ISSN: 2469-5750 Marra et al. J Dermatol Res Ther 2020, 6:085 DOI: 10.23937/2469-5750/1510085 Volume 6 | Issue 1 Journal of Open Access Dermatology Research and Therapy RevIew ARtIcle Manuka Honey and Pediatric Patients: A Review 1* 2 2 Paola Martina Marra, DDS, MS , Rossella Santoro, MS , Giuseppe Diana, MS , Angelo Check for Itro, MD, MS1 and Annalisa Itro, PhD1 updates 1Complex Operative Unit of Stomatological Surgery in Developmental Age, University of Campania Luigi Vanvitelli, Italy 2Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Italy *Corresponding author: Paola Martina Marra, DDS, MS, Complex Operative Unit of Stomatological Surgery in Developmental Age, University of Campania Luigi Vanvitelli, Naples, Italy, Tel: +39-3338626207 the nectar, as well as the quantity of vitamins, mainly Abstract represented by vitamins group B, vitamin C, vitamin K, Manuka is a monofloral honey with New Zealand and Aus- carotene and pantothenic acid. tralian origins. It takes its name from the L. scoparium or tea-tree (manuka or tea tree) plant, whose flowers rich in There is sufficient evidence that recommends the pollen and nectar feed the bees during the production of use of honey in the management of wounds and burns, honey. To be labeled as "New Zeland manuka honey", bees must use at least 70% of the pollen and nectar from manu- thanks to the antibacterial, antiviral, anti-inflammatory ka. This honey has nutritional properties similar to those of and antioxidant properties of its components [1-7]. other types of honey even if, containing some active ingre- dients, it seems to inherit many phytotherapeutic and me- In particular, a large number of studies on the ther- dicinal characteristics. Not surprisingly, the manuka plant apeutic use of honey have focused on Manuka honey and honey are used in traditional Maori medicine and in produced by the species Leptospermum scoparium, a contemporary pharmacology. flowering plant native to New Zealand and Australia Keywords [7-15]. Dihydroxyacetone, methylglyoxal, antioxidants and flavonoids are unique and natural components of Children, Manuka honey, Oral cavity Manuka honey and have manifested a wide range of bi- ological effects, including antibacterial, antithrombotic, Introduction anti-inflammatory, ant allergic and vasodilator effects Honey is a remedy with a several virtues: Emollient, [16]. laxative, detoxifying, nourishing and moisturizing. It is Several clinical studies indicate honey as an excellent particularly used for lungs and intestines. In fact, it is detergent-disinfectant for infected wounds [4,7,9,11]. used as a laxative in case of constipation, as an emol- Manuka honey has been recently approved by the FDA lient in chronic bronchitis, it relieves inflammation of (Food and Drug Administration) for the treatment of the mouth and throat, while it is not recommended in burns and ulcers. The physical and bioactive proper- case of chronic diarrhea and in newborns as they are ties of honey, in fact, positively affect the wound heal- very sensitive to its laxative action. ing process as it determines an increase in the release The secret of honey is in the mix of sugars, vitamins, of oxygen from the hemoglobin, creating an unfavor- essential amino acids, enzymes, mineral salts, growth able environment for the activity of proteases [6-9]. stimulating factors and essential oils that act as antibi- In addition, honey stimulates the release of peripheral otics and have interesting therapeutic effects. In par- monocytes of cytokines and chemokines, such as TNF ticular, the sugar component of honey consists of fruc- α, IL 6, IL 1β and TGF β, accelerating the healing process tose (70%) and glucose (30%), the percentages of which [17,18]. vary from honey to honey depending on the origin of From an oral point of view, several studies have as- Citation: Marra PM, Santoro R, Diana G, Itro A, Itro A (2020) Manuka Honey and Pediatric Patients: A Review. J Dermatol Res Ther 6:085. doi.org/10.23937/2469-5750/1510085 Accepted: June 09, 2020: Published: June 11, 2020 Copyright: © 2020 Marra PM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Marra et al. J Dermatol Res Ther 2020, 6:085 • Page 1 of 3 • DOI: 10.23937/2469-5750/1510085 ISSN: 2469-5750 certained that honey is not a cariogenic agent [19-33], may seem that there is no need to use honey in children but rather has a bactericidal action as it contains inhibin, due to the low complication rate resulting from the ex- a substance that performs an inhibitory action against traction of the teeth and the rapid healing process in Streptococcus mutans, reducing the production of acids these subjects, it is nevertheless possible to use honey and the phenomena of demineralization of enamel and to improve the process of wound healing from more