November 2004

Dear Readers: Here's the Article for this Month:

Name of article:

TOPICAL HONEY APPLICATION VS. ACYCLOVIR FOR THE TREATMENT OF RECURRENT HERPES SIMPLEX LESIONS

Author(s): Noori S. Al-Waili

Abstract: Med Sci Monit 2004; 10/8: MT94-98

In a previous article of the month (June 2003) a study by Biswal et al. on the clinical efficacy of topical application of honey in healing post-radiotherapy mucositis in cancer patients was reported.

Here is another study of the use of honey in clinical practice.

Al-Waili carried out a prospective randomized clinical trial comparing topical applications of honey vs acyclovir cream in patients with recurrent episodes of labial and genital herpex simplex infections (lesions).

Sixteen otherwise healthy patients were studied. They had:

1. labial (N° 8) and genital (N° 8) herpetic lesions,

2. a history of recurrent attacks (a mean of 6 episodes for genital herpes and 5 for labial herpes in the previous year; duration of episodes from 7 to 12 days without antiviral treatments)

3. not been previously treated with systemic acyclovir

4. a positive blood samples to HSV antibodies

5. treatments during the course of two consecutive attacks with topical applications of honey for one attack (4 times a day for 15 minutes) and 5% acyclovir cream (six times a day), for the other attack.

For comparison purposes between treatments, the following parameters were considered:

• healing time of the skin

• time to complete pain relief

• pain intensity (from none to severe)

• duration of episodes

• n° of patients who did not develop skin lesions (aborted cases)

• occurrence of crust

For labial herpes, mean duration of attacks, occurrence of crust, healing time and pain duration (all considered in n° of days) were significantly lower when treated with honey with respect to acyclovir treatment (p< 0.05). Similarly for genital herpes, all parameters considered were significantly in favour of honey treatment except for the occurrence of crust that was 28% better with honey treatment but not significantly different with acyclovir treatment.

All patients treated with acyclovir, labial or genital herpes lesions, developed crust whereas only half of the patients developed crust when honey was used.

In 5 patients on honey treatment, the typical burning sensation and irritating pain, characteristic of herpetic lesions, disappeared after 24 hours whereas this did not occur in any of the patients treated with acyclovir. In these latter patients, pain during the first 24 hours and for some in the first 48 hours was mild to moderate.

In 3 patients treated with honey and in none treated with acyclovir the attacks aborted.

As far as side-effects are concerned, none were encountered in patients treated with honey whereas 3 patients suffered from intense itchiness with acyclovir

Why I chose this article

This non-blind study carried out on a small number of patients confirms the necessity to further investigate the clinical effects and antimicrobial properties of honey and its healing properties on mucous lesions and symptoms associated with them.

Regards,

Carla Ripamonti, MD
Member of the Board of Directors, IAHPC