Natural Remedies for Wound Healing: What the Evidence Supports and What to Skip

A clean cut on your thumb heals because your body closes it. Not because of what you put on it. That's the uncomfortable starting point here, and most of the internet skips past it.

Natural remedies for wound healing are mostly tradition with no trial behind them. One has genuine evidence. A couple have thin evidence. One has evidence it made healing slower. And one old favorite can damage your liver. Here is the sort, by what the research shows. If the wound still needs cleaning, start with our rundown of proven natural wound cleaning solutions.

What actually makes a wound heal?

Three things, and none is a plant. Get the wound clean, keep it covered, keep it from drying into a hard scab. Everything else is a small adjustment on top.

1. Clean it with plain water and mild soap. Merck Manuals says "Smaller dirt and particles that cannot be seen are removed by washing with mild soap and tap water." University of Utah Health's Dr. Troy Madsen recommends 5 to 10 minutes under lukewarm tap water at a gentle flow, and says tap water is fine if you'd drink it.

2. Skip the harsh stuff. Merck is blunt: "Harsher agents, such as alcohol, iodine, and peroxide, are not recommended," because "These solutions can damage tissue, impairing the capacity to heal." Madsen says it plainer: hydrogen peroxide "may be killing the germs, but it's also killing the healthy tissue in there too."

3. Cover it, and keep it from drying out. Cleveland Clinic notes that "Scabs usually develop when a skin wound remains dry," that scabs can slow healing, and that you should "keep them moist with petroleum jelly and cover them with a bandage."

One exception. CDC's emergency wound guidance says to cover a clean wound, but to "Leave unclean wounds, bites, and punctures open." Those are wounds a professional needs to see anyway.

Do any natural remedies for wound healing have real evidence behind them?

One does. Honey. After that it thins out fast, and in one case it points the wrong way.

An honest note first. NCCIH, the federal center that evaluates this category, publishes fact sheets on aloe vera, tea tree oil and turmeric, but none on honey for wounds. The honey evidence below comes from a Cochrane review and an FDA device clearance.

Is honey good for wound healing, and does the jar in your pantry count?

Honey has the best evidence of any botanical here, and no, the jar in your pantry isn't the same product.

The Cochrane review of honey as a topical wound treatment covered 26 trials and 3,011 participants. Its overall verdict is cautious: "It is difficult to draw overall conclusions regarding the effects of honey as a topical treatment for wounds." But two findings stand up. Honey healed partial thickness burns about 4.7 days faster than conventional dressings (high quality evidence, 2 trials, 992 people). And it closed infected post-operative wounds faster than antiseptic washes plus gauze (moderate quality, 1 trial, 50 people).

What medical grade honey actually is

A regulated, sterilized product. The FDA clearance for one honey dressing (510(k) K121227, cleared May 23, 2012) describes "sterile, single-use wound care dressings for use in moist wound management" built from Leptospermum scoparium honey, sealed into tubes before sterilization using gamma irradiation. It's cleared over the counter for minor abrasions, cuts and burns, and for ulcers and surgical wounds only under a professional's supervision.

Why the pantry jar is a different thing

Jenkins and Cooper tested 18 table honeys against a medical grade honey in Wounds in 2009. Only 9 showed any antibacterial activity. The medical honey was the most potent and it was sterile. The table honeys were not: 3 contained clostridia. The authors wrote that "the use of non-sterile honey samples cannot be justified."

That's also the reason for the one rule with no exceptions. CDC states it flatly: "Do not feed honey to a child who is younger than 1 year old." Honey can carry the bacteria that cause botulism. It doesn't go near an infant, in food or on skin.

Does aloe vera help wounds heal?

For burns, possibly. For open wounds, the best review found no good evidence, plus a trial where aloe made healing slower.

NCCIH says "Clinical research suggests topical application of aloe gel may speed burn healing and reduce burn-related pain," and calls that a small body of evidence. For diabetic foot ulcers, it says "there isn't enough reliable information."

The Cochrane review of aloe vera for acute and chronic wounds is harder: "There is currently an absence of high quality clinical trial evidence to support the use of Aloe vera topical agents or Aloe vera dressings as treatments for acute and chronic wounds." In one included trial of surgical wounds healing by secondary intention, "Aloe vera significantly delayed healing," by a mean difference of 30 days (95% confidence interval 7.59 to 52.41). The reviewers say their trials must be viewed with extreme caution for risk of bias, so that's not proof aloe is harmful. It's a reason to stop assuming it helps.

NCCIH does note topical aloe is generally tolerated, though burning, itching, rash and eczema have been reported.

What does the evidence say about calendula, tea tree oil, turmeric and comfrey?

Thin, thin, absent and risky, in that order.

Calendula

A systematic review by Matthew Leach in Wounds (2008) found 6 randomized trials of topical calendula. Only 1 was good quality, so results were not pooled. His conclusion: "Undoubtedly, further investigation is needed to establish whether Calendula has a place in mainstream wound care." No federal agency publishes a position on calendula for wounds, so we won't manufacture one.

Tea tree oil

NCCIH reports a small amount of evidence for acne and athlete's foot, and says that for other conditions there is "not enough evidence to determine whether topical tea tree oil is useful." It summarizes no wound-healing research at all, and warns that "Tea tree oil should not be swallowed."

Turmeric

No wound evidence to report. NCCIH says plainly, "We don't know enough to definitively conclude if turmeric or curcumin is beneficial for any health purposes," and doesn't discuss wound healing at all. Topical curcumin can cause hives or itching.

Comfrey

The hardest no here. Comfrey contains pyrrolizidine alkaloids, 0.003 to 0.2 percent in dry leaves and 0.2 to 0.4 percent in dry roots per the NTP toxicological review, which also summarizes case reports tying comfrey to liver toxicity.

On July 6, 2001, FDA told industry that firms should "immediately stop marketing comfrey-containing supplements and alert consumers to stop using the products." The FTC enforcement that followed requires topical comfrey to carry this warning: "This product should not be taken orally, used as a suppository, or applied to broken skin." An open wound is broken skin. That's the whole answer.

What should you stop putting on a wound?

Short list, and most of it's in your kitchen.

• Hydrogen peroxide, rubbing alcohol and full-strength iodine. Merck: these "can damage tissue, impairing the capacity to heal." Utah Health adds that in someone who already heals slowly, that damage matters more.

• Butter, flour, cayenne, chewing tobacco and spider webs. No agency or journal we could reach publishes a clinical trial of any of them, so we won't invent a result. What they reliably do is put dirt into a wound you just cleaned.

• Undiluted essential oils. No wound-healing evidence, a real irritation risk, nothing to gain.

• Letting it air dry into a hard scab. Cleveland Clinic says scabs form when a wound stays dry and can slow healing. Don't pick one off, either.

The allergy problem nobody warns you about

Botanicals and antibiotic ointments both cause allergic contact dermatitis. Merck lists "Antibiotics (bacitracin, sulfonamides, neomycin)" among common causes, and notes that "Even ointments, creams, and lotions used to treat dermatitis can cause such a reaction." NCCIH reports the same kind of reaction from aloe and tea tree oil.

The practical tell: if a wound that was improving turns itchy and red in the exact shape of the dressing or the ointment smear, that's likelier a reaction than an infection. Stop the product. If you can't tell which it is, ask a clinician, not a forum.

When should you stop treating a wound at home and get real care?

When any one of these is true. Not when several are.

• Size and depth. Merck says get help if a cut "is longer than about 1/3 inch (3/4 centimeter), is on the face, appears deep, or has edges that separate." MedlinePlus adds any wound over a quarter inch (0.64 centimeter) deep.

• Bleeding you can't stop. Merck says apply firm pressure for at least 5 minutes. MedlinePlus says call 911 if bleeding is severe or won't stop after 10 minutes of pressure. Our guide to stopping severe bleeding with pressure, packing and tourniquets covers that case.

