Superiority of propolis and honey over topical acyclovir for herpes simplex: A meta-analysis.

2026-01-06
International journal of STD & AIDS 37(5)
- Nurdjannah Jane Niode
- Paulus Mario Christopher
- Trina Ekawati Tallei

PubMed: 41496519
DOI: 10.1177/09564624251413431

Study Design

Type: Meta-Analysis
Methods: Systematic search of PubMed, Scopus, Europe PMC, and the Cochrane Library to identify studies comparing topical propolis and/or honey with 5% acyclovir for herpes simplex lesions. Clinical outcomes were synthesized using random-effects models.

BackgroundTopical antiviral agents, particularly acyclovir, are standard over-the-counter treatments for minor herpes simplex infections. However, natural products such as propolis and honey have drawn attention for their potential antiviral and wound healing-promoting properties. This meta-analysis aimed to systematically evaluate and compare the efficacy and safety profiles of propolis and/or honey with 5% topical acyclovir in the management of labial and genital herpes.MethodsA systematic search of PubMed, Scopus, Europe PMC, and the Cochrane Library was performed to identify studies comparing topical propolis and/or honey with 5% acyclovir for herpes simplex lesions. Clinical outcomes were synthesized using random-effects models, with outcomes reported as mean difference (MD) and odds ratio (OR).ResultsSeven studies were included in the analysis. Treatment with propolis and/or honey was associated with quicker lesion resolution (MD: -1.87 days; 95% CI: -2.73 to -1.01; p < 0.0001) and higher healing rates by day 7 (OR: 4.71; 95% CI: 2.70-8.25; p < 0.00001). No significant difference was observed in the number of aborted attacks (p = 0.66). Propolis and/or honey also reported reduced pain duration (MD: -0.96 days; p = 0.03) and pain intensity (MD: -6.53; p = 0.0002), with more patients reporting being symptom-free by day 3. No significant difference was observed in adverse events (AEs) rates between the natural therapy and acyclovir groups.ConclusionsPropolis and/or honey demonstrated superior lesion healing and pain relief compared to 5% acyclovir, with comparable safety, supporting their potential as safe and effective alternatives to conventional antiviral therapy.

Research Insights

Honey→Improved Symptom-Free Status
more patients reporting being symptom-free by day 3
Effect
Beneficial
Effect size
Moderate
Honey→Increased Healing Rate
higher healing rates by day 7 (OR: 4.71; 95% CI: 2.70-8.25; p < 0.00001)
Effect
Beneficial
Effect size
Large
Honey→Reduced Attack Abortion Rate
No significant difference was observed in the number of aborted attacks (p = 0.66)
Effect
Neutral
Effect size
Small
Honey→Reduced Lesion Healing Time
Treatment with propolis and/or honey was associated with quicker lesion resolution (MD: -1.87 days; 95% CI: -2.73 to -1.01; p < 0.0001)
Effect
Beneficial
Effect size
Moderate
Honey→Reduced Pain Duration
Propolis and/or honey also reported reduced pain duration (MD: -0.96 days; p = 0.03)
Effect
Beneficial
Effect size
Small
Honey→Reduced Pain Intensity
pain intensity (MD: -6.53; p = 0.0002)
Effect
Beneficial
Effect size
Moderate
Propolis→Improved Symptom-Free Status
more patients reporting being symptom-free by day 3
Effect
Beneficial
Effect size
Moderate
Propolis→Increased Healing Rate
higher healing rates by day 7 (OR: 4.71; 95% CI: 2.70-8.25; p < 0.00001)
Effect
Beneficial
Effect size
Large
Propolis→Reduced Attack Abortion Rate
No significant difference was observed in the number of aborted attacks (p = 0.66)
Effect
Neutral
Effect size
Small
Propolis→Reduced Lesion Healing Time
Treatment with propolis and/or honey was associated with quicker lesion resolution (MD: -1.87 days; 95% CI: -2.73 to -1.01; p < 0.0001)
Effect
Beneficial
Effect size
Moderate
Propolis→Reduced Pain Duration
Propolis and/or honey also reported reduced pain duration (MD: -0.96 days; p = 0.03)
Effect
Beneficial
Effect size
Small
Propolis→Reduced Pain Intensity
pain intensity (MD: -6.53; p = 0.0002)
Effect
Beneficial
Effect size
Moderate

Adverse Events Reported

Honey→adverse events
No significant difference was observed in adverse events (AEs) rates between the natural therapy and acyclovir groups.
Finding
No significant difference
Propolis→adverse events
No significant difference was observed in adverse events (AEs) rates between the natural therapy and acyclovir groups.
Finding
No significant difference