Manuka Honey Wound Care: Will It Help You To Recover?

Explored through a range of scientific research, Manuka honey as a topical wound aid has experienced a resurgence in recent years.

In this 2018 study, researchers discuss how Manuka honey on wounds may be helpful:

"Manuka honey has been shown to be especially useful against antibiotic-resistant bacteria [12,36]. The many functions of Manuka honey thus not only clear wound debris, maintain hydration, control inflammation, and stimulate healing, but also sterilize the wound."

It's worth being clear from the outset that this kind of research is largely laboratory-based, and that laboratory findings do not automatically translate into guaranteed outcomes for a person with a wound at home. Throughout this article we'll try to be precise about what has actually been shown, where, and in what setting — laboratory dish, animal model, or human trial — so you can make sense of the claims rather than take them at face value.

In this article, we will explore some of the common beliefs out there about Manuka honey and wounds, the research that has been conducted to investigate them and how it has been used in practice.

We will explore:

• A brief history of Manuka honey for wounds
• Why do people use Manuka honey to heal wounds?
• How are people using Manuka honey on wounds?
• Important cautions to be aware of
• Our top Manuka honey picks.

A Brief History of Manuka Honey for Wounds

Does Manuka honey heal wounds?

Humans have been keeping bees for honey since around 7,000BC for numerous uses, with records of honey also in some of the world's oldest medical journals.

Historians have found that honey was used as a remedy by the ancient Greeks, Egyptians and Romans, with plenty of reference to it in sacred texts. Use of honey can also be found in Chinese medicine and Ayurveda.

The native Māori people of New Zealand have referred to Manuka as taonga or 'treasure', and found a vast range of uses for it including tools, artefacts, preparing food, medicine and more! Gum and leaves from the plant were used to produce aids for fevers, stomach and urinary problems, to make moisturisers and burn ointments, along with a number of other therapeutic uses.

With such a far-reaching global (and historical) footprint, it's easy to see how honey has such a wholesome, healing reputation. But is there any science in the story? With the development of modern medicine and research, has anything been found to suggest that Manuka honey really is as full of promise as the history books suggest? As we'll see below, the modern picture is more nuanced than the folklore — some findings are encouraging, others are preliminary, and some popular assumptions don't hold up as neatly as marketing might suggest.

Why Do People Use Manuka Honey to Heal Wounds?

In 2007, the US FDA approved Manuka honey as a possible wound treatment. Let's take a deeper look at why, and the Manuka honey wound healing research we have available.

As we discuss in our blog about Manuka honey for scars, our bodies are usually good at healing themselves naturally. That being said, we can always give them a helping hand at achieving optimum conditions to heal safely.

Our skin goes through a few phases when healing:

• Inflammation to clot blood and clear damaged tissue.
• Increased vascularity to feed the affected area with moisture and nutrients.
• Increased fibroblast and collagen production to rebuild cells.
• Maturation of this collagen to strengthen bonds.

It has been suggested in research like that below, that honey may aid in each of these stages.

"Honey has been reported to have an inhibitory effect on around 60 species of bacteria, some species of fungi and viruses. Antioxidant capacity of honey is important in many disease conditions and is due to a wide range of compounds including phenolics, peptides, organic acids, enzymes, and Maillard reaction products." - Source.

Hydrogen peroxide appears to be present in most honeys and is believed by some to give them an antibiotic quality. Where Manuka honey may be special however, is due to its high levels of another compound: methylglyoxal (MG).

One area where laboratory research has been particularly interesting is bacterial biofilms — the protective layers some bacteria form on a wound surface that can make infections harder to clear. In vitro laboratory studies suggest manuka-type honeys can break down and clear Staphylococcus aureus biofilms, including some antibiotic-resistant strains, more effectively than non-manuka honey. Notably, this is a laboratory (in-vitro) finding rather than a demonstrated clinical outcome in patients, and interestingly, the researchers behind this work found that methylglyoxal alone could not reproduce the effect — suggesting other, still unidentified, components of the honey are contributing alongside MG. This complicates the simple story that "MG is the active ingredient" and is a useful reminder that Manuka honey's activity likely comes from a combination of compounds working together, not a single silver-bullet molecule.

