Wound Care

The use of Manuka Honey as a wound dressing material, an ancient remedy that has been rediscovered, is becoming of increasing interest as more reports of its effectiveness are published. The clinical observations recorded are that infection is rapidly cleared, inflammation, swelling and pain are quickly reduced, odour is reduced, sloughing of necrotic tissue is induced, granulation and epithelialisation are hastened, and healing occurs rapidly with minimal scarring. The antimicrobial properties of Manuka Honey prevent microbial growth in the moist healing environment created. Unlike other topical antiseptics, Manuka Honey causes no tissue damage. In fact, in animal studies it has been demonstrated histologically that it actually promotes the healing process. It has a direct nutrient effect as well as drawing lymph out to the cells by osmosis. The stimulation of healing may also be due to the acidity of honey. The osmosis creates a solution of honey in contact with the wound surface which prevents the dressing sticking, so there is no pain or tissue damage when dressings are changed. There is much anecdotal evidence to support its use, and randomised controlled clinical trials that have shown that Manuka Honey is more effective than silver sulfadiazine and a polyurethane film dressing for the treatment of burns.


Many medical professionals are using Manuka Honey and getting good results in patients with wounds that have not responded to standard treatment. Clearing bacterial infection from a wound is essential to allow the healing process to occur. Recent tests on many strains of multi-antibiotic-resistant bacteria such as MRSA strains MRSA, VRE and Acinetobacter baumarii have shown that these bacteria have no resistance to Manuka Honey. These "superbugs" are a serious clinical problem as infections with them often cannot be treated at all with antibiotics.


The most common skin wound infecting species of bacteria, Staphylococcus aureus has been found to be particularly sensitive to Manuka Honey. Studies indicate that Manuka Honey is very effective as a dressing for wounds, burns and skin ulcers for the following reasons:

• inflammation, swelling and pain are quickly reduced;
  
• malodour is reduced;
  
• shedding of dead tissue is induced so surgical removal is unnecessary;
  
• healing occurs rapidly with minimal scarring and with no need for skin grafting;
  
• infection is rapidly cleared.

Key Points:

1. Manuka Honey is a traditional topical treatment for infected wounds. It can be effective on antibiotic-resistant strains of bacteria.


3. The antibacterial properties of Manuka Honey include the release of low levels of hydrogen peroxide. Some honeys have an additional phytochemical antibacterial component.


4. Many authors support the use of Manuka Honey in infected wounds and some suggest its prophylactic use on the wounds of patients susceptible to MRSA and other antibiotic-resistant bacteria.


5. The viscosity of Manuka Honey provides a protective barrier to prevent wounds becoming infected.


6. Manuka Honey creates a moist healing environment that allows skin cells to regrow across a healing wound flush with the surface of the wound, preventing deformity of the skin. (If a dry scab forms on a wound, the skin cells can only grow across the wound deeper down where it is moist.)


7. Manuka Honey causes scabs and dead cells to lift off the surface of the wound, leaving a clean healthy wound bed in which regrowth of tissue can occur.


8. Manuka Honey stimulates the regrowth of tissue involved in the healing process. It stimulates the formation of new blood capillaries and the growth of fibroblasts that replace the connective tissue of the deeper layer of the skin and produce the collagen fibers that give strength to the repair. In addition, honey stimulates the growth of epithelial cells that form the new skin cover over a healed wound. Honey thus prevents scarring and keloid formation, and removes the need for skin grafting even with quite large wounds.


9. Manuka Honey does not stick to the underlying wound tissues, so there is no tearing away of newly formed tissue, and no pain, when dressings are changed.


10. Manuka Honey has an anti-inflammatory action, which reduces the swelling around a wound. This improves circulation and thus hastens the healing process. It also reduces pain. The amount of fluid exuding from wounds is also decreased by the antiinflammatory action.


11. The high sugar content of Manuka Honey draws lymph out of a wound, which lifts dirt out of the wound bed.


12. Manuka Honey prevents the odor that is commonly associated with serious wounds and skin ulcers, by clearing bacterial infection, and more immediately, by providing sugar to any bacteria present. In this environment, lactic acid is produced instead of the smelly byproducts of the degradation of protein.


