The Science Behind Honey in Dermatology: Wound Healing, Rosacea, and Beyond

B25025 I By Lara Campbell, PharmD Class of 2026, Appalachian College of Pharmacy

From ancient remedies to modern science, honey remains one of nature’s most powerful and versatile healing agents. Not only does it aid in skin repair and wound care, but ingesting honey has also been shown to support immune function, metabolic health, and even alleviate allergy symptoms. Below, we explore the clinical research behind the topical uses of honey.

Why Honey Works on the Skin

A unique combination of antibacterial properties, moisture retention, anti-inflammatory activity, and promotion of tissue regeneration drives honey’s skin-healing effects. These mechanisms make it useful in managing burns, chronic wounds, and inflammatory skin disorders.

What the Research Shows

1. Burn Wound Healing

• • Participants: 50 patients with moderate burns (23–24% total body surface area, ~12–13% full thickness)
  • Intervention: Honey dressings (with delayed grafting if required) vs. early tangential excision (TE) with immediate grafting
  • Duration: Treatment until wound closure, follow-up at 3 months post-discharge
  • Primary Outcome: Graft requirement, cosmetic and functional results, blood replacement
  • Results: Cosmetic and functional outcomes at 3 months were better with TE (92% good/excellent) vs. honey (55%, with some contractures).
  • Conclusion: Early excision and grafting produced superior long-term outcomes, but honey dressings reduced blood transfusion needs and delayed or avoided surgery in many cases, making honey a useful option in resource-limited settings (Subrahmanyam, 1999, PMID: 10630854).

2. Atopic Dermatitis (Wound Care)

• • Participants: 14 adults with bilateral atopic dermatitis (AD) lesions
    
  • Intervention: Manuka honey (MH) applied overnight on one lesion vs. untreated contralateral lesion
    
  • Duration: 7 consecutive nights
    
  • Primary Outcome: Change in Three-Item Severity score; reduction in skin staphylococci; mechanistic cytokine effects
  • Results:
    • MH-treated lesions showed significant clinical improvement compared to control lesions.
    • No significant difference in Staphylococcus colonization after 7 days.
    • In vitro, MH downregulated IL‑4–induced CCL26 release from keratinocytes and inhibited mast cell degranulation.
  • Conclusion: Manuka honey improved lesion severity and demonstrated anti-inflammatory and immunomodulatory effects, suggesting potential benefit in AD symptom management (Alangari et al., 2017, PMID: 28474502).

3. Rosacea

• • Participants: 138 adults with rosacea (≥16 years old)
    
  • Intervention: Honevo (90% kanuka honey + 10% glycerine) vs. Cetomacrogol cream
    
  • Duration: Twice daily for 8 weeks
    
  • Primary Outcome: ≥2‑point improvement in the Investigator Global Assessment of Rosacea Severity Score (IGA‑RSS)
  • Results:
    • 34.3% in the Honevo group vs. 17.4% in the control group achieved the primary outcome (RR 2.03; p = 0.020).
    • Clinician-rated severity and patient-reported improvement (VAS) both favored Honevo at weeks 2 and 8.
  • Conclusion: Honevo significantly improved rosacea severity compared to standard moisturizer, with both clinicians and patients reporting clearer skin and reduced symptoms (Braithwaite et al., 2015, PMID: 26109117).

4. Skin Healing (Graft Donor Sites)

• • Participants: Patients with split-thickness skin graft donor sites
    
  • Intervention: Honey-impregnated gauze vs. paraffin gauze, hydrocolloid dressings, and saline-soaked gauze
    
  • Duration: Until complete donor site healing
    
  • Primary Outcome: Healing time and pain scores
  • Results:
    • Honey dressings promoted faster healing and less pain than paraffin or saline gauze.
    • Healing time and comfort were similar between honey and hydrocolloid dressings.
  • Conclusion: Honey is a safe, effective, and practical alternative for donor site management, especially where advanced dressings may not be available (Misirlioglu et al., 2003, PMID: 12562348).

5. Moisturizing & Intertrigo

• • Participants: Adults with intertrigo in large skin folds
    
  • Intervention: Honey barrier cream vs. zinc oxide ointment
    
  • Duration: Treatment period (exact duration per protocol not specified in abstract)
    
  • Primary Outcome: Symptom improvement and comfort
  • Results:
    • Both treatments were similarly effective for intertrigo resolution.
    • Patients using honey cream reported less itching and better comfort.
  • Conclusion: Honey barrier cream is a safe and comfortable alternative to zinc oxide for intertrigo management (Nijhuis et al., 2012, PMID: 23131911).

How to Use It Topically

• Honey‑impregnated dressings: For minor wounds and graft donor sites; change daily until healed.
  
• Creams or gels with 60–90% therapeutic honey: For eczema, rosacea, or inflammation—apply twice daily.
  
• Manuka or kanuka honey variants: Use 100% raw honey or ≥60% honey cream on intact skin or mild inflammation..

Takeaway

Topical honey is not just folklore—it is a proven aid for wound healing, infection control, and moisturizing damaged skin, especially in chronic wounds and burn care.

References

1. Subrahmanyam M. Early tangential excision and skin grafting of moderate burns is superior to honey dressing: a prospective randomised trial. Burns. 1999 Dec;25(8):729‑731. doi: 10.1016/s0305-4179(99)00063-7. PMID: 10630854.
2. Alangari AA, Morris K, Lwaleed BA, Lau L, Jones K, Cooper R, Jenkins R. Honey is potentially effective in the treatment of atopic dermatitis: Clinical and mechanistic studies. Immun Inflamm Dis. 2017 Jun;5(2):190‑199. doi: 10.1002/iid3.153. Epub 2017 Mar 30. PMID: 28474502; PMCID: PMC5418133.
3. Braithwaite I, Hunt A, Riley J, Fingleton J, Kocks J, Corin A, Helm C, Sheahan D, Tofield C, Montgomery B, Holliday M, Weatherall M, Beasley R. Randomised controlled trial of topical kanuka honey for the treatment of rosacea. BMJ Open. 2015 Jun 24;5(6):e007651. doi: 10.1136/bmjopen-2015-007651. PMID: 26109117; PMCID: PMC4480029.
4. Misirlioglu A, Eroglu S, Karacaoglan N, Akan M, Akoz T, Yildirim S. Use of honey as an adjunct in the healing of split‑thickness skin graft donor site. Dermatol Surg. 2003 Feb;29(2):168‑172. doi: 10.1046/j.1524‑4725.2003.29043.x. PMID: 12562348.
5. Nijhuis WA, Houwing RH, Van der Zwet WC, Jansman FG. A randomised trial of honey barrier cream versus zinc oxide ointment. Br J Nurs. 2012 Nov 8‑21;21(20):9‑10, 12‑13. PMID: 23131911.

Acknowledgment: 
This blog was prepared with assistance from ChatGPT by OpenAI. 

Note:
This content is for informational purposes only and is not intended as medical advice. Always consult your healthcare provider before starting any supplement.

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