The UMF grading system, used to regulate genuine Manuka honey, looks for the following components to indicate authenticity:

"[that] required methylglyoxal (MGO) levels are present - linked to antibacterial properties [and the] minimum required level of Leptosperin... is present - linked to anti-inflammatory properties… The amount of Leptosperin increases as the UMF grading level increases".

It's worth flagging, though, that a higher UMF number is not necessarily a guarantee of stronger antibacterial performance against a given wound pathogen. Laboratory testing of over-the-counter manuka honeys found that a higher UMF rating did not consistently correspond to stronger antibacterial activity against wound isolates, including drug-resistant organisms — in that particular sample, lower-UMF honey sometimes outperformed higher-UMF honey against staphylococci and Pseudomonas. This is in-vitro evidence from a single study, and it doesn't overturn the value of grading systems generally, but it does suggest that the UMF number alone shouldn't be treated as a precise, linear measure of antibacterial strength — it's one useful indicator of quality among several, not a strict potency scale.

A literature review published in the medical journal Wounds Research found the following benefits of honey in healing wounds:

"The physical properties of honey... expedite the healing process: its acidity increases the release of oxygen from haemoglobin thereby making the wound environment less favorable for the activity of destructive proteases, and the high osmolarity of honey draws fluid out of the wound bed to create an outflow of lymph as occurs with negative pressure wound therapy."

This same review differentiates between normal honey and Manuka honey, based on antibacterial activity:

"...there is much variation in potency between different honeys. There are 2 types of antibacterial activity. In most honeys the activity is due to hydrogen peroxide, but much of this is inactivated by the enzyme catalase that is present in blood, serum, and wound tissues. In Manuka honey, the activity is due to methylglyoxal which is not inactivated. The Manuka honey used in wound-care products can withstand dilution with substantial amounts of wound exudate and still maintain enough activity to inhibit the growth of bacteria."

This same review differentiates between normal honey and Manuka honey, based on antibacterial activity. That said, Manuka is not necessarily the only honey with meaningful antibacterial action. In-vitro comparisons have found that some non-manuka honeys, such as Chilean Ulmo honey, can match or even exceed Manuka honey's antibacterial activity against MRSA and other wound-relevant bacteria in laboratory assays — although the mechanism differs, relying on hydrogen peroxide rather than methylglyoxal. Again, this is laboratory evidence only, but it's a useful corrective to the idea that Manuka is uniquely superior among all honeys as a wound sterilant; rather, it appears to be one of several honeys with documented antibacterial activity, distinguished mainly by the stability of its MG-based mechanism.

This sustained antibacterial activity makes it particularly valuable for oral applications, where maintaining a clean environment is crucial for healing. Learn more about Manuka honey for teeth and oral health.

With its historical reputation coupled with more modern scientific research, it's easy to see why people may choose to try Manuka honey on wounds. It is worth noting, though, that one specific population deserves particular caution: people with diabetes. A theoretical concern has been raised — not a clinical finding — that methylglyoxal, the very compound prized for Manuka honey's antibacterial activity, is also a glycating agent known to contribute to advanced glycation end-products, which have separately been implicated in impaired diabetic wound healing. The author of this commentary is explicit that this remains unproven for Manuka honey specifically, and calls for randomised controlled trials in diabetic ulcer patients before any conclusions are drawn either way. In the meantime, this is a good reason for anyone managing a diabetic wound to involve their treating clinician in any decision to use a honey-based product, rather than self-treating.

