Honey

Honeybees (Apis mellifera, A. cerana, A. dorsata, A. floria, A. andreniformis, A. koschevnikov, and A. laborisa) play a key role in propagating numerous plants, flower nectar, and flower pollen as well as in pollinating approximately one-third of common agricultural crops, including fruits, vegetables, nuts, and seeds (Time magazine; Proc. Biol. Sci. 2007;274[1608]:303-13). Indeed, the honeybee is the lone insect that produces food regularly consumed by human beings (Am. J. Ther. 2014;21:304-23). Honey, which contains more than 180 compounds, is produced by honeybees from flower nectar. This sweet food product is supersaturated in sugar, and also contains phenolic acids, flavonoids, ascorbic acid, alpha-tocopherol, carotenoids, the enzymes glucose oxidase and catalase, organic and amino acids, and proteins (J. Food Sci. 2008;73:R117-24). Honey has been used since ancient times in Ayurvedic medicine to treat diabetes and has long been used to treat infected wounds (Ayu 2012;33:178-82; Clin. Infect. Dis. 2009;49:1541-9). Currently, honey is used in Ayurvedic medicine to treat acne, and it is incorporated in various cosmetic formulations such as facial washes, skin moisturizers, and hair conditioners (Ayu 2012;33:178-82).

History

For at least 2,700 years, traditional medical practice has included the use of topically applied honey for various conditions, with many modern researchers retrospectively attributing this usage to the antibacterial activity of honey (Am. J. Ther. 2014;21:304-23; Clin. Infect. Dis. 2008;46:1677-82). Honey served as a potent anti-inflammatory and antibacterial agent in folk remedies in ancient Egypt, Greece, and Rome, with written references to the medical application of bee products dating back to ancientEgypt, India, and China (Am. J. Ther. 2014;21:304-23; Cancer Res. 1993;53:1255-61; Evid. Based Complement. Alternat. Med. 2013;2013:697390)). For more than 4,000 years, honey has been used in Ayurvedic medicine, and its use has been traced to the Xin dynasty in China (Am. J. Ther. 2014;21:304-23). The antibacterial characteristics of honey were first reported in 1892 (IUBMB Life 2012;64:48-55). Russia and Germany used honey for wound treatment through World War I. The traditional medical application of honey began to subside with the advent of antibiotics in the 1940s(Burns 2013; 39:1514-25; Int. J. Clin. Pract. 2007;61:1705-7).

Chemistry

Myriad biological functions are associated with honey (antibacterial, antioxidant, antitumor, anti-inflammatory, antibrowning, and antiviral) and ascribed mainly to its constituent phenolic compounds, such as flavonoids, including chrysin (J. Food Sci. 2008;73:R117-24). Indeed, medical grade honeys such as manuka honey (a monofloral honey derived from Leptospermum scoparium, a member of the Myrtaceae family, native to New Zealand) and Medihoney® (a standardized mix of Australian and New Zealand honeys) are rich in flavonoids (Int. J. Clin. Pract. 2007;61:1705-7;J. Int. Acad. Periodontol. 2004;6:63-7; Evid. Based Complement. Alternat. Med. 2009;6:165-73;J. Agric. Food Chem. 2012;60:7229-37). Honey has a pH ranging from 3.2 to 4.5 and an acidity level that stymies the growth of many microorganisms (Burns 2013;39:1514-25; J. Clin. Nurs. 2008;17:2604-23; Nurs. Times. 2006;102:40-2; Br. J. Community Nurs. 2004;Suppl:S21-7 ).

