Effects of Three Types of Honey on Cutaneous Wound Healing

Hatice Ozlem Nisbet, DVM, PhD; Cevat Nisbet, DVM, PhD; Murat Yarim, DVM, PhD; Ahmet Guler, PhD; Ahmet Ozak, DVM, PhD



In This Article

Abstract and Introduction


Aim. To evaluate the effects of three types of honey (chestnut, blossom, and rhododendron) on the healing of full-thickness wounds.
Methods. Twenty-four (24) New Zealand White female rabbits were used. Four 1.5 cm x 1.5 cm full-thickness skin wounds were created on the back of each animal and treated with pure honey or sterile saline, respectively. Wounds were assessed by wound measurements and collection of samples at 7, 14, and 21 days post wounding to evaluate the healing process. Variables of interest were hydroxyproline concentration and gross and microscopic morphological characteristics reflective of wound healing. Wounds of the honey-treated groups healed much faster than the control group.
Results. On day 7, the formation of granulation tissue, epithelization, angiogenesis, and fibroplasia levels increased in the honey-treated groups (P < 0.05). A statistical difference between the honeys was not detected.
Conclusion. The present results suggest that honey accelerates the inflammatory reaction and initiates healing early on in the treatment process.


Topical application of honey to full-thickness skin wounds has been recognized for centuries as effective in controlling infection and producing a clean granulating wound bed. The recorded observations show that inflammation, swelling, and pain are quickly reduced, unpleasant odors cease, sloughing of necrotic tissue occurs without the need for debridement, dressings can be removed painlessly (without causing damage to the re-growing tissue), and healing occurs rapidly with minimal scarring, eliminating the need for grafting.[1–4]

Laboratory evidence suggest that honey has antibacterial properties that are due partly to its acidity and partly to phytochemicals from the nectar of particular plants.[5] Honey is mildly acidic and has a pH between 3.2–4.5.[6] Topical acidification of wounds promotes healing.[7] The hydrogen peroxide produced by honey is responsible for the stimulation of tissue growth. Hydrogen peroxide has been shown to stimulate fibroblast growth in cell culture at micro- and nanomolar concentrations.[8]

The medical and nutritional properties of honey depend on its chemical composition. The chemical composition of honey varies depending on the plant source, season, and production methods.[9] There are many types of honey derived from different plant sources but currently only 2 honeys are approved for therapeutic use—Medihoney™ (Capilano, Australia)[10] and Active Manuka Honey (New Zealand)—both of which are unifloral and derived from Leptospermum spp (tea trees). These honeys are thought to have additional therapeutic properties derived from the floral source.[10,11] Pure chestnut honey (PCH) and pure rhododendron honey (PRH) are unifloral honeys, while pure blossom honey (PBH) is multifloral. Honey has an obvious potential for use in a variety of clinical settings, and while a few clinics and individuals are using honey therapeutically, further research is needed to determine whether the source of honey can affect wound healing.

This prospective, randomized study was designed to observe the clinical effects of three different types of honey and to correlate their biochemical and histopathological properties.

To the authors' knowledge, nothing in the literature has compared the activities of pure chestnut honey, pure blossom honey, and pure rhododendron honey using a full-skin, cutaneous wound model.