On the animal-research side, in one rat-model study, daily topical Manuka honey applied to excision wounds was associated with faster wound contraction and epithelialisation than a comparator honey (acacia honey), across both diabetic and non-diabetic animals over a 21-day period. This is preclinical, small-scale evidence (six animals per group) rather than a demonstration in human diabetic wound patients, and it should not be read as proof that Manuka honey is safe or effective for diabetic wound care in people — but it is an interesting data point that sits alongside the theoretical glycation concern above, illustrating just how much remains to be clarified through proper human trials.

Vets using Manuka honey for animal wounds

Vets have also been trying Manuka honey for animals with positive results:

*"Having been used in patients for many years honey has performed as well if not better than some of the most well loved and respected antibiotics and antimicrobials when used in wounds.

Combining the anti-inflammatory and debridement properties, the more recent medical grade high Unique Manuka Factor Manuka products provide a safe and extended antimicrobial effect potent enough to challenge the most common wound pathogens including the more recent resistant species."*

In this article, UK Vet details the various ways that vets apply the honey based on the wound type, from direct application packed with a dressing to using syringes and dilutions.

Sydney University equine surgical specialist Andrew Dart had similar conclusions after trying Manuka honey on significant horse wounds:

"I have been doing wound-healing studies for many years and if you look across the board there are very few, if any, compounds that have a consistent repeatable effect. The wound treated daily with UMF 20 honey showed a nice pink, even and healthy bed of granulation of tissue, whereas our control had a rough, unhealthy bed of granulation tissue with a necrotic centre with poor blood supply."

Shona Blair, a microbiologist at the University of Technology, Sydney, warns consumers of the significance of grading:

"There's a huge difference if the labelling is accurate – UMF 20 honey is four times more powerful and active against golden staph than UMF 5 honey [for example]."

It's a helpful reminder, though, from the laboratory comparisons discussed above, that grading is not the whole story — it should be treated as one signal of quality and authenticity, not the sole predictor of how a particular honey will perform against a particular pathogen.

How People are Using Manuka Honey for Healing Wounds

In this study by Dr. Peter Molan at the University of Waikato, New Zealand, recommendations are listed based on scientific evidence to achieve optimal results when using Manuka honey on wounds:

• Use it as early in the healing process as possible: "honey is most effective before a wound has been allowed to become deeply infected."

• Use specific types of honey: "the higher the potency of the [antibacterial properties of the] honey on the surface, the further down into the tissues will be the minimum effective level of the antibacterial substances… Manuka honey has a unique, unidentified, antibacterial component in addition to the enzymatically generated hydrogen peroxide that is common to all honeys."

• Use dressings which will hold enough honey on the wound to generate results and prevent leaking: "It is important to hold sufficient honey in place on a wound to get a good therapeutic effect, providing a "reservoir" of sufficient quantity such that its antibacterial and other bioactive components are not excessively diluted by exudate and not substantially depleted by diffusion into the wound tissues."

• Ensure that the honey is in full contact with the affected area: "Contact between the wound bed and the honey is essential for the antibacterial and other bioactive components of the honey to be able to diffuse into the wound tissues."

• Make sure you also cover areas surrounding the wounds: "This allows diffusion through the skin of the antibacterial components to clear infection in periwound tissue, and of the anti-inflammatory components to reduce inflammation and edema."

• Change the dressing regularly: "...honey is a water soluble material that readily takes up wound fluid and thus becomes diluted… the dressings need to be changed at least weekly to maintain a "reservoir" of bioactive components as these diffuse away into the wound tissues and deplete the content in the honey on the surface."

See the study for greater detail on each of these, plus other more specific recommendations.

Beyond these practical dressing guidelines, some small human studies have started to look at measurable changes in wounds treated with Manuka honey. One small, non-randomised, open-label clinical study followed 17 patients with 20 chronic, non-healing ulcers and found that Manuka honey dressings were associated with a statistically significant reduction in wound surface pH over two weeks — and, interestingly, wounds that showed a greater drop in pH also tended to show a greater reduction in size. This is genuinely useful preliminary human evidence, but it's important to be precise about its limits: it was not a randomised controlled trial, there was no comparator dressing for direct comparison, and the study's own authors call for further research before drawing firm conclusions about cause and effect. If you have a chronic or non-healing wound, this finding is a reason for interest, not a reason to delay seeing a clinician.

