Conference Coverage

Case report: Longstanding actinic keratosis responds to kanuka honey



– Not all honeys are created equal, Theodore Rosen, MD, said at the meeting provided by Global Academy for Medical Education.

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Kanuka (Kunzea ericoides) is shown in bloom.

“It seems that kanuka is the new manuka,” said Dr. Rosen, professor of dermatology at Baylor College of Medicine, Houston. These lesser-known New Zealand bush honeys may be something to watch because research and case reports continue to provide intriguing hints of how these honeys exert their immunomodulatory effects on skin, he commented, describing a recent case report describing the elimination of a large, long-standing actinic keratosis (AK) with application of kanuka honey.

Manuka (Leptospermum scoparium) is a large bush native to both Australia and New Zealand. Kanuka (Kunzea ericoides) is quite similar in size and appearance, but native only to New Zealand. Honey made from the flowers of these bushes possesses some unique properties that make it an attractive addition to wound healing regimens, according to a 2014 study (Int J Gen Med. 2014;7:149-58).

The study examined samples of manuka, kanuka, a manuka/kanuka blend, and clover honey. The investigators found that kanuka honey, and to a lesser extent manuka honey, exerted a potent anti-inflammatory effect in human embryonic kidney cells. The honeys interfered with toll-like receptor 1 and 2 signaling, which would reduce the production of proinflammatory cytokines.

Kanuka’s potency seems directly related to its unusually high level of arabinogalactan, according to Saras Mane, MD, primary author of the AK case report (Case Rep Dermatol Med. 2018 May 31;2018:4628971). Dr. Mane is with the Medical Research Institute of New Zealand in Wellington.

Saras Mane, MD

The actinic keratosis on the patient's hand at basline (left), before topical application of the kanuka honey ointment. The actinic keratosis on the patient's hand (right) after three months of applying a kanuka honey ointment.

“The immunomodulatory properties of kanuka honey in particular are thought to be more potent than other New Zealand honeys due to the relatively high concentrations of arabinogalactan proteins present,” Dr. Mane and his coauthors wrote in the case report. “These proteins have been shown to stimulate release of TNF-alpha from monocytic cell lines in vitro.”

The report involved a 66-year-old man who was enrolled in a randomized trial of a commercialized medical-grade kanuka honey ointment (Honevo, 90% kanuka honey, 10% glycerin; Honeylab NZ) for rosacea.


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