Does Honey Have Health Benefits?
Do not use honey for wound healing in diabetic foot ulcers or other chronic wounds—the highest quality evidence shows no proven clinical benefit despite widespread traditional use. 1
Evidence-Based Recommendation for Clinical Use
For Diabetic Foot Ulcers (Most Rigorously Studied Application)
The International Working Group on the Diabetic Foot (IWGDF) 2024 guidelines provide a strong recommendation against using honey or bee-related products for wound healing in diabetes-related foot ulcers, based on systematic review of all available evidence. 1
Key findings from the evidence base:
Six randomized controlled trials evaluating topical honey or bee products were identified, but all were deemed at high risk of bias due to lack of blinding, small sample sizes, and methodological flaws. 1
The only properly blinded study using royal jelly found no difference in healing over 12 weeks compared to placebo—this is the highest quality single study available. 1
Multiple studies comparing honey dressings to conventional treatments (povidone-iodine, saline) showed no significant differences in complete healing rates, amputation prevention, or time to healing when properly analyzed. 1, 2
No studies reported data on amputation rates, cost-effectiveness, or quality of life outcomes. 1
Why the Evidence Fails to Support Honey Use
Critical methodological problems plague the existing research:
Significant heterogeneity exists in ulcer types studied, standard care provided, and honey preparations used, making meaningful comparisons impossible. 1
Studies showing apparent positive results were consistently non-blinded and at high risk of bias, meaning any reported benefits should be treated with extreme caution. 1, 3
A 2016 systematic review concluded there is "insufficient good quality data to realistically conclude on the efficacy of honey on diabetic foot ulcers," despite honey's safety profile. 3
Practical Clinical Implications
Common pitfall to avoid: While honey is generally safe with minimal adverse effects, safety alone does not justify clinical use in the absence of proven benefit. 1, 4
What to use instead for diabetic foot ulcers:
- Sharp debridement performed by trained clinicians based on clinical need. 1
- Basic wound dressings that absorb exudate and maintain a moist wound healing environment. 1
- For non-infected neuro-ischemic ulcers failing standard care after 2+ weeks: consider sucrose-octasulfate impregnated dressings (the only dressing with moderate-quality evidence supporting its use). 1
- Appropriate offloading devices and integrated foot care. 1
Broader Health Claims
While older reviews and traditional medicine sources cite honey's potential antioxidant, antimicrobial, and anti-inflammatory properties for various conditions (respiratory, gastrointestinal, cardiovascular), 5, 6 these claims lack the rigorous clinical trial evidence needed to support specific medical recommendations. The IWGDF guidelines represent the most methodologically sound assessment of honey's clinical utility in a specific medical condition, and their strong negative recommendation should inform clinical decision-making. 1, 4
Resource considerations: Honey products cost similarly to standard dressings, but without demonstrated clinical benefit or formal cost-effectiveness data, their use cannot be justified in evidence-based practice. 1, 4