Apitherapy

Honey in early medical writing

A 2013 pharmacology review by Eteraf-Oskouei and Najafi states that human use of honey has been traced to about 8,000 years ago through Stone Age paintings, and that honey was among the most frequently listed substances in Egyptian remedies, cited as appearing about 500 times in 900 remedies. The same review describes Hippocratic preparations such as oxymel (vinegar and honey) and hydromel (water and honey). These statements come from a biomedical review rather than a primary historical study, so the dates and counts are the authors' summary of older scholarship.

The review also records honey in Ayurvedic texts for digestion, cough and skin complaints, in the Qur'an and early Islamic medicine, and in the writing of Avicenna, roughly 1,000 years ago, who listed it among remedies for tuberculosis. These are historical indications. They show how honey was valued within those medical systems and do not show that it was effective for the conditions named.

Apitherapy as a modern label

A 2010 German medical-history article by Teichfischer examined the concept and history of apitherapy and described it as having been in a process of institutionalization for about four decades, which places its organization as a named movement from around the 1970s. The article's English abstract characterizes bee venom therapy as the real root of this stream within natural medicine. Only the abstract was read for this page, so its detailed account of eighteenth- and nineteenth-century sources is not summarized here.

Honey also returned to hospital wound care in the late twentieth and early twenty-first centuries. A 2008 guide for healthcare professionals by Evans and Flavin described a sizeable renaissance in honey as a topical wound treatment and a growing range of honey-based wound products. Allergists writing in 2018 noted that live bee acupuncture is often performed in private health centers or by nonmedical practitioners, which places it in a different setting from clinical wound care.

Apitherapy and hive products

Allergists Vazquez-Revuelta and Madrigal-Burgaleta define apitherapy as the use of substances from honeybees, such as honey, propolis, royal jelly or venom, to relieve various medical conditions. A 2025 allergy review by Matuszewska-Mach and colleagues calls apitherapy a branch of alternative medicine and lists the honeybee products in use as honey, bee pollen, bee bread, royal jelly, propolis, beeswax and bee brood.

Propolis, sometimes called bee glue, is the resinous material bees collect from living plants to build and adapt their nests, according to a 2013 review by de Groot. The umbrella term covers very different substances, so findings for one product cannot be carried over to another.

Bee venom therapy terms

Bee venom therapy is the subset of apitherapy that uses venom. A 2015 systematic review by Park and colleagues distinguishes bee sting acupuncture, in which a live bee stings the skin at chosen points, from bee venom acupuncture, in which venom is injected at acupuncture points, and also covers sweet bee venom and apitoxin injections. Live bee acupuncture is the form the 2018 fatal case report describes.

Venom immunotherapy is a separate desensitization treatment for people with venom allergy. Park and colleagues included it in their harms review, but it has a different purpose and setting from bee venom acupuncture, and the two should not be treated as one practice.

Medical-grade honey

Evans and Flavin state that honey used for wound management has to be medical grade, meaning it has been sterilized by gamma irradiation and has a standardized antibacterial activity, and that only such honeys can be registered as medical devices. They advise caution with unregulated, unlicensed honey products for wounds. This guide was written for practitioners in the United Kingdom, and product registration requirements differ by country.

Products taken by mouth or applied to skin

Much apitherapy takes the form of self-selected products. De Groot notes that propolis is sold as a dietary supplement, in products marketed for health protection, in biopharmaceuticals and in cosmetics. A 2025 pharmacovigilance overview by Rocha Filho and colleagues describes honey, bee venom, propolis, royal jelly, bee pollen and beeswax as used across food, cosmetic and pharmaceutical industries, which means quality and labeling vary widely between products.

Honey dressings in clinical wound care

In clinical wound care, honey is applied as a dressing to burns, ulcers or surgical wounds by nurses and other clinicians. The trials pooled in the 2015 Cochrane review compared honey with conventional dressings, silver sulfadiazine cream, antiseptic washes, saline soaks and other treatments. Evans and Flavin advise clinicians to check manufacturers' information on evidence, indications, contraindications and safety before choosing a honey-based product. This setting is distinct from home or alternative use of table honey.

Bee venom therapy sessions

In live bee acupuncture, the practitioner holds a stinging bee directly against sites chosen for the condition. The woman described in the 2018 Spanish case report had attended sessions every four weeks for two years before her fatal reaction. In bee venom acupuncture, used mainly in Korean medicine, venom is injected at acupoints. A 2020 review by Jang and Kim found that 8 of 12 randomized trials were conducted in South Korea and that other trials delivered venom by ultrasound gel or ointment.

Uses described by practitioners and users

Bee venom is used for its proposed anti-inflammatory and analgesic effects, according to Jang and Kim, and the trials they found addressed Parkinson's disease, frozen shoulder, knee osteoarthritis, low back pain, jaw disorders, muscle soreness, pelvic inflammatory disease and polycystic ovary syndrome. The patient in the fatal case report had sought apitherapy for muscular contractures and stress. These are reasons for use and trial topics, not established effects.

Honey is a long-standing household remedy for cough, a use examined in a Cochrane review of children's acute cough. Propolis is described in laboratory work as having antibacterial, antifungal and antiviral properties and is promoted for health protection and disease prevention, according to de Groot. Laboratory activity does not show a clinical benefit in people.