• Punctures and bites. Merck singles out punctures because they "introduce contamination deep under the skin," and names animal and human bites as especially likely to get infected.

• Anything embedded. MedlinePlus says don't pull a foreign object out yourself.

• Nerve or tendon injury. Loss of sensation or movement, per Merck. A wound over a knuckle or joint stays here until someone checks the tendon.

• Diabetes or a weakened immune system. Smaller margin for error, and CDC's tetanus guidance treats severe immunodeficiency as its own risk category.

• Infection. Merck says pain that "worsens a day or more after the injury is often the first sign," with redness, swelling, pus and fever following, and that help should be sought "within several hours."

What about tetanus?

CDC sets two clocks, and this is where a lot of advice goes wrong. For a clean and minor wound, you need a booster if your last tetanus vaccine was "10 or more years ago." For a dirty or major wound, the threshold drops to "5 or more years ago." Tetanus immune globulin (250 international units) is for dirty or major wounds in people with unknown or incomplete vaccination, HIV or severe immunodeficiency.

A conflict you will meet: Merck's first aid page just says get help if you have not had a tetanus shot in 5 years, with no clean-versus-dirty split. CDC is more specific. Either way, if you can't remember your last booster, that's your answer.

And the point of the article. No natural remedy substitutes for cleaning, closure, or antibiotics when those are what the wound needs. Honey is a dressing, not a suture. If you're weighing whether a cut is a home job, read how to treat a cut at home, from cleaning to closing.

Frequently asked questions

Is honey good for wound healing?

Medical grade honey has the best evidence of any natural remedy for wound healing. A Cochrane review of 26 trials and 3,011 people found honey healed partial thickness burns about 4.7 days faster than conventional dressings. That evidence is for sterile, FDA-cleared honey dressings, not the pantry jar: of 18 table honeys tested in Wounds, only 9 had any antibacterial activity and 3 contained clostridia. Honey is never used on a child under 1.

Can you put aloe vera on an open wound?

There is no good evidence that it helps, and one trial where it hurt. The Cochrane review on aloe vera found an absence of high quality trial evidence for acute and chronic wounds, and in one trial of surgical wounds healing by secondary intention, aloe significantly delayed healing by a mean of 30 days. NCCIH does say topical aloe gel may speed burn healing, but burns and open wounds are different questions.

Is it safe to put tea tree oil or other essential oils on a cut?

No, not undiluted, and there is no good reason to. NCCIH summarizes no wound-healing research on tea tree oil, and says that outside acne and athlete's foot there is not enough evidence to tell whether it is useful. It can also cause skin redness or irritation.

Should you let a cut air out and scab over?

No. Cleveland Clinic says scabs usually develop when a skin wound stays dry, and that scabs can slow healing compared with wounds that do not scab. Keeping a clean wound moist with petroleum jelly and covered is the better call. The exception is CDC's: leave unclean wounds, bites and punctures open, and those are wounds a clinician should see anyway.

When do you need a tetanus shot after a cut?

CDC uses two intervals. For a clean and minor wound, you need a booster if your last tetanus vaccine was 10 or more years ago. For a dirty or major wound, the threshold is 5 or more years. Anyone with an unknown vaccination history or an incomplete primary series should be vaccinated whatever the wound type.

The numbers, in one place

You never know, but you can always be ready.

Sources: Cochrane, honey as a topical treatment for wounds, Cochrane, aloe vera for wounds, NCCIH aloe vera, NCCIH tea tree oil, NCCIH turmeric, Merck Manuals, first aid for cuts, scrapes and wounds, Merck Manuals, contact dermatitis, MedlinePlus, cuts and puncture wounds, CDC emergency wound care, CDC tetanus wound management guidance, CDC botulism prevention, FDA 510(k) K121227, FTC comfrey enforcement, NTP comfrey toxicological review, Jenkins and Cooper, Wounds 2009, Leach, Calendula officinalis and wound healing, Cleveland Clinic, scabs, University of Utah Health on hydrogen peroxide.