What is honey?
Honey is created from flower nectar and secretions from the upper digestive tract of the honey bee. It is composed mostly of carbohydrates, though it also contains some free amino acids, vitamins, trace elements, and polyphenols.[7] It has been used for wound healing for thousands of years.[8][9]
What are honey’s main benefits?
Honey has been used to treat oral mucositis, a potentially serious side effect of the treatment of head and neck cancers.[10][11] Honey has also been used to treat skin conditions such as wounds and burns[12][5] and diabetic foot ulcers.[13][14][15]
Honey may help treat cough,[16][17] canker sores,[18] herpes sores,[9] and dry eye.[19]
What are honey’s main drawbacks?
Honey should not be given to infants under 12 months of age. This is because honey can contain Clostridium botulinum (the bacterium that causes botulism), and infants less than 12 months of age have poor immunity against this bacterium.[16][20]
Because honey is primarily composed of sugar, researchers have wondered if it could negatively affect weight or metabolic health. However, meta-analyses of RCTs have found moderate-quality evidence that honey had no effect on blood lipids (LDL-C, HDL-C)[21] or ALT.[22] Furthermore, a 2023 meta-analysis of RCTs found a beneficial effect on blood lipids (reduced total cholesterol and triglycerides; low-quality evidence). Some studies even found reductions to fasting blood sugar (low-quality evidence)[6] and weight (moderate-quality evidence).[23]
How does honey work?
Honey has antibacterial, antiviral, antifungal, and anti-inflammatory properties.[7][16][24][25][26][27][28][29] Specifically, honey may work through a variety of factors, such as hydrogen peroxide, non-peroxides, nitric oxide, polyphenols, a high osmolality (strongly drawing water out of the cells of bacteria), and its acidity.[30][31]
Honey contains less-commonly found sugars, such as allulose, tagatose, and isomaltulose, which have been associated with improvements in cardiometabolic risk factors.[32][33]
What are other names for Honey
- Raw honey
- Unpasteurized honey
- Manuka honey
- Medihoney
- Propolis
- Royal jelly
Dosage information
In oral mucositis, many studies used a dose of 20 mL (approximately 1 tablespoon) of honey swallowed before and after radiation therapy.[1]
For cough in children, doses of 5–10 mL (approximately 1–2 teaspoons), for example, in 90 mL of milk, have been studied.[2]
For skin, a majority of studies applied honey topically to the affected areas.[3][4][5]
A 2023 meta-analysis of 18 RCTs which examined honey for metabolic health did not find a dose-response effect for any outcomes, except the improvements of systolic blood pressure were not as large when the dose was over 10% of daily total calories (50–62 grams for people eating 2,000–2,500 calories per day). In other words, higher dosages did not increase or decrease the effectiveness of honey for improving metabolic outcomes in some studies. The researchers in this meta-analysis did note that they examined studies which used honey at doses of 5–125 grams, with a median dose of 40 grams (approximately 3 tablespoons).[6]
Frequently asked questions
Honey is created from flower nectar and secretions from the upper digestive tract of the honey bee. It is composed mostly of carbohydrates, though it also contains some free amino acids, vitamins, trace elements, and polyphenols.[7] It has been used for wound healing for thousands of years.[8][9]
Honey has been used to treat oral mucositis, a potentially serious side effect of the treatment of head and neck cancers.[10][11] Honey has also been used to treat skin conditions such as wounds and burns[12][5] and diabetic foot ulcers.[13][14][15]
Honey may help treat cough,[16][17] canker sores,[18] herpes sores,[9] and dry eye.[19]
A common side effect of treatment for head or neck cancer is oral mucositis (OM). This condition can range from mild inflammation of the mouth and throat to severe ulcers that make swallowing extremely painful or even impossible. This can lead to weight loss and the need for parenteral (tube-fed) nutrition.[34][35]
There is strong and consistent evidence to show that honey improves OM.[36][37][11][38][1][39][7][35][40][41][10][42][34] Typically, the effects are stronger in moderate or severe OM[10][11][42] or in people who received radiation treatments (as opposed to chemotherapy).[7] Honey was found to be effective for improving intolerable pain in OM,[10][11][1] interruptions to cancer treatment caused by OM, and weight loss due to OM,[1] and it may not be effective for improving mild OM.[1]
In studies which examined the relative effectiveness of honey for OM (i.e., how effective honey is compared to herbs like turmeric, or the usual care like iodine), honey was often one of the most effective interventions among the interventions studied.[35][40][7][42][41]
A 2018 Cochrane review of RCTs found that honey reduces acute (short-term) cough symptoms in children more than a placebo and by an overall similar amount to some over-the-counter medications (low to moderate quality evidence).[16] A 2021 meta-analysis of studies done in children and adults had similar findings, reporting that honey improved upper respiratory tract infection symptom scores by a large amount compared to a placebo (1 study) and reduced cough frequency and severity by small amounts compared to the usual care (4–6 studies; overall moderate risk of bias in this meta-analysis).[17]
