What are the benefits and uses of manuka honey in medical treatment?

Benefits of Manuka Honey in Medical Treatment

Manuka honey is not recommended for routine wound healing in diabetic foot ulcers due to insufficient evidence of benefit, according to multiple clinical guidelines. 1

Evidence Against Routine Use in Diabetic Wounds

The International Working Group on the Diabetic Foot (IWGDF) and the American Diabetes Association provide strong recommendations against using honey or bee-related products, including Manuka honey, for wound healing in diabetes-related foot ulcers 1. This recommendation is based on:

• Limited evidence from only three small controlled studies on honey use in wound care, with none showing convincing evidence of benefit compared to iodine-containing dressings 2
• Studies on honey products for wound healing being generally small, unblinded, and at high risk of bias 1
• A Cochrane review concluding that health services should consider avoiding routine use of honey dressings until sufficient evidence of effect is available 2

Potential Benefits of Manuka Honey

Despite the lack of strong clinical evidence for diabetic wounds, research suggests Manuka honey may have several properties that could be beneficial in other contexts:

1. Antimicrobial properties:

   • Contains methylglyoxal (MGO) which provides non-peroxide bacteriostatic properties 3
   • Shows broad-spectrum antibacterial activity, including against MRSA at concentrations ≥10% 4

2. Wound healing properties:

   • Physical properties that may support healing:
     • Acidity increases oxygen release from hemoglobin
     • High osmolarity draws fluid out of wound beds 3
   • May stimulate immune response and suppress inflammation 3
   • Supports autolytic debridement of wounds 3

3. Burn wound healing:

   • Recent (2025) porcine model study showed Manuka honey treatment was associated with:
     • Significantly increased collagen density compared to control group (p<0.05)
     • Lower macrophage activity and reduced Ki67 expression
     • Trend toward faster reepithelialization and improved epidermal regeneration 5

Safety and Quality Considerations

Important caveats when considering Manuka honey use:

• Allergic reactions are possible, particularly in individuals with bee product allergies 1
• Quality and composition vary significantly based on bee feeding source, harvesting conditions, and geographic origin 1
• Not subject to the same FDA efficacy and safety standards as pharmaceuticals 1
• Processing methods can affect therapeutic properties - vacuum-prepared honey appears more bactericidal than cooked honey 4

Clinical Implications

When considering Manuka honey for medical treatment:

1. For diabetic foot ulcers: Established evidence-based wound care approaches should be considered first 1

2. For other wounds: Select dressings principally on the basis of exudate control, comfort and cost 2

3. For burns: Emerging evidence suggests potential benefits, but further clinical trials are needed to fully establish its role in practice 5

The current body of evidence suggests that while Manuka honey has promising biological properties in laboratory and animal studies, its clinical application remains limited by insufficient high-quality human clinical trials demonstrating clear benefit over conventional treatments.