Mānuka Honey and Mouth Ulcers: The Trial Evidence

A randomized clinical trial in 2014 compared topical honey directly with a standard topical corticosteroid for recurrent aphthous ulcers (canker sores). The result, in a small sample, was favorable for honey.

What the trial found

El-Haddad, Asiri, Al-Qahtani and Al-Ghmlas (2014, Quintessence International) conducted a double-blind randomized controlled trial comparing topical honey with topical triamcinolone acetonide on minor recurrent aphthous ulcers. Outcome measures included pain reduction, ulcer size, and erythema score over 7 days.

The honey group showed faster pain reduction and ulcer resolution than the corticosteroid group at multiple time points. The authors concluded that honey "may be regarded as an effective alternative for treating recurrent aphthous ulcers."

What the trial does and does not establish

The trial used pure unifloral honey (not specifically Mānuka), and applied it three times daily to the ulcer area. The mechanism is theorized to be honey's antibacterial activity combined with osmotic effect on the ulcer surface.

The sample size was modest. The result has not been independently replicated in a large multi-center trial. Generalizing to all canker-sore presentations or to severe / Behçet's-related ulcers is not supported.

What this means for buyers

• For occasional minor canker sores, the evidence is suggestive that topical honey application may speed resolution.
• Mānuka honey's higher MGO content provides more of the studied antibacterial compound. UMF 10+ or above is a reasonable starting point. See UMF explained.
• For frequently recurring or severe ulcers, see a dentist or oral medicine specialist; established treatments exist.

If you are buying Mānuka, our roundup covers current options.

Sources

• El-Haddad SA, Asiri FY, Al-Qahtani HH, Al-Ghmlas AS. Efficacy of honey in comparison to topical corticosteroid for treatment of recurrent minor aphthous ulceration: a randomized, blind, controlled, parallel, double-center clinical trial. Quintessence International. 2014;45(8):691-701.
• Mavric E, Wittmann S, Barth G, Henle T. Identification and quantification of methylglyoxal as the dominant antibacterial constituent of Leptospermum scoparium (Mānuka) honeys from New Zealand. Molecular Nutrition & Food Research. 2008;52(4):483-9.