13. Manuka Honey rapidly clears infection from wounds. It is fully effective even with antibiotic-resistant strains of bacteria. Unlike antiseptics and antibiotics, there is no impairment of the healing process through adverse effects on wound tissues.


14. Manuka Honey's antibacterial quality not only rapidly clears existing infection, it protects wounds from additional infection.


15. Manuka Honey debrides wounds and removes malodor.


16. Manuka Honey's anti-inflammatory activity reduces edema and minimizes scarring.


17. Manuka Honey stimulates growth of granulation and epithelial tissues to speed healing.


The antibacterial potency of honey of average level activity is well in excess of that needed to stop the growth of MRSA and VRE. Since honey is of proven effectiveness in clearing wounds of infection with other bacteria, and it gives many other benefits as a wound dressing material, there is good justification for trying it for the treatment of wounds infected with MRSA and VRE.

The unusual antibacterial activity of manuka honey is about twice as great as the hydrogen peroxide activity of other honey against VRE, but against MRSA the activity of the two honeys is similar. On wounds, some hydrogen peroxide may be broken down, so honey with hydrogen peroxide activity may be less effective.


First Aid Antiseptic Lotion with Manuka Honey reduces and guards against bacterial contamination or skin infection in minor cuts, scrapes and burns. Click here for more information or to purchase this product.

What's special about active manuka honey?

For the past 19 years honey researchers at the University of Waikato have been investigating what many local New Zealanders have accepted as common wisdom: our local manuka honey is a superior treatment for wound infections. Manuka honey is gathered in New Zealand from the manuka bush, Leptospermum scoparium, which grows uncultivated throughout the country. (More recently, as a result of systematic screening of Australian honeys, a honey with the same properties has been found to be produced from Leptospermum polygalifolium, which grows uncultivated in a few parts of Australlia.)

After the results of this work became known through publications in scientific journals, many people contacted the Honey Research Unit to find out what is so special about active manuka honey. The pertinent facts are:

• Honey has an antibacterial activity, due primarily to hydrogen peroxide formed in a "slow-release" manner by the enzyme glucose oxidase present in honey, which can vary widely in potency. Some honeys are no more antibacterial than sugar, while others can be diluted more than 100-fold and still halt the growth of bacteria. The difference in potency of antibacterial activity found among the different honeys is more than 100-fold.
  
• "Active manuka honey" (and its Australian equivalent) is the only honey available for sale that is tested for its antibacterial activity. It contains an additional antibacterial component found only in honey produced from Leptospermum plants: what has been called the "Unique Manuka Factor" (UMF). There is evidence that the two antibacterial components may have a synergistic action.
  
• UMF is not affected by the catalase enzyme present in body tissue and serum. This enzyme will break down, to some degree, the hydrogen peroxide which is the major antibacterial factor found in other types of honey. If a honey without UMF were used to treat an infection, the potency of the honey's antibacterial activity would most likely be reduced because of the action of catalase.
  
• The enzyme that produces hydrogen peroxide in honey is destroyed when honey is exposed to heat and light. But UMF is stable, so there is no concern about manuka honey losing its activity in storage.
  
• The enzyme that produces hydrogen peroxide in honey becomes active only when honey is diluted. But UMF is active in full strength honey, which will provide a more potent antibacterial action diffusing into the depth of infected tissues.
  The enzyme that produces hydrogen peroxide in honey needs oxygen to be available for the reaction, so may not work under wound dressings or in wound cavities. Honey with UMF is active in all situations.
  
• The enzyme that produces hydrogen peroxide in honey becomes active only when the acidity of honey is neutralised by body fluids, but then the honey is diluted.
  The enzyme that produces hydrogen peroxide in honey could be destroyed by the protein-digesting enzymes that are in wound fluids.
  
• The UMF antibacterial activity diffuses deeper into skin tissues than does the hydrogen peroxide from other types of honey.
  
• Honey with UMF is more effective than that with hydrogen peroxide against some types of bacteria. For example, active manuka honey with UMF is about twice as effective as other honey against Eschericihia coli and Staphylococcus aureus, the most common causes of infected wounds.

Many medical professionals are using active manuka honey - and getting good results in patients with wounds that have not responded to standard treatment. For example, a successful trial of active manuka honey on unresponsive skin ulcers was recently published in the New Zealand Medical Journal. In addition, staff at a large hospital in Brisbane, Australia, recently used active manuka honey as a wound dressing on a patient for whom honey without UMF had failed. In other hospitals clinicians have likewise noted improvement in healing rates when changing from other honey to a manuka honey with a good level of UMF.

