One is a flower. The other is a manufacturing process. Here's the difference — in plain English.
Manuka is a type of honey — produced by bees foraging on Leptospermum scoparium in New Zealand and parts of Australia. It contains methylglyoxal (MGO), a stable antibacterial compound not found in meaningful amounts in other honeys.
Medical grade honey is not a flower at all — it is a process. Honey (most often Manuka, but not always) is gamma-irradiated, tested batch by batch, and manufactured as a sterile single-use wound dressing under ISO 13485, with a CE mark or FDA clearance.
The 30-second comparison
Aspect
Manuka honey (jar)
Medical grade honey
What it is
A food — a single floral source
A sterile medical device made from honey
Regulated as
Food (FSA, FDA food, MPI)
Medical device (CE / FDA 510(k) / TGA)
Sterile?
No — contains bacterial spores
Yes — gamma-irradiated to SAL 10⁻⁶
Activity tested
MGO rating on label (optional)
MGO or antibacterial assay on every batch
Safe on an open wound
No
Yes — designed for it
Typical price
£15–£60 / 250 g jar
£8–£20 / 25 g single-use tube
Example brands
Comvita, Manuka Doctor, Manuka Health
Activon, Algivon, Medihoney, L-Mesitran
Why food-grade Manuka isn't safe on a wound
Honey straight from the hive contains low levels of Clostridiumand other bacterial spores. They're harmless to a healthy adult gut but dangerous in an open wound, where the warm, moist tissue is an ideal incubator. Gamma irradiation at 25 kGy reliably destroys these spores without damaging MGO — which is why every medical-grade product is sterilised before it leaves the factory.
Is medical grade always Manuka?
No. The Dutch Revamil / Bfactor pasture-blossom honey is the active ingredient in the L-Mesitranrange and is registered as a medical device throughout Europe — its antibacterial activity is broader-spectrum (hydrogen peroxide, bee defensin-1, modest MGO) rather than MGO-dominant. Surgihoney RO is a UK-engineered honey with enhanced peroxide generation. All three are medical grade; only one is Manuka.
So which should I buy?
For eating — to support general wellness, throat soothing or cooking — a food-grade Manuka jar is the right product, and you do not need a medical-grade dressing.
For a wound, burn, ulcer or skin tear — even a small one — buy a CE-marked or FDA-cleared honey dressing. See our independent where to buy medical grade honey guide for UK and US options.
Frequently asked questions
Is all Manuka honey medical grade?
No. The vast majority of Manuka honey is sold as a food. Only a small fraction is gamma-sterilised, bioburden-controlled and packed under ISO 13485 as a registered wound-care device. A high MGO number on a supermarket jar does not make it medical grade.
Is medical grade honey always Manuka?
No. Manuka is the most common source, but Dutch Revamil/Bfactor pasture-blossom honey (the basis of L-Mesitran) is also a registered medical device, and engineered honey products like Surgihoney RO are too. 'Medical grade' describes how the honey is processed and regulated, not the flower.
Can I use food-grade Manuka on a wound?
It is not advisable. Even high-MGO supermarket Manuka is not sterile — it can carry Clostridium spores that are harmless when eaten but unsafe in an open wound. For any broken skin, use a CE-marked or FDA-cleared honey dressing.
The science behind Manuka honey's activity against wound pathogens — and why almost no consumer brand will print the word 'antimicrobial' on the jar.
Few natural products have been studied for antimicrobial activity as thoroughly as Manuka honey. Yet walk down any supermarket aisle and you will struggle to find a Manuka jar that explicitly says “antibacterial” or “antimicrobial” on the label. That gap between the published science and what brands are allowed to say is the single biggest source of confusion for consumers — and it is exactly why the medical grade honey category exists as a separate, regulated product class for burns and wound care.
What makes Manuka honey antimicrobial
Manuka honey’s activity against bacteria is multi-modal — it does not rely on a single mechanism, which is part of why resistance has not been documented in the way it has for conventional antibiotics.
Methylglyoxal (MGO) — Formed non-enzymatically from dihydroxyacetone (DHA) in Manuka nectar. MGO is the principal non-peroxide antibacterial compound and is heat- and enzyme-stable, which is why Manuka activity survives storage and dilution in wound fluid better than peroxide-only honeys.
Hydrogen peroxide — Released slowly by the enzyme glucose oxidase when honey is diluted by exudate. Provides continuous low-level antibacterial cover without the tissue toxicity of pharmaceutical-strength peroxide.
Low pH (3.2–4.5) — Acidic wound environments inhibit bacterial protease activity and support fibroblast function.
High osmolarity — Honey’s ~80% sugar content draws water out of bacterial cells, suppressing growth.
Bee defensin-1 — A small antimicrobial peptide contributed by the bee that adds activity against gram-positive organisms.
Why companies avoid “antimicrobial” claims on pack
This is the question that surprises most consumers. The science is published in peer-reviewed journals; hospitals use Manuka-based dressings every day. So why won’t the jar say so?
The answer is regulatory. In every major market, the moment a product makes a medicinal or antimicrobial claim, it stops being a food and becomes either a medicine or a medical device:
UK — MHRA and the Food Standards Agency. Any claim to treat, prevent or cure disease triggers the Human Medicines Regulations 2012. “Antibacterial” on a food label is a borderline medicinal claim by function.
EU — Regulation (EC) 1924/2006 on nutrition and health claims prohibits any health claim not on the authorised EFSA list. No antimicrobial claim for honey is on that list.
USA — FDA classifies products by intended use. Saying honey “kills bacteria” on a food label reclassifies it as an unapproved drug, triggering enforcement letters.
Australia / NZ — TGA and MPI enforce similar rules. New Zealand’s MPI also separately polices Manuka authenticity through the four-chemical + DNA test.
The compliant workaround the industry has settled on is to publish a laboratory potency grade — MGO (mg/kg of methylglyoxal), UMF (Unique Manuka Factor), or NPA (Non-Peroxide Activity) — without translating it into a health claim. A jar marked “MGO 550+” tells an informed buyer the antibacterial potential without the brand ever printing the regulated word.
That is also why the same Manuka honey, lifted from a food jar into a sterile tube, can suddenly be marketed for wound care: the product has been re-manufactured under ISO 13485 quality systems, sterilised, and CE/UKCA-marked as a medical device. The chemistry is the same; the legal status, sterility and intended use are completely different.
Medical grade honey for wound care
In a wound-care context, the same antimicrobial chemistry is delivered through sterