Honey For Burns
Can honey be used to heal burns, and is there clinical evidence to support its use?
Honey is well known for its anti-bacterial properties, but is there sufficient evidence to support the use of honey for burns?
Indeed, there are 2 studies presenting quality evidence that honey dressings can actually heal partial thickness
burns more quickly than conventional treatments. The evidence is important for credibility. If hospitals want to use honey for burns, medical staff need reassurance that it will help the patient as quickly as possible.
An ancient remedy.....
Certainly, honey has been used in ancient medicine, including as a treatment for wounds.
However, in ancient times there were no attempts made to prove efficacy in the scientific, regulated way as is the requirement today.
This is a very important point. The term 'ancient times' can suddenly imply mystery, secrets, an air of the exotic and 'forgotten knowledge'. But just because something was used in ancient times, does not mean it is better, and that it was used with special wisdom!
However, this does not mean that honey is ineffective! Indeed, many people rate honey very highly for a number of conditions from coughs to eczema (although currently there is only a small amount of evidence to support use in eczema). The anti-bacterial properties of honey are well documented and researched. It has been proven to be effective against MRSA. Many people rate 'Medical Grade Honey' very highly.
Why we need studies - not hearsay
In modern times there is a well accepted process for establishing the efficacy and safety of medical treatments.
This means, if we want to use honey for burns in a clinical setting, it must be proven scientifically through the use of quality clinical trials. Those rules apply to conventional pharmaceutical medicines, as well as 'natural product based' (of which, there are many being tested in clinical settings, on a regular basis).
This requirement is a good thing - remember, regulations evolved many years ago, out of the need to avoid harm to the public, and put a stop to quacks on street corners selling dirt as a treatment for warts etc.
These days, some people may think this is just game playing by big pharma, but personally I agree that actually - products must be tested first!
(Though I appreciate, big pharmaceutical companies can more easily afford the trials).
It's also true that honey is sometimes combined with other ingredients that are well regarded by the public, such as Aloe Vera.
Nevertheless, if rules are allowed to be relaxed for one treatment, they can be relaxed for another. Hospitals and clinicians must demonstrate care - not negligence. To treat somebody with a substance not properly tested could result in harm and law suits.
Honey for burns - the clinical research
It’s sometimes difficult to work out whether individual clinical studies are properly set up, but a recent Cochrane review by Jull et al 2015, looked at 26 different trials involving more than 3000 patients that examined the use of honey in wound healing, of which 11 trials looking at the use of honey for burns.
It is not clear from the review, which trials used which type of honey (for example, manuka honey, medical grade honey etc).
Partial thickness burns affect the top two layers of skin, the epidermis and the hypodermis, and are often called ‘second degree burns’. These burns are more serious than first degree burns, because a deeper layer of skin is damaged and they are more painful and more prone to infection.
The reviewers state that 2 of the studies, show what they
describe as ‘high quality evidence’ that honey dressings heal partial thickness
burns more quickly than conventional treatments.
These studies specifically looking at honey in burns, involve 992 patients – so they are not small and insignificant studies!). Conventional treatments with which honey was compared, included:
- polyurethane film,
- paraffin gauze,
- soframycin-impregnated gauze,
- sterile linen,
and
- leaving the burns exposed.
However, were there any negative side-effects or consequences of using honey for burns?
Are there any risks to using honey for burns?
It was not clear whether or not there are fewer infections if honey dressings are used for burns instead of conventional dressings.
Jull et al examined ten trials (involving over 800 patients!) that compared the use of honey in burns with use of silver sulfadiazine (SSD) in burns, and found:
- There was low quality evidence from four of the studies that honey heals burns more quickly than the silver sulfadiazine.
- The other six studies provide strong evidence that, while there is “no difference in the overall risk of healing” for honey compared with SSD, interestingly, there is good evidence that there is an overall reduction in the risk of adverse events for honey compared with SSD.
So whilst the results look very interesting, the issue of infection and risk following the use of honey for burns would really need to be looked at more vigorously before it could be used on a wider basis. Robust trials are a key requirement of any advanced medical care system.
Indeed, the authors concluded:
"Honey appears to heal partial thickness burns more quickly than conventional treatment (which included polyurethane film, paraffin gauze, soframycin-impregnated gauze, sterile linen and leaving the burns exposed) and infected post-operative wounds more quickly than antiseptics and gauze.
Beyond these comparisons any evidence for differences in the effects of honey and comparators is of low or very low quality and does not form a robust basis for decision making."
Should I use honey to treat my burns, and how can I use it?
Competent health bodies, such as the UK NHS, point out that honey used in clinical settings, is medical grade honey. This means that, for example, it has been through a process to ensure it is not contaminated, and is presented in an appropriate format.
Do remember, there have been a number of scandals around contaminated honey. For example, more manuka honey is sold than is actually produced! There have been scandals of 'cheap' honey being smuggled from China into the West - containing anti-biotics and even lead.
In addition, take a look at your burn. Should you seek medical assistance (especially for burns on a child or elderly person, or if there are any other relevant medical issues). If you have an allergy to bee products including honey, obviously you should not use it, even as a topical treatment.
Then again, personally, I'm fit and healthy, and I would be prepared to try honey for burns if the burn was very minor, and the product used appeared to be suitable, and I'd be happy to have it in my first aid box - but that's me.
References:
Jull et al – Cochrane review: https://www.ncbi.nlm.nih.gov/pubmed/25742878
- Baghel et al: “A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients.” https://www.ncbi.nlm.nih.gov/pubmed/20368852 Mashhood AA, Khan TA, Sami AN. Honey compared with 1% silver sulfadiazine cream in the treatment of superficial and partial thickness burns. Journal of Pakistan Association of Dermatologists 2006;16(1):14-9.
- Memon AR, Tahir SM, Khushk IA, Ali Memon G. Therapeutic effects of honey versus silver sulfadiazine in the management of burn injuries. Journal of Liaquat University Medicine and Health Sciences 2005;4(3):100-4.
- Subrahmanyam M. Topical application of honey in treatment of burns. British Journal of Surgery 1991;78(4):497-8. https://www.ncbi.nlm.nih.gov/pubmed/2032114
- Subrahmanyam
M. Honey-impregnated gauze
versus amniotic membrane in the treatment of burns. Burns 1994;20(4):331-3. http://www.sciencedirect.com/science/article/
pii/0305417994900612?via%3Dihub -
Subrahmanyam M. A prospective
randomised clinical and histological study of superficial burn wound healing
with honey and silver sulfadiazine. Burns 1998;24(2):157-61. http://www.sciencedirect.com/science/article/
pii/S0305417997001137?via%3Dihub
Did You Know?
Toxic Honey Was Used In Ancient Warfare!