Manuka honey's use isn't limited to skin wounds, either — researchers have also explored its tolerability in more delicate applications. A randomised, investigator-masked human trial tested a Manuka honey-based eye cream applied nightly for two weeks to the eyelids of 25 healthy volunteers, and found it to be well tolerated, with no significant adverse changes in visual acuity, ocular surface health, or inflammatory markers. It's worth being clear that this trial was assessing safety and tolerability rather than wound-healing efficacy, and that the authors themselves note their results support — but don't replace — future efficacy trials in patients with the target condition (blepharitis). It's also a specially formulated medical/cosmetic product tested in healthy volunteers, not a reason to apply raw or food-grade honey near the eyes.

Manuka Honey and Wound Care with New Zealand Honey Co.

Based on the findings above, when using honey for wound care, you want the highest potency of antibacterial and antioxidant activity available.

With plenty of imposters on the market, Manuka honey has a unique grading system. Authentic Manuka Honey should show two grades: its UMF™ and MGO (or MG) levels.

(Bear in mind that MGO is not regulated in the same way as UMF™, so if a honey is missing the latter, it may not have met the same standards). As the laboratory comparisons above illustrate, grading is best understood as an indicator of authenticity and quality control rather than a precise, guaranteed predictor of antibacterial performance against every pathogen — but it remains the most reliable tool consumers currently have for verifying genuine Manuka honey.

All of our Manuka honey products are independently tested and graded both on UMF™ and MGO. So if you want the real deal, check out our top honeys here (look for UMF™ 20+ to if you're using it for wound care).

Cautions

Before trying Manuka honey for any kind of wound care, please keep the following in mind:

• This page is for general health information only and is not medical advice, a treatment recommendation, or a substitute for consultation with a qualified clinician.
• Manuka honey must never be given to or used on infants under 12 months of age in any form, including wound care, due to the risk of infant botulism.
• Wounds that are severe, deep, rapidly worsening, accompanied by high fever, spreading redness, or that are not healing should be assessed by a clinician promptly rather than self-treated.
• Food-grade Manuka honey (sold for eating) is different from medical-grade Manuka honey wound dressings, which are sterilised, quality-controlled, and regulated for clinical use. Statements about laboratory or clinical studies on wound dressings should not be taken as endorsement of using kitchen-grade honey on wounds.
• People with diabetes should be aware that blood-sugar management and wound-healing considerations differ from the general population; any use of honey-based products for wound care should be discussed with a treating clinician.
• Findings from laboratory (in-vitro) and animal studies do not necessarily translate into safe or effective outcomes in humans, and small or uncontrolled human studies described here are preliminary, not definitive proof of clinical benefit.

Taken together, the research picture on Manuka honey and wound care is genuinely promising but still developing. There's a long history of traditional use, a growing body of laboratory evidence pointing to antibacterial and biofilm-disrupting activity, some encouraging animal and small human studies, and practical guidance from practitioners on how it's used in the field. At the same time, grading numbers aren't a precise potency scale, methylglyoxal alone doesn't explain everything, and several of the more exciting findings come from small, uncontrolled, or preclinical studies that need to be followed up with larger, well-controlled human trials — particularly in specific populations like people with diabetes. Approaching Manuka honey with informed curiosity, rather than as a guaranteed cure, is the most honest way to make use of what the science currently shows.

Also on our blog:

• What is the best Manuka honey for scars?
• How to find the best Manuka honey for your skin.
• Natural immunity-boosting drink with Manuka honey.
• Why is Manuka honey expensive?
• Manuka honey for teeth & oral health