In a 2017 Cochrane review of RCTs, honey improved the burn healing rate (+145% increase in the chance that the burns healed; moderate certainty of evidence) and healing time (−4 days; very low certainty of evidence) compared to the control (topical antibiotics). In this review, honey had the strongest evidence of the interventions studied.[5]
A 2016 Cochrane review of RCTs found that honey (compared to topical antibiotics) helped surgical wounds close on their own (e.g., without stitches) and shortened the length of hospital stay by 2.5 days, though these findings were only based on 1 small trial.[3] A 2021 meta-analysis with more evidence (12 studies) compared honey to iodine for wound healing and found a large reduction in the duration of healing and reductions in the length of hospital stay (−3.1 days) and pain scores (−17%).[12]
A 2016 meta-analysis of 4 studies which examined honey after tonsil removal found that, compared to a placebo, there were large reductions in pain medication usage on days 1–5 but inconsistent reductions of pain scores. In addition, there were consistently moderate to large improvements in wound healing on days 1–14 compared to a placebo.[43]
A 2024 meta-analysis of 5 RCTs examining honey for wounds from childbirth (from cesarean delivery or vaginal birth) reported that compared to a placebo, honey reduced pain, the use of pain medication, and complications and increased satisfaction with treatment. Notably, honey did not improve how well the wounds healed compared to a placebo.[31]
Three meta-analyses of honey for diabetic foot ulcers from 2019–2023 reported improvements to healing time and rate, pain, and/or length of hospital stay, compared to the usual care.[13][14][15]
A 2016 Cochrane review reported very-low-certainty evidence (only 1 study) that honey was as effective as an antiseptic plus an antibiotic for improving pressure ulcers (bed sores).[4]
In a 2022 network meta-analysis of 72 RCTs, honey ranked second out of 18 interventions for reducing the healing time of canker sores, where it reduced the healing time by 3.3 days compared to a placebo.[18]
In a 2022 meta-analysis of 9 RCTs, topically applied honey reduced the healing time of oral herpes sores (a.k.a. cold sores) or genital herpes sores more than acyclovir (an antiviral medication; 8 days for honey, 9 days for acyclovir) and was as effective as acyclovir for pain relief.[9]
A 2023 meta-analysis of 5 RCTs found that manuka honey improved several outcomes of dry eye compared to a control, such as the ocular surface disease index, the tear evaporation rate, and the frequency of lubrication. While no serious adverse events were noted, temporary stinging and redness was reported but generally tolerated.[19]
Honey should not be given to infants under 12 months of age. This is because honey can contain Clostridium botulinum (the bacterium that causes botulism), and infants less than 12 months of age have poor immunity against this bacterium.[16][20]
Because honey is primarily composed of sugar, researchers have wondered if it could negatively affect weight or metabolic health. However, meta-analyses of RCTs have found moderate-quality evidence that honey had no effect on blood lipids (LDL-C, HDL-C)[21] or ALT.[22] Furthermore, a 2023 meta-analysis of RCTs found a beneficial effect on blood lipids (reduced total cholesterol and triglycerides; low-quality evidence). Some studies even found reductions to fasting blood sugar (low-quality evidence)[6] and weight (moderate-quality evidence).[23]
Honey has antibacterial, antiviral, antifungal, and anti-inflammatory properties.[7][16][24][25][26][27][28][29] Specifically, honey may work through a variety of factors, such as hydrogen peroxide, non-peroxides, nitric oxide, polyphenols, a high osmolality (strongly drawing water out of the cells of bacteria), and its acidity.[30][31]
Honey contains less-commonly found sugars, such as allulose, tagatose, and isomaltulose, which have been associated with improvements in cardiometabolic risk factors.[32][33]
Overall, different types of honey appear to have little to no difference in their effects, though the effects of natural or raw honey might be stronger.[7][6]
In a 2019 meta-analysis of RCTs, “pure, natural” honey reduced the odds of having moderate to severe oral mucositis (OM) from cancer treatment by 89%, compared to 75% for honey overall, where the difference between honey types (pure, natural honey vs. manuka honey vs. local honey) reached statistical significance.[7]
In contrast, a 2024 meta-analysis of RCTs found no differences between different types of honey for the treatment of OM.[10] Furthermore, manuka honey and Medihoney have had similar effects on wound healing.[8][31]
The honey type might matter more for metabolic outcomes. In the subanalyses of a 2023 meta-analysis of RCTs examining honey’s cardiometabolic effects, raw honey reduced body weight, total cholesterol, triglycerides, and fasting glucose, whereas processed honey did not. Furthermore, clover or Robinia honeys reduced total cholesterol, triglycerides, and fasting blood glucose, whereas polyfloral honeys did not.[6]
More research is required to assess whether the honey type matters and in what contexts, and if so, which properties of honey (e.g., if the honey has been pasteurized and/or filtered, which flowers the nectar came from) may be responsible for these different effects.
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