ex- dentine. Therefore, pure honey, rich in inhibin, does not tensive surgeries such as those to remove mastodons present a danger to the teeth, indeed if used in place of and odontomas, the extraction of multiple teeth under sugar, it protects them. general anesthesia, and also frenectomy procedures. In these cases, honey can play an important role in reduc- Abdelmegid, et al. [25] in fact, showed that irrigation ing pain, swelling and postoperative complications, and of the oral cavity with a solution of honey and green tea, speeding up healing [35,36]. for 2 minutes can reduce the S. mutans count in chil- dren aged 7 to 10 years. In addition, English, et al. [30] In addition, a large number of children suffer from and Atwa, et al. [32] reported that this natural product systemic conditions, such as leukemia whose therapeu- prevents the aggregation of dental plaque, gingivitis tic procedure can lead to cyclic neutropenia and oral and other gum disease. According to many researchers, ulcers. Given the compromised immune system, these therefore, honey would have an effective soothing ef- patients show very slow healing and have a higher risk fect on gingivitis and periodontal diseases [33-34]. of infection. Therefore, the use of an effective, inexpen- sive and available drug that can speed up the wound Soni, et al. [13] assessed the effect of honey on the healing process in these children may be particularly resolution of alveolar osteitis by reporting that C-reac- recommended. tive protein levels decreased significantly after honey treatment, resulting in rapid wound healing. In addition, Ultimately, therefore, the use of honey is a simple severity of pain, erythema and swelling also decreased and inexpensive technique, which has no side effects significantly. Honey-based medicines can therefore be and is easily tolerated by the child for its pleasant taste used to treat alveolar osteitis, a frequent post-operative and aroma, also improving the approach to the inter- complication of permanent tooth extractions (mandibu- vention from a psychological point of view. Therefore, lar molars and wisdom teeth). its use is recommended after minor and even major sur- geries in the oral cavity. El-Haddad, et al. [17] conducted a pilot study to eval- uate the clinical efficacy of the local application of hon- Conflicts of Interest ey for the treatment of some common inflammatory, The authors declare no conflicts of interest. vesiculobullous and ulcerative lesions of the oral cavity. Their injuries included recurrent aphthous stomatitis, References recurrent intraoral herpetic ulcers, atrophic/erosive 1. Ashraf S (2015) Use of aloevera and honey on post ex- oral lichen planus, oral candidiasis and oral psoriasis. traction healing. Int J Dent Health Sci 2: 636-639. The results showed that in all subjects, pain, itching, and 2. Carter DA, Blair SE, Cokcetin NN, Bouzo D, Brooks P, et al. injury sizes decreased and patients in general reported (2016) Therapeutic Manuka honey: No longer so alternati- improvements in injuries based on the parameters de- ve. Front Microbiol 7: 569. scribed in the study. Topical application of honey could 3. Lee DS, Sinno S, Khachemoune A (2011) Honey and in fact prevent or in any case reduce secondary infec- wound healing: An overview. Am J Clin Dermatol 12: 181- tion, which is very common in many vesicular and ulcer- 190. ative lesions, such as RAS, herpes and lichen planus. This 4. Cook NC, Samman S (1996) Flavonoids-chemistry, meta- ability of honey has been attributed to its ability to de- bolism, cardioprotective effects, and dietary sources. J Nutr crease the synthesis of prostaglandins in the area where Biochem 7: 66-76. it is applied, to increase the formation of nitric oxide in 5. Al-Mamary M, Al-Meeri A, Al-Habori M (2002) Antioxidant the wound area, and to reduce the proliferation of bac- activities and total phenolics of different types of honey. teria and fungi, and also to its properties antioxidants. Nutr Res 22: 1041-1047. 6. Cooper R (2007) Honey in wound care: Antibacterial pro- Hwang, et al. [20] assessed the effect of honey on perties. GMS Krankenhhyg Interdiszip 2: 51. postoperative pain after tonsillectomy in a systematic review reporting that the pain was less; therefore, there 7. Molan P Rhodes T (2015) Honey: A biologic wound dres- sing. Wounds 27: 141-151. was less need for analgesics than in the control group. 8. Khosravi Samani M, Poorsattar Bejeh Mir A, Mohamma- Other studies, [35,36] conducted on patients from dnejad G, Sajadi B, Fereshtehnejad Seyed M (2011) The 4 to 9 years of age undergoing extraction of decidu- potential of honey to promote wound healing in periodon- ous molars, have shown how the application of Ma- tology: A pilot randomized clinicaltrial. Med J Islam Repub Iran 25: 177-185.