Clinical wound care as a separate use

The use of sterilized, standardized honey dressings by wound care clinicians is a distinct clinical application, supported by its own trials. Evidence from those trials concerns specific wound types and regulated products. It should not be read as support for eating honey, for propolis or royal jelly supplements, or for bee venom therapy, which are separate claims with separate and much thinner evidence.

Honey dressings for wounds

The 2015 Cochrane review by Jull and colleagues included 26 trials with 3,011 participants. High-quality evidence from 2 trials (992 people) found that honey dressings healed partial thickness burns about 4.7 days sooner than conventional dressings. Against silver sulfadiazine, high-quality evidence from 6 trials found no difference in healing within six weeks, with fewer adverse events in the honey groups. Honey also healed infected post-operative wounds faster than antiseptic washes and gauze in one trial of 50 people.

For venous leg ulcers, minor acute wounds, diabetic foot ulcers, cutaneous leishmaniasis and mixed chronic wounds, the effects of honey were unclear, with low or very low quality evidence. The reviewers concluded that, beyond partial thickness burns and infected post-operative wounds, the evidence does not form a robust basis for decision making.

Oral honey for acute cough in children

The 2018 Cochrane review by Oduwole and colleagues included 6 randomized trials with 899 children aged 12 months to 18 years. Moderate-certainty evidence suggested honey probably reduces cough frequency more than no treatment or placebo, and low-certainty evidence suggested it may have a similar effect to dextromethorphan. Most children received honey for one night only, and the authors found no strong evidence for or against its use. Gastrointestinal complaints were more common with honey than with placebo.

Bee venom therapy trials

Jang and Kim's 2020 review of randomized trials excluded live bee stings and found 12 trials with 20 to 367 participants. Two Parkinson's disease trials with twice-weekly injections reported better motor scores, while a trial with monthly dosing found no benefit. Trials in frozen shoulder, knee osteoarthritis and low back pain reported some pain or function gains, but low back pain trials showed no quality-of-life improvement. Most trials came from one country and were small, and the authors called for larger trials.

In their meta-analysis of randomized trials, Park and colleagues found that bee venom acupuncture carried a relative risk of adverse events of 3.61 compared with saline injection, an estimate they said could be over- or underestimated because of poor reporting. More than half of the recommended items for reporting harms were missing from the trials they assessed.

Propolis, royal jelly and bee pollen

The sources reviewed for this page do not establish clinical benefits for propolis, royal jelly or bee pollen in people. De Groot summarizes biological activity mainly from laboratory work, and the allergy and pharmacovigilance reviews address harms rather than effectiveness. PubMed searches for apitherapy in titles, and for systematic reviews of these products, did not yield a clinical efficacy review that was opened and verified for this page, so no conclusions about their effectiveness are drawn here.

Bee venom therapy and anaphylaxis

Vazquez-Revuelta and Madrigal-Burgaleta reported a 55-year-old woman in Spain, with no prior reactions, asthma or atopy, who had tolerated monthly live bee acupuncture for two years. During a session she developed wheezing, breathlessness and loss of consciousness immediately after a sting. No adrenaline was available at the clinic and the ambulance took 30 minutes. Prolonged low blood pressure caused a massive stroke and coma, and she died weeks later of multiorgan failure. Tests confirmed sensitization to honeybee venom.

The authors wrote that previous tolerance does not prevent a reaction and that repeated exposure favors sensitization. They concluded that the practice is unsafe and unadvisable. Park and colleagues' review of 145 studies found adverse events in a median of 28.87% of patients in venom immunotherapy audits, reported systemic reactions including anaphylaxis, and recorded one death after treatment by an unqualified bee sting acupuncture practitioner.

Allergy to other hive products

De Groot's review covers contact allergy and allergic contact dermatitis from propolis in supplements and cosmetics. Matuszewska-Mach and colleagues cite a Polish study in which 17 of 558 beekeepers (3.05%) had propolis allergy, report anaphylaxis after royal jelly and bee pollen, and describe a child with atopy who died after taking royal jelly. They note specific antibodies to royal jelly in up to 17% of adults with asthma and describe honey allergy as rare but able to cause anaphylaxis.

Rocha Filho and colleagues' pharmacovigilance overview lists severe asthma attacks after royal jelly, contact dermatitis and systemic reactions from propolis, allergic reactions to beeswax in cosmetics, grayanotoxin poisoning from some honeys, and pollen supplements adulterated with undeclared drugs. They found allergic responses to be the most common adverse event, especially in people with atopy.

Honey and infants

The United States Centers for Disease Control and Prevention advises not feeding honey to a child younger than 1 year because honey can contain bacteria that cause botulism. Eteraf-Oskouei and Najafi identify infant botulism from Clostridium spores as the main concern with honey and note that gamma irradiation of medical honey can remove this hazard. Rocha Filho and colleagues also list infant botulism among adverse events linked to honey.

Suitability and care boundaries

The reviews identify people with asthma, eczema, hay fever or other atopic conditions, and beekeepers, as at higher risk of serious allergic reactions to hive products. Vazquez-Revuelta and Madrigal-Burgaleta call for screening for sensitization, full information about risks, practitioner training in managing severe reactions, and rapid access to adrenaline and intensive care wherever stings are given. No statutory regulation or training standard for apitherapy practitioners was verified for this page. Bee products should not delay or replace assessment and treatment of wounds, infections or chronic illness.