Antibacterial activity

In 2008, Kwakman et al. found that within 24 hours, 10%-40% (vol/vol) medical grade honey (Revamil) destroyed antibiotic-susceptible and antibiotic-resistant isolates of Staphylococcus aureus,S. epidermidis, Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca. After 2 days of honey application, they also observed a 100-fold decrease in forearm skin colonization in healthy volunteers, with the number of positive skin cultures declining by 76%. The researchers concluded that Revamil exhibits significant potential to prevent or treat infections, including those spawned by multidrug-resistant bacteria (Clin. Infect. Dis. 2008;46:1677-82). Honey has been demonstrated to be clinically effective in treating several kinds of wound infections, reducing skin colonization of multiple bacteria, including methicillin-resistant S. aureus (Clin. Infect. Dis. 2008;46:1677-82) and enhancing wound healing, without provoking adverse effects ( Clin. Infect. Dis. 2009;49:1541-9). Manuka honey and Medihoney are the main forms of medical grade honey used in clinical practice. Nonmedical grade honey may contain viable bacterial spores (including clostridia), and manifest less predictable antibacterial properties (Clin. Infect. Dis. 2009;49:1541-9).

Honey is used in over-the-counter products as a moisturizing agent and in hair-conditioning products based on its strong humectant properties. It is also used in home remedies to treat burns, wounds, eczema, and dermatitis, especially in Asia (Ayu 2012;33:178-8).

Seborrheic dermatitis/dandruff

In 2001, Al-Waili assessed the potential of topically applied crude honey (90% honey diluted in warm water) to treat chronic seborrheic dermatitis of the scalp, face, and chest in 30 patients (20 males and 10 females, aged 15-60 years). Over the initial 4 weeks of treatment, honey was gently rubbed onto lesions every other day for 2-3 minutes at a time, with the ointment left on for 3 hours before gentle warm-water rinsing. Then, in a 6-month prophylactic phase, the participants were divided into a once-weekly treatment group and a control group. Skin lesions healed completely within 2 weeks in the treatment group, after significant reductions in itching and scaling in just the first week. Subjective improvements in hair loss were also reported. Relapse was observed in 12 of the 15 subjects in the control group within 2-4 months of therapy cessation and none in the treatment group. The author concluded that weekly use of crude honey significantly improves seborrheic dermatitis symptoms and related hair loss (Eur. J. Med. Res. 2001;6:306-8).

Wound healing

In February 2013, Jull published a review of 25 randomized and quasirandomized trials evaluating honey in the treatment of acute or chronic wounds, finding that honey might delay healing in partial- and full-thickness burns, compared with early excision and grafting, but it does not significantly enhance healing of chronic venous leg ulcers. They suggested that while honey may prove to be more effective than some conventional dressings for such ulcers, evidence is currently insufficient to support this claim ( Cochrane Database Syst. Rev. 2013;2:CD005083). Later that year, Vandamme et al. identified 55 studies in a literature review suggesting that honey stimulates healing of burns, ulcers, and other wounds. They also found, despite some methodologic concerns, that honey exerts antibacterial activity in burn treatment and deodorizing, debridement, anti-inflammatory, and analgesic activity ( Burns 2013;39:1514-25).

Conclusion

Honey has a long history of traditional medicinal use and has been found to display significant biologic activity, including antibacterial, antioxidant, antitumor, anti-inflammatory, antibrowning, and antiviral. The antibacterial properties of honey are particularly compelling. While more research, in the form of randomized, controlled trials, is needed prior to incorporating bee products into the dermatologic armamentarium as first-line therapies, the potential of honey usage for skin care is promising.

Dr. Baumann is chief executive officer of the Baumann Cosmetic & Research Institute in Miami Beach. She founded the cosmetic dermatology center at the University of Miami in 1997. Dr. Baumann wrote the textbook “Cosmetic Dermatology: Principles and Practice” (McGraw-Hill, April 2002), and a book for consumers, “The Skin Type Solution” (Bantam, 2006). She has contributed to the Cosmeceutical Critique column in Skin & Allergy News since January 2001. Dr. Baumann has received funding for clinical grants from Allergan, Aveeno, Avon Products, Galderma, Mary Kay, Medicis Pharmaceuticals, Neutrogena, Philosophy, Stiefel, Topix Pharmaceuticals, and Unilever.

