning and noticed that “everything has slowed down to normal.”
Considering its potency for healing wounds in the skin, it’s not surprising that honey is the oldest and most universal skincare ingredient in use. In Japan, women are said to use honey to soften their hands and keep them wrinkle-free. In China, honey has been mixed with crushed orange seeds and applied to pimples.
In the Persian Gulf, it’s been mixed with egg yolk, avocado, lemon and yogurt to make a moisturizing and exfoliating mask. Creole women in Louisiana have mixed it with herbs as a beauty regimen and to ward off evil ghosts.25
Medicinally, as a treatment for skin diseases, honey’s use dates at least as far back as the Middle Ages, but new research has confirmed its effectiveness against a litany of skin disorders, including acne, contact dermatitis, eczema, fungal infections such as ringworm and athlete’s foot, rosacea, psoriasis, herpes and various rashes.
As well as being lethal to microbes responsible for wound infections, honey has been shown to curb the growth of dermatophytes that cause ringworm rashes. It targets Candida albicans, a cause of skin yeast infections, and kills Propionibacterium, a cause of acne.26
It seems crude honey targets Malassezia, yeast species implicated in seborrheic dermatitis and folliculitis as well. Crude or raw honey was used in one study to completely reverse stubborn seborrheic dermatitis rash and dandruff, and to prevent the hair fallout that sometimes comes with it.
Thirty patients, aged 15–60, who had chronic seborrheic dermatitis of the scalp, face and chest with scaling, itching and hair loss were asked to gently rub diluted crude honey (90 percent honey diluted in warm water) onto their lesions for two to three minutes every other day for four weeks. They left the honey on for three hours, then gently rinsed it off with warm water.
Within one week, they experienced relief from intense itching and their skin stopped scaling. The lesions healed and disappeared completely within two weeks. As well, they reported less hair loss.
Next, the patients who had healed were divided into two groups: honey was applied topically to one group once a week, and the other group received no preventive treatment. The researchers monitored them for six months.
None of the patients with weekly honey application experienced a relapse, but the group without it saw their lesions come back within two to four months.27
A small study comparing patients with genital and mouth herpes saw patients treated with honey recover 30–60 percent quicker than those using the antiviral medication acyclovir. And unlike the acyclovir patients, they had no side effects.28
A 2024 review of the dermatological uses of honey by Robert Schwartz, head of the Department of Dermatology at Rutgers New Jersey Medical School, points to a stack of case reports, clinical trials and in vitro studies. It concludes that honey is a “safe, cost-effective, and readily available treatment option for many skin conditions, including microbial infections, atopic dermatitis, psoriasis, necrotizing fasciitis, ulcers, as well as thermal and other types of wounds.”29
Honey has a long history in the treatment of eye diseases. Studies have shown that its unique properties make it useful for managing dry eye disease.30
It helps to heal meibomian gland dysfunction (MGD), herpes virus and contact lens–related keratitis (inflammation of the clear layer forming the front of the eye) and blepharitis (inflammation of the eyelid).31 And as a natural antimicrobial, it prevents infection after eye surgery.
“There’s an eye drop that kills bacteria and microbes, stabilizes the tear film and helps with your eye glands, reduces inflammation and works as an antioxidant. That’s super cool,” says Dr Joseph Allen, an optometrist at the Pinecone Vision Center in Sartell, Minnesota, and the founder of Doctor Eye Health, an educational YouTube channel.
He never heard about the healing properties of manuka honey in optometry school. Comments on his channel clued him in, and he was surprised at just how much research there is to support honey for eye conditions. There are also over-the-counter honey eye drops, like Optimel, made for the purpose.
In one 2017 study from Queensland University of Technology in Australia, patients who had MGD (the oil glands in their eyelids were not secreting enough oil) used Optimel twice a day for two months. They showed clear improvement in symptoms, better meibomian gland function and slower tear evaporation.32
Another study, published by New Zealand researchers in 2018, reported that manuka honey drops could kill live Demodex mites that infest eyelids and eyelashes as effectively as the usual treatment, a tea tree oil solution.33 Although it’s not been studied in clinical trials yet, people who have the mites or have ocular rosacea might consider using manuka eye drops or gel.
