Dear Doctor: We used to tease our grandmother for putting a dab of honey on our scraped knees when we were kids. But now I’m hearing about something called “medical-grade” honey. Does that actually exist? How does it work? Maybe our granny was right all along?
Dear Reader: When your grandmother treated your injuries with honey, she was following a curative practice that dates back at least to the ancient Egyptians. Not only did they use honey in wound care, but they harnessed its antimicrobial properties to help embalm and preserve their dead.
Today, medical-grade honey has emerged as an important tool in the fight against antimicrobial resistance, which is a growing global health threat. Used primarily for the treatment of wounds and burns, medical-grade honey harnesses the unique properties of what turns out to be a surprisingly complex substance. And thanks to expanding research into its therapeutic uses, which had long been dismissed as a questionable alternative therapy, honey has entered the medical mainstream.
We think of honey as a sweetener, and it’s true that it’s composed primarily of fructose and glucose. In addition to those sugars, however, honey has been found to contain up to 200 other unique bioactive compounds. These include vitamins, minerals, enzymes, amino acids and fatty acids. Honey is also rich in phytonutrients. These are biologically active chemicals that are found in plants. Many of them are antioxidants, which have anti-inflammatory properties.
As researchers began to look more closely at honey, they discovered that the antibacterial and antimicrobial properties it had been credited with in folk medicine were indeed real. Studies have shown that honey has an inhibitory effect on scores of different kinds of bacteria and other microbes. This includes salmonella, shigella, H. pylori and E. coli, which can cause nausea, vomiting and diarrhea, and some of which can lead to serious illness and even death.
Honey’s antimicrobial properties work in several ways. It’s acidic, so its low pH inhibits bacterial growth. And unlike antibiotics, which damage a bacterium’s cell walls, honey deprives the microorganism of water. The low moisture content of honey starves bacteria of the water they require to survive and grow. At the same time, its high sugar content induces osmosis, a process that physically extracts moisture from microbes and hinders their growth. Complex enzymatic interactions also inflict damage on microbes. Honey forms a protective barrier and keeps the wound moist. At the same time, micronutrients nourish the injured tissues and promote healing.
But if you are tempted to reach for a jar of honey in your pantry to rub on a burn or wound, hold off. Unlike the honey that Grandma used, medical-grade honey is a sterile product that has been formulated and processed for safety and efficacy and is less likely to cause an immune system reaction. The specific type of honey matters, too. A variety known as Manuca honey contains antibacterial agents in greater concentrations than other honeys, as well as several other distinct compounds that make it uniquely well-suited for healing. Various types of medical-grade honey are used in healing wounds and burns, for managing skin conditions such as eczema and dermatitis, for gastrointestinal infections and for digestive health. With resistance to antimicrobial medications becoming an ever more serious problem, medical-grade honey offers a viable alternative avenue of treatment.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.
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