Honeybees (Apis mellifera, A. cerana, A. dorsata, A. floria, A. andreniformis, A. koschevnikov, and A. laborisa) play a key role in propagating numerous plants, flower nectar, and flower pollen as well as in pollinating approximately one-third of common agricultural crops, including fruits, vegetables, nuts, and seeds (Time magazine; Proc. Biol. Sci. 2007;274[1608]:303-13). Indeed, the honeybee is the lone insect that produces food regularly consumed by human beings (Am. J. Ther. 2014;21:304-23). Honey, which contains more than 180 compounds, is produced by honeybees from flower nectar. This sweet food product is supersaturated in sugar, and also contains phenolic acids, flavonoids, ascorbic acid, alpha-tocopherol, carotenoids, the enzymes glucose oxidase and catalase, organic and amino acids, and proteins (J. Food Sci. 2008;73:R117-24). Honey has been used since ancient times in Ayurvedic medicine to treat diabetes and has long been used to treat infected wounds (Ayu 2012;33:178-82; Clin. Infect. Dis. 2009;49:1541-9). Currently, honey is used in Ayurvedic medicine to treat acne, and it is incorporated in various cosmetic formulations such as facial washes, skin moisturizers, and hair conditioners (Ayu 2012;33:178-82).

History

For at least 2,700 years, traditional medical practice has included the use of topically applied honey for various conditions, with many modern researchers retrospectively attributing this usage to the antibacterial activity of honey (Am. J. Ther. 2014;21:304-23; Clin. Infect. Dis. 2008;46:1677-82). Honey served as a potent anti-inflammatory and antibacterial agent in folk remedies in ancient Egypt, Greece, and Rome, with written references to the medical application of bee products dating back to ancientEgypt, India, and China (Am. J. Ther. 2014;21:304-23; Cancer Res. 1993;53:1255-61; Evid. Based Complement. Alternat. Med. 2013;2013:697390)). For more than 4,000 years, honey has been used in Ayurvedic medicine, and its use has been traced to the Xin dynasty in China (Am. J. Ther. 2014;21:304-23). The antibacterial characteristics of honey were first reported in 1892 (IUBMB Life 2012;64:48-55). Russia and Germany used honey for wound treatment through World War I. The traditional medical application of honey began to subside with the advent of antibiotics in the 1940s(Burns 2013; 39:1514-25; Int. J. Clin. Pract. 2007;61:1705-7).

Chemistry

Myriad biological functions are associated with honey (antibacterial, antioxidant, antitumor, anti-inflammatory, antibrowning, and antiviral) and ascribed mainly to its constituent phenolic compounds, such as flavonoids, including chrysin (J. Food Sci. 2008;73:R117-24). Indeed, medical grade honeys such as manuka honey (a monofloral honey derived from Leptospermum scoparium, a member of the Myrtaceae family, native to New Zealand) and Medihoney® (a standardized mix of Australian and New Zealand honeys) are rich in flavonoids (Int. J. Clin. Pract. 2007;61:1705-7;J. Int. Acad. Periodontol. 2004;6:63-7; Evid. Based Complement. Alternat. Med. 2009;6:165-73;J. Agric. Food Chem. 2012;60:7229-37). Honey has a pH ranging from 3.2 to 4.5 and an acidity level that stymies the growth of many microorganisms (Burns 2013;39:1514-25; J. Clin. Nurs. 2008;17:2604-23; Nurs. Times. 2006;102:40-2; Br. J. Community Nurs. 2004;Suppl:S21-7 ).