More recent research has looked at the use of manuka honey in chronic corneal swelling after surgery, such as cataract surgery, that can cause blurred vision and pain. For example, the Vision Eye Institute in Brisbane, Australia, treated 18 patients who had post-operative corneal edema in one or both eyes that lasted longer than one month post-op.
They were treated with Optimel antibacterial manuka honey eye drops and saw the swelling go down immediately. The effect lasted up to several hours, and they enjoyed sharper vision as well.
Over time, the drops lowered inflammation and improved their vision further, although they didn’t penetrate deeper layers of the cornea or cure the condition. The only observed side effect was temporary stinging after the drops were applied.34
Warning: Do not apply manuka honey or other raw honey directly to your eyes. Formulated over-the-counter drops with manuka honey, like Optimel, have been irradiated with gamma rays to remove any bacterial spores (see below, for a safe way to make eye drops at home).
You can make your own honey mixtures with artificial tears, saline solution or sterilized water. Here’s one DIY recipe.
Ingredients
½ cup water or saline
½ tsp honey
Method
Manuka honey thrashes a variety of bacteria and the tough-to-penetrate biofilms that form in wounds and infections, so researchers recently started looking at its effects on bacteria associated with dental plaque, cavities and gum problems. They found it inhibits a number of bugs that cause disease associated with aggressive periodontitis.1
In one study at the University of Otago in New Zealand, 30 volunteers chewed or sucked either a manuka “honey leather” or sugarless chewing gum for 10 minutes three times a day, after each meal. The trial lasted for 21 days.
The manuka honey group showed highly significant reductions in plaque and bleeding compared to the control group, which saw no significant changes.2
Wondering about the effects of the fermentable sugars in the honey? A 2017 experiment confirmed the antibacterial activity of two honeys, including manuka. But they found both honey alone and honey with the common bug Streptococcus mutans broke down hydroxyapatite, a mineral in teeth.3
Bees may be the source of another natural remedy against gingivitis, however. Iranian researchers reviewed 22 papers and found bee propolis, the resin-like substance bees make to repair their hives, is a “promising agent to balance oral microbiota and prevent oral diseases” due to its anti-inflammatory and antibacterial activity.
“Propolis is a desirable preventive option for various oral health conditions, including dental caries and periodontal diseases,” they concluded.4
If honey is mostly sugar, which is linked to inflammation and metabolic diseases including diabetes and Alzheimer’s, then you would expect to see it wallop the lipid profiles of people who eat it. That was not what researchers from Saudi Arabia reported in their 2021 review of the literature on the topic, however.
They looked at studies of a total of 370 people, comparing those who consumed honey to those who didn’t, and found honey consumption lowered total cholesterol levels and was linked to an increase in “good” high-density lipoprotein (HDL) cholesterol and a reduction in “bad” LDL cholesterol. Finally, honey was found to lower levels of fat in the blood.1
Although the doses and types of natural honey differed in the experiments, a “small quantity of honey can be recommended” for patients whose fat and cholesterol levels are out of balance, the researchers said.
Honey contains polyphenols, including quercetin, gallic acid, and chrysin, which have all been shown to trigger the immune system in ways that protect neurons. Its potent antibacterial, anti-inflammatory, and antioxidant status has led researchers to look into its ability to treat neurodegenerative diseases like Alzheimer’s and Parkinson’s.1
Scientists recently reviewed 34 original papers examining honey’s effect on brain health and concluded there are four main benefits: neuroprotection, memory boosting, and stress and pain fighting.2
A 2022 study reported two sides to manuka honey: It improved oxidation stress and delayed paralysis in a worm model of Alzheimer’s disease, but its sugar content impaired the worms’ locomotion, an indicator of increased tau protein, a feature of the disease. In other words, the honey ameliorated one pathway of Alzheimer’s while fueling another.3
Two newer rat studies were more optimistic. One reported that honey effectively ameliorated poor cognitive performance, anxiety and motor coordination.4
In another, researchers gave Kelulut honey (from Malaysian bees known as stingless bees) to rats with Alzheimer’s at a dose of 1 g/kg body weight for four weeks. They found these rats had a lower “pathological burden of disease” than those not eating the honey, including less tau protein. They also found evidence of greater neuroprotective effects.5
See Healthy shopping: How to choose manuka honey for six things to look for when buying manuka honey.
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