Exploring the Therapeutic Potential of Topical Honey in Atopic Dermatitis.

Dear Editor:Honey is one of the oldest natural medicines and has been shown to have antimicrobial, anti-infl ammatory, and antioxidant properties.Though topical honey is most well known in the context of treating wounds, several studies have investigated the use of topical honey in the management of atopic dermatitis (AD).Preliminary evidence suggests that topical honey is a promising treatment option, though the mechanisms by which honey produces therapeutic benefi ts in AD are not yet well understood.Several therapeutic mechanisms have been proposed, including modulation of the skin microbiome, activation of aryl hydrocarbon receptor (AHR) signaling, and modulation of local prostaglandin and nitric oxide (NO) synthesis and activity.On January 19, 2025, an online search was conducted using the databases PubMed, Embase, and Web of Science to identify all published clinical trials investigating the use of honey in the treatment of AD in human participants.This search yielded 5 studies that met our inclusion/exclusion criteria.A detailed summary of all study characteristics and outcomes can be found in Table 1.Four studies reported that treatment with topical honey resulted in statistically signifi cant improvements in AD symptoms using measures of severity including Three-Item Severity scores, SCORing Atopic Dermatitis, and Visual Analog Scale (VAS).[1][2][3][4] One study also measured outcomes in eczematous external otitis using VAS and found that VAS scores for discomfort and itching signifi cantly decreased after 2 weeks of treatment with honey eardrops.3 Only 1 of the 5 studies reported that treatment with honey was not signifi cantly more effi cacious than control (aqueous cream).5 Two studies collected bacterial swabs of lesions before and after honey treatment.2,3 While both studies found that treatment with manuka honey did not signifi cantly change skin culture results of Staphylococcus aureus, 1 study did fi nd