Antibacterial activity

In 2008, Kwakman et al. found that within 24 hours, 10%-40% (vol/vol) medical grade honey (Revamil) destroyed antibiotic-susceptible and antibiotic-resistant isolates of Staphylococcus aureus,S. epidermidis, Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca. After 2 days of honey application, they also observed a 100-fold decrease in forearm skin colonization in healthy volunteers, with the number of positive skin cultures declining by 76%. The researchers concluded that Revamil exhibits significant potential to prevent or treat infections, including those spawned by multidrug-resistant bacteria (Clin. Infect. Dis. 2008;46:1677-82). Honey has been demonstrated to be clinically effective in treating several kinds of wound infections, reducing skin colonization of multiple bacteria, including methicillin-resistant S. aureus (Clin. Infect. Dis. 2008;46:1677-82) and enhancing wound healing, without provoking adverse effects ( Clin. Infect. Dis. 2009;49:1541-9). Manuka honey and Medihoney are the main forms of medical grade honey used in clinical practice. Nonmedical grade honey may contain viable bacterial spores (including clostridia), and manifest less predictable antibacterial properties (Clin. Infect. Dis. 2009;49:1541-9).

Honey is used in over-the-counter products as a moisturizing agent and in hair-conditioning products based on its strong humectant properties. It is also used in home remedies to treat burns, wounds, eczema, and dermatitis, especially in Asia (Ayu 2012;33:178-8).

Seborrheic dermatitis/dandruff

In 2001, Al-Waili assessed the potential of topically applied crude honey (90% honey diluted in warm water) to treat chronic seborrheic dermatitis of the scalp, face, and chest in 30 patients (20 males and 10 females, aged 15-60 years). Over the initial 4 weeks of treatment, honey was gently rubbed onto lesions every other day for 2-3 minutes at a time, with the ointment left on for 3 hours before gentle warm-water rinsing. Then, in a 6-month prophylactic phase, the participants were divided into a once-weekly treatment group and a control group. Skin lesions healed completely within 2 weeks in the treatment group, after significant reductions in itching and scaling in just the first week. Subjective improvements in hair loss were also reported. Relapse was observed in 12 of the 15 subjects in the control group within 2-4 months of therapy cessation and none in the treatment group. The author concluded that weekly use of crude honey significantly improves seborrheic dermatitis symptoms and related hair loss (Eur. J. Med. Res. 2001;6:306-8).

Wound healing

In February 2013, Jull published a review of 25 randomized and quasirandomized trials evaluating honey in the treatment of acute or chronic wounds, finding that honey might delay healing in partial- and full-thickness burns, compared with early excision and grafting, but it does not significantly enhance healing of chronic venous leg ulcers. They suggested that while honey may prove to be more effective than some conventional dressings for such ulcers, evidence is currently insufficient to support this claim ( Cochrane Database Syst. Rev. 2013;2:CD005083). Later that year, Vandamme et al. identified 55 studies in a literature review suggesting that honey stimulates healing of burns, ulcers, and other wounds. They also found, despite some methodologic concerns, that honey exerts antibacterial activity in burn treatment and deodorizing, debridement, anti-inflammatory, and analgesic activity ( Burns 2013;39:1514-25).

Conclusion

Honey has a long history of traditional medicinal use and has been found to display significant biologic activity, including antibacterial, antioxidant, antitumor, anti-inflammatory, antibrowning, and antiviral. The antibacterial properties of honey are particularly compelling. While more research, in the form of randomized, controlled trials, is needed prior to incorporating bee products into the dermatologic armamentarium as first-line therapies, the potential of honey usage for skin care is promising.

Dr. Baumann is chief executive officer of the Baumann Cosmetic & Research Institute in Miami Beach. She founded the cosmetic dermatology center at the University of Miami in 1997. Dr. Baumann wrote the textbook “Cosmetic Dermatology: Principles and Practice” (McGraw-Hill, April 2002), and a book for consumers, “The Skin Type Solution” (Bantam, 2006). She has contributed to the Cosmeceutical Critique column in Skin & Allergy News since January 2001. Dr. Baumann has received funding for clinical grants from Allergan, Aveeno, Avon Products, Galderma, Mary Kay, Medicis Pharmaceuticals, Neutrogena, Philosophy, Stiefel, Topix Pharmaceuticals, and Unilever.

Honeybees (Apis mellifera, A. cerana, A. dorsata, A. floria, A. andreniformis, A. koschevnikov, and A. laborisa) play a key role in propagating numerous plants, flower nectar, and flower pollen as well as in pollinating approximately one-third of common agricultural crops, including fruits, vegetables, nuts, and seeds (Time magazine; Proc. Biol. Sci. 2007;274[1608]:303-13). Indeed, the honeybee is the lone insect that produces food regularly consumed by human beings (Am. J. Ther. 2014;21:304-23). Honey, which contains more than 180 compounds, is produced by honeybees from flower nectar. This sweet food product is supersaturated in sugar, and also contains phenolic acids, flavonoids, ascorbic acid, alpha-tocopherol, carotenoids, the enzymes glucose oxidase and catalase, organic and amino acids, and proteins (J. Food Sci. 2008;73:R117-24). Honey has been used since ancient times in Ayurvedic medicine to treat diabetes and has long been used to treat infected wounds (Ayu 2012;33:178-82; Clin. Infect. Dis. 2009;49:1541-9). Currently, honey is used in Ayurvedic medicine to treat acne, and it is incorporated in various cosmetic formulations such as facial washes, skin moisturizers, and hair conditioners (Ayu 2012;33:178-82).

History

For at least 2,700 years, traditional medical practice has included the use of topically applied honey for various conditions, with many modern researchers retrospectively attributing this usage to the antibacterial activity of honey (Am. J. Ther. 2014;21:304-23; Clin. Infect. Dis. 2008;46:1677-82). Honey served as a potent anti-inflammatory and antibacterial agent in folk remedies in ancient Egypt, Greece, and Rome, with written references to the medical application of bee products dating back to ancientEgypt, India, and China (Am. J. Ther. 2014;21:304-23; Cancer Res. 1993;53:1255-61; Evid. Based Complement. Alternat. Med. 2013;2013:697390)). For more than 4,000 years, honey has been used in Ayurvedic medicine, and its use has been traced to the Xin dynasty in China (Am. J. Ther. 2014;21:304-23). The antibacterial characteristics of honey were first reported in 1892 (IUBMB Life 2012;64:48-55). Russia and Germany used honey for wound treatment through World War I. The traditional medical application of honey began to subside with the advent of antibiotics in the 1940s(Burns 2013; 39:1514-25; Int. J. Clin. Pract. 2007;61:1705-7).

Chemistry

Myriad biological functions are associated with honey (antibacterial, antioxidant, antitumor, anti-inflammatory, antibrowning, and antiviral) and ascribed mainly to its constituent phenolic compounds, such as flavonoids, including chrysin (J. Food Sci. 2008;73:R117-24). Indeed, medical grade honeys such as manuka honey (a monofloral honey derived from Leptospermum scoparium, a member of the Myrtaceae family, native to New Zealand) and Medihoney® (a standardized mix of Australian and New Zealand honeys) are rich in flavonoids (Int. J. Clin. Pract. 2007;61:1705-7;J. Int. Acad. Periodontol. 2004;6:63-7; Evid. Based Complement. Alternat. Med. 2009;6:165-73;J. Agric. Food Chem. 2012;60:7229-37). Honey has a pH ranging from 3.2 to 4.5 and an acidity level that stymies the growth of many microorganisms (Burns 2013;39:1514-25; J. Clin. Nurs. 2008;17:2604-23; Nurs. Times. 2006;102:40-2; Br. J. Community Nurs. 2004;Suppl:S21-7 ).

Antibacterial activity

In 2008, Kwakman et al. found that within 24 hours, 10%-40% (vol/vol) medical grade honey (Revamil) destroyed antibiotic-susceptible and antibiotic-resistant isolates of Staphylococcus aureus,S. epidermidis, Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca. After 2 days of honey application, they also observed a 100-fold decrease in forearm skin colonization in healthy volunteers, with the number of positive skin cultures declining by 76%. The researchers concluded that Revamil exhibits significant potential to prevent or treat infections, including those spawned by multidrug-resistant bacteria (Clin. Infect. Dis. 2008;46:1677-82). Honey has been demonstrated to be clinically effective in treating several kinds of wound infections, reducing skin colonization of multiple bacteria, including methicillin-resistant S. aureus (Clin. Infect. Dis. 2008;46:1677-82) and enhancing wound healing, without provoking adverse effects ( Clin. Infect. Dis. 2009;49:1541-9). Manuka honey and Medihoney are the main forms of medical grade honey used in clinical practice. Nonmedical grade honey may contain viable bacterial spores (including clostridia), and manifest less predictable antibacterial properties (Clin. Infect. Dis. 2009;49:1541-9).

Honey is used in over-the-counter products as a moisturizing agent and in hair-conditioning products based on its strong humectant properties. It is also used in home remedies to treat burns, wounds, eczema, and dermatitis, especially in Asia (Ayu 2012;33:178-8).

Seborrheic dermatitis/dandruff

In 2001, Al-Waili assessed the potential of topically applied crude honey (90% honey diluted in warm water) to treat chronic seborrheic dermatitis of the scalp, face, and chest in 30 patients (20 males and 10 females, aged 15-60 years). Over the initial 4 weeks of treatment, honey was gently rubbed onto lesions every other day for 2-3 minutes at a time, with the ointment left on for 3 hours before gentle warm-water rinsing. Then, in a 6-month prophylactic phase, the participants were divided into a once-weekly treatment group and a control group. Skin lesions healed completely within 2 weeks in the treatment group, after significant reductions in itching and scaling in just the first week. Subjective improvements in hair loss were also reported. Relapse was observed in 12 of the 15 subjects in the control group within 2-4 months of therapy cessation and none in the treatment group. The author concluded that weekly use of crude honey significantly improves seborrheic dermatitis symptoms and related hair loss (Eur. J. Med. Res. 2001;6:306-8).

Wound healing

In February 2013, Jull published a review of 25 randomized and quasirandomized trials evaluating honey in the treatment of acute or chronic wounds, finding that honey might delay healing in partial- and full-thickness burns, compared with early excision and grafting, but it does not significantly enhance healing of chronic venous leg ulcers. They suggested that while honey may prove to be more effective than some conventional dressings for such ulcers, evidence is currently insufficient to support this claim ( Cochrane Database Syst. Rev. 2013;2:CD005083). Later that year, Vandamme et al. identified 55 studies in a literature review suggesting that honey stimulates healing of burns, ulcers, and other wounds. They also found, despite some methodologic concerns, that honey exerts antibacterial activity in burn treatment and deodorizing, debridement, anti-inflammatory, and analgesic activity ( Burns 2013;39:1514-25).

Conclusion

Honey has a long history of traditional medicinal use and has been found to display significant biologic activity, including antibacterial, antioxidant, antitumor, anti-inflammatory, antibrowning, and antiviral. The antibacterial properties of honey are particularly compelling. While more research, in the form of randomized, controlled trials, is needed prior to incorporating bee products into the dermatologic armamentarium as first-line therapies, the potential of honey usage for skin care is promising.

Dr. Baumann is chief executive officer of the Baumann Cosmetic & Research Institute in Miami Beach. She founded the cosmetic dermatology center at the University of Miami in 1997. Dr. Baumann wrote the textbook “Cosmetic Dermatology: Principles and Practice” (McGraw-Hill, April 2002), and a book for consumers, “The Skin Type Solution” (Bantam, 2006). She has contributed to the Cosmeceutical Critique column in Skin & Allergy News since January 2001. Dr. Baumann has received funding for clinical grants from Allergan, Aveeno, Avon Products, Galderma, Mary Kay, Medicis Pharmaceuticals, Neutrogena, Philosophy, Stiefel, Topix Pharmaceuticals, and Unilever.