None of the results being obtained clinically should be considered evidence that active manuka honey is more effective than other honey - a comparative clinical trial will be needed to establish that. Nevertheless, there are good theoretical reasons for choosing to use active manuka honey with a good level of UMF for management of wound infections.

To rate the potency of antibacterial activity of honey, I devised the testing method and the UMF number. The UMF numbers come from a standard laboratory test of antibacterial activity, with honey being compared with a standard antiseptic (phenol, also known as carbolic) for potency. For example, a honey with a UMF rating of 4 would be equivalent to the antiseptic potency of 4% solution of phenol, as used as carbolic disinfectant; a honey with a rating of 10 would have a potency equivalent to a 10% solution of phenol.

Medical professionals in New Zealand use active manuka honey with a rating of UMF 10 or higher. Although good results may be obtained with lower levels of activity, there is a chance that the lower activity will not be enough to fully clear an infection. In addition, honey with a lower level of activity will not allow as much of the antibacterial elements to diffuse into infected tissue, which could mean that effective control of infection may not be achieved in deeper tissue.

To alleviate any concern over the possible risk of introducing infection by the use of an unprocessed natural product on wounds, honey can be sterilised by gamma irradiation without loss of any of its antibacterial activity. Active manuka honey and the Australian Leptospermum honey are commercially available sterilised in this way.

Honey may take the sting out of the NHS superbugs

Honey has the power to defeat the hospital superbugs which claim up to 5,000 lives a year, scientists have discovered.

Renowned for thousands of years for its medicinal properties, it is able to kill off mutant bacteria, including MRSA which has defeated all but the strongest antibiotics.

The latest discovery by researchers at the University of Wales in Cardiff comes at a time of growing scientific interest in the substance's healing properties.

Honey contains natural antibacterial agents which experts have discovered can prevent the growth of a number of hospital-acquired wound infections, even at very low concentrations.

Outbreaks of the infections cost the Health Service £1billion a year in extra treatment.

They kill 5,000 British hospital patients a year and are a factor in a further 15,000 deaths.

Honey was revered by the ancient Greeks and Egyptians as a powerful medicinal agent and used to help heal burns and sores.

During World War I, German physicians mixed it with cod liver oil to use as a surgical dressing for battle wounds.

But widespread use of antibiotics to combat infections in the latter part of the last century left it back in the kitchen cupboard.

The latest findings followed laboratory experiments on bacteria gathered from infected wounds and hospital surfaces, including MRSA.

The team at the University of Wales Institute in Cardiff found honey attacked the bugs even when it was diluted in another medium. Microbiologist Dr Rose Cooper explained: 'I have found that even at concentrations as low as 3 per cent, honey is able to inhibit the growth of the bacteria.

'It is probable that at higher concentrations the honey would destroy the MRSA. This is very encouraging news and a good start.'

Varieties of honey from Australia and New Zealand have proved most effective. Their high sugar content creates a waterless environment in which the bacteria cannot survive.

The honey is also highly acidic due to the presence of the enzyme glucose oxidase, adding to its antibacterial properties.

Dr Cooper said this enzyme produces a secret weapon - hydrogen peroxide, which was once used as a wound disinfectant in hospitals.

Honey is primarily composed of fructose, glucose and water. It also contains enzymes, vitamins B and C, iron, magnesium, calcium, sodium, silica, manganese and potassium.

Dr Cooper said supermarket honey was not suitable for treating wounds.

'The honey we used was irradiated and had not been exposed to high temperatures like pasteurised runny honey you get in the shops,' she said.

'Even honey you might buy in health food shops could contain bacteria spores which you would not want to introduce to wounds.'

Another trial involving 20 patients at Aintree Hospital in Liverpool found dressings soaked in Manuka honey from New Zealand were effective in treating wounds infected with drug-resistant bacteria.

Manuka is made from one of New Zealand's native plants and has long been used in folk medicine. A larger trial has now been ordered.

Harnessing honey's healing power

Honey has been known for its healing properties for thousands of years - the Ancient Greeks used it, and so have many other peoples through the ages.
Even up to the second world war, honey was being used for its antibacterial properties in treating wounds.

But with the advent of penicillin and other antibiotic drugs in the twentieth century, honey's medicinal qualities have taken a back seat.

But that might be about to change - thanks to one New Zealand based researcher.

Working in his Honey Research Unit at the University of Waikato, in the central North Island, biochemist Professor Peter Molan has identified one particular type of honey with extraordinary healing qualities.

Professor Molan has shown that honey made from the flowers of the manuka bush, a native of New Zealand, has antibacterial properties over and above those of other honeys.

Mystery ingredient

He said: "In all honeys, there is - to different levels - hydrogen peroxide produced from an enzyme that bees add to the nectar.

"In manuka honey, and its close relative which grows in Australia called jellybush, there's something else besides the hydrogen peroxide.

"And there's nothing like that ever been found anywhere else in the world."

That "something else" has proved very hard to pin down. Even now, after more than twenty years of research, Peter Molan admits he still has no idea exactly what it is.

But he has given it a name: unique manuka factor, or UMF.

And he has found a way to measure its antibacterial efficacy, by comparing UMF manuka honey with a standard antiseptic (carbolic, or phenol) in its ability to fight bacteria. The results are astonishing.

He said: "We know it has a very broad spectrum of action.

"It works on bacteria, fungi, protozoa. We haven't found anything it doesn't work on among infectious organisms."

Resistant strains

In fact, he says UMF manuka honey can even tackle antibiotic resistant strains of bacteria - a growing problem for hospitals around the world.

"Staphylococcus aureas is the most common wound-infecting species of bacteria, and that's the most sensitive to honey that we've found.

"And that includes the antibiotic resistant strains - the MRSA - which is just as sensitive to honey as any other staphylococcus aureas."

Clinical trials at the Waikato Hospital have shown that even out of the lab, UMF manuka honey has amazing healing properties.

Nurse practitioner Julie Betts has successfully used honey to treat leg ulcers and pressure sores. And she says it helps healing after surgery - particularly for diabetic patients.

"It has an anti-inflammatory effect as well, so if I want to do several things apart from actually controlling the bacteria in that wound, then that's when I'll use honey."

Cancer treatment

Cancer specialist Dr Glenys Round has also found honey to be an effective treatment.

"We've been using honey to treat fungating wounds, where the cancer has broken through the skin," she said.

"The results in that situation have been excellent."

Most recently, she has had success in using honey dressings on patients with wounds or ulcers resulting from radiation therapy.

"Most of these patients in the past had tried various other conventional treatments without good success, and that is the reason why at least initially honey was tried."

Most patients seem happy to try the honey treatment.

"They don't have a problem with it at all," said Julie Betts.

"Humans in general have a fondness I think for natural remedies, so they're quite happy to use them."

"I think the problem we encounter is when people don't understand how it works.

"They think that sourcing any honey will achieve the same outcome, and that's not always true."

There’s a buzz about manuka honey

The healing powers of honey have been well known since Pythagoras’ time. We suck honey lozenges to soothe our throats, we stir in a spoonful to sweeten hot drinks when we’re sick. Now, some scientists believe that one particular kind, manuka honey, has antibacterial properties that can be used to treat everything from skin conditions to digestive disorders.
And the buzz about the honey’s healing properties is growing. Once regarded as about as effective as chicken soup, manuka honey is increasingly being used to treat everything from eczema to tummy upsets. Sonia Forde, a Pilates teacher with two children, Maia, 7, and Ruben, 4, became convinced of its healing properties when it cleared up Molluscum contagiosum spots on Ruben’s face. The jelly-like spots are harmless but unsightly and Forde had tried various remedies without success.

Her GP had told her that they would eventually disappear of their own accord, but then she heard about a friend who had successfully treated her son’s Molluscum contagiosum by applying manuka honey. Forde tracked down a high-strength honey in her local health-food shop and began dabbing it on Ruben’s spots every night. “Within a few days they were getting smaller,” she says. “Two weeks later, they had completely cleared up.”

Made by bees that collect pollen from the manuka bush, Leptospermum scoparium, which grows wild in New Zealand, manuka honey has a slightly medicinal flavour and when applied to skin has been found by some studies to effectively treat wounds and ulcers that have failed to respond to standard medicine.

So strong is its anti-bacterial component, that it has been given its own classification, the unique manuka factor (UMF). Strengths range from UMF5, which is believed to be equivalent to a 5 per cent solution of a standard antiseptic, to UMF20, which is equivalent to a 20 per cent solution of antiseptic. Different strengths are recommended for treating different conditions.

The honey not only fights infection and aids tissue healing but has been found in clinical trials to reduce inflammation and scarring. It has also been used successfully, when taken orally, on digestive problems, from diarrhoea and indigestion to stomach ulcers and gastroenteritis. Its healing properties appear to be due to the presence of the enzyme glucose oxidase, which produces hydrogen peroxide — an antiseptic — and its high sugar concentration, which inhibits bacterial growth. But researchers are unable to pinpoint any one particular constituent to explain why manuka honey has such strong antibacterial qualities.

A study published in the European Journal of Medical Research in 2003 discovered that manuka honey — when compared with conventional treatments for infected postoperative Caesarean sections and hysterectomy wounds — had an 85 per cent success rate compared with 50 per cent for routine treatments.

Before Forde applied the honey to her son’s spots, she had already been giving both her children a daily teaspoon of UMF10 honey to ward off common colds and to treat the occasional bout of constipation: “The beauty of it is that they both love the strong honey taste,” she says. “I used to spread it on toast or give them a teaspoon in the morning. It was easy, unlike taking the herbal remedy echinacea, which I have to bribe them both with sweets to get them to swallow.”

Last year, manuka-honey wound dressings and sterilised manuka-honey creams were licensed for use in NHS hospitals. And scientists at the University of Wales Institute, Cardiff (UWIC), are investigating whether it could help to combat MRSA, the antibiotic-resistant “superbug”. “In the past year, honey has become accepted into conventional medicine,” says Dr Rose Cooper, the head of the University of Wales Institute research team.

“When I embarked on this work eight years ago, it was dismissed as an ancient remedy and an alternative therapy. But there have been cases where MRSA has been eradicated from patients’ wounds which have been treated with the honey.”

Cooper believes that although honey cannot combat MRSA once it has reached the bloodstream, it can stop the initial wound infection spreading within the body, and can also halt the spread of the bug to other patients. And while she acknowledges that more clinical trials are needed, she is cautiously optimistic: “It could be very effective preventatively,” she says. “It could be used as a form of infection control.”

Meanwhile, in the Forde household, even Sonia’s honey-sceptic husband has become a convert: “Initially he thought it was dubious,” she says. “But when he saw Ruben’s spots disappear it made him think that it must have some sort of healing property. Now if he has a cold coming on, I see him having a teaspoon for himself.”

Pollen count

WHAT IS IT? Manuka honey is made by bees that collect pollen from the manuka bush, pictured right, a member of the myrtle family. It can be taken internally — doctors recommend one teaspoonful before food — or applied neat to the skin. Only sterilised honey, intended for medical use, should be used on wounds.

SUITABLE FOR: Manuka honeys below UMF (unique manuka factor) 10 are recommended for maintaining general health and good digestion. UMF10 to UMF15 are for indigestion, heartburn and diarrhoea. They can also be used externally on cuts, grazes, burns, fungal infections and wounds. UMF20 can treat gastroenteritis and stomach ulcers. There are also manuka honey creams for cold sores and acne.

Use of Manuka honey in leg ulceration

The historical and current literature reports the successful use of honey to manage a diversity of wound aetiologies. However, only in the last 40 years is research on its mode of action and contribution to wound healing being investigated. The challenge of managing chronic non healing wounds generated interest in researching non standard therapies. The aims of the study were to gain insight into the practical use of Manuka honey in wound management. The objective was to test the feasibility of further rigorous research into the use of honey in the management of chronic wounds. Instrumental case series were used to examine the use of Manuka honey in eight cases of leg ulceration. To collect the necessary data, photographs, acetate tracings, data monitoring and patient comments and observations were used to add greater reliability and validity to the findings. The wounds were dressed weekly with Manuka honey. The results obtained showed three males and five females with ulceration of different aetiologies were studied. A mean initial wound size for all wounds of 5·62 cm2 was obtained. At the end of four-week treatment period, the mean size was 2·25 cm2. Odour was eliminated and pain reduced. The conclusions drawn were that the use of Manuka honey was associated with a positive wound-healing outcome in these eight cases. Arterial wounds showed minimal improvement only.

Honey helps healing

Honey could be the new antibiotic, according to scientific research from the University of Wales Institute Cardiff (UWIC) presented Monday, 06 September 2004 at the Society for General Microbiology’s 155th Meeting at Trinity College Dublin.

By studying the way bacteria protect themselves from attack by forming slimy clumps, scientists have discovered that honey may be an effective new weapon in breaking up the microbes’ defences. The researchers from the School of Applied Sciences at UWIC looked at the dangerous infections that commonly get into wounds, such as Pseudomonas bacteria.

“If the bacteria can multiply enough to form a slimy mass called a biofilm - the sort of slime you get round a sink plughole for instance - they are much less sensitive to antibiotics and antiseptics,” says Ana Henriques of UWIC. “Doctors looking after badly injured and infected patients urgently need to remove these biofilms so that they can treat their wounds safely, and prevent the spread of antibiotic-resistant bacteria.”

The scientists studied six different strains of the bacteria, five of which came from injuries, and grew them in the laboratory to form biofilms, which are notoriously difficult to treat when they appear as hospital infections. Biofilms prevent healing in wounds and may lead to chronic ulcers.

The laboratory grown samples were treated with Manuka honey, then unattached bacteria were washed off and the remaining slime layer studied after different time periods. In every sample the biofilm was disrupted making it more susceptible to the treatment with conventional antibiotics.

“This suggests that simple honey could be a realistic alternative to treatment with antibiotics and antiseptics,” says Ana Henriques. “With the rise in hospital infections from resistant bacteria, we need more effective treatments quickly. Dressings impregnated with Manuka honey became available for prescription earlier this year, and for the first time we have shown that honey is effective against these tough biofilms as well as slowing isolated bacteria.”

The research could have a major impact in developing countries where honey is cheap and readily available, but modern pharmaceuticals are more difficult to obtain. Honey is easy to use and has no known harmful side effects on human health.

Rural District Nurses still remember using honey to treat difficult sores, anecdotal evidence exists of the use of honey in local hospitals in Cardiff in the 1970’s, and folk remedies recommended that warriors should pack battle wounds with honey and lay fresh spiders webs across the top to keep out dirt and help healing. This latest research suggests that honey may not have been such an old wives’ tale.

Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds.

The antibacterial action of honey in infected wounds does not depend wholly on its high osmolarity. We tested the sensitivity of 58 strains of coagulase-positive Staphylococcus aureus, isolated from infected wounds, to a pasture honey and a manuka honey. There was little variation between the isolates in their sensitivity to honey: minimum inhibitory concentrations were all between 2 and 3% (v/v) for the manuka honey and between 3 and 4% for the pasture honey. Thus, these honeys would prevent growth of S. aureus if diluted by body fluids a further seven-fold to fourteen-fold beyond the point where their osmolarity ceased to be completely inhibitory. The antibacterial action of the pasture honey relied on release of hydrogen peroxide, which in vivo might be reduced by catalase activity in tissues or blood. The action of manuka honey stems partly from a phytochemical component, so this type of honey might be more effective in vivo. Comparative clinical trials with standardized honeys are needed.

After decades of turning up their noses at this ancient wound dressing, modern doctors are turning sweet on honey.

Peter Molan, Ph.D., likes to tell the story of the 20-year-old wound. Infected with antibiotic-resistant bacteria, an abscess oozed in an English woman's armpit long after it had been drained. Nothing seemed to help, and the pain prevented her from working.

Then in August of 1999, she read about the remarkable wound-healing properties of honey. She convinced doctors to apply some to the dressing to her arm, and a month later the wound healed. Now she's back at work.

Novel as this treatment sounds, it would have inspired yawns among doctors in ancient Egypt, according to May Berenbaum, Ph.D., a University of Illinois entomologist. "Honey has been used for centuries to treat a wide range of medical problems like wounds, burns, cataracts, skin ulcers and scrapes," she says. "And now various researchers worldwide are also studying -- and finding -- strong antimicrobial properties in some honeys."

Honey fell from favor as a wound dressing when antibiotic dressings were developed during World War II. But the new research -- and the rise of antibiotic-resistant bacteria -- are putting this old-time folk remedy into the contemporary medicine chest.

Last year, the Australian Therapeutic Goods Administration -- the equivalent of the U.S. Food and Drug Administration -- approved honey as a medicine. A company in Australia this year began marketing medical honey as a wound dressing in pharmacies there. It's available in the United States through the Internet.

Honey helps wounds in several ways, says Molan. Its thickness provides a protective barrier. The hydrogen peroxide it contains is released slowly, killing germs in the wound. Some as-yet-unknown ingredients reduce inflammation, while others, perhaps amino acids and vitamin C, speed the growth of healthy tissue. Honey even makes wounds smell better, possibly because when bacteria in wounds eat honey's sugars, they give off sweeter-smelling gases.

Dozens of studies, in animals and humans, have documented such benefits. One of the most convincing reports, published in the 1998 issue of the journal Burns, tells how researchers from the Dr. V. M. Medical College in Maharashtra, India, compared honey with silver sulfadiazine, the standard treatment for superficial burns.

The researchers first smeared honey on gauze and used it to dress the burns of 52 patients. Another 52 patients got the same treatment but with silver sulfadiazine in place of the honey.

In the 52 patients treated with honey, 87% healed within 15 days, compared with 10% of those treated with silver sulfadiazine. The honey-treated patients also experienced less pain, leaking of wound fluid, and scarring.

Molan, a biochemist at the University of Waikato in New Zealand, and other researchers have found special bacteria-killing properties in honey made from the nectar of the tea tree (Leptospermum). In laboratory experiments, reported in the November 1992 Journal of Applied Bacteriology, Molan and his colleagues found that it was particularly effective in slaying staphylococcus aureus.

This so-called "Golden Staph" -- which infested the English woman's 20-year-old wound -- sometimes survives the most potent antibiotics, killing its victims. "Manuka honey has worked in very desperate cases where nothing else has worked," says Molan.

Based on the research of Molan and others, an Australian company is now marketing Manuka honey under the name Medihoney. To make it, beekeepers set their hives close to tea trees so the bees will gather their nectar.

Studies so far have found no side effects other than an occasional slight burning sensation when the honey is applied. Though honey sometimes contains the spores of bacteria that cause botulism, Molan says there have been no reported cases of this bacteria or anything else in honey infecting a wound.

Experts do caution that infants should not eat honey because of the botulism risk. "But it's still OK to use honey on children's (and infants') burns or scrapes," says Molan.

Molan also believes it is safe to use ordinary supermarket honey on such minor wounds. And it's a lot cheaper than antibiotic ointments. But since ingredients vary depending on the nectar from which the honey is made, Medihoney offers the advantage of laboratory testing.

It's one medicine that doesn't need a spoonful of sugar to help it go down.

Charles Downey is a journalist, magazine writer, and content provider who frequently writes about medicine and early childhood development for the New York Times Syndicate. He has also written for Reader's Digest, Playboy, McCall's, Woman's Day, Boys' Life, and many other publications on four continents.

Easy Honey Uses

Antibacterial: Apply honey to cuts, scrapes, or burns and cover with a clean bandage. Change dressings one to three times daily, as needed. Note: excessive hear or prolonged exposure to light can rob honey of its antibacterial properties. Always store in a dark, cool place.

Disinfectant: Take several tablespoons of honey daily for internal disinfection.

Nursing salve: Nursing mothers, try covering cracked, sore nipples with honey-soaked gauze to prevent infection.

Sore throats: Many opera singers and honey to a glass of warm milk and sip slowly. This helps soothe the throat.

Insomnia: Mix a half glass of warm water with 2 tablespoons of honey and the juice of a lemon and an orange. The darker the honey, the better this works.

Honey pick-me-up: Combine 2 tablespoons honey, 2 teaspoons pollen, a teaspoon of ginseng, and dried orange peel. Take with a spoon. Asian healers believe that this creates a feeling of total rejuvenation.

Diarrhea: In 8 ounces of water, mix 4 large tablespoons of honey. This works well for bacterial diarrhea. Those with diabetes should be cautious about taking so much honey at one time.

Dieting: Honey's double action (providing instant energy boost, while maintaining sugar levels for a long time), satisfies the hunger for sweets and may keep you feeling fuller longer. For some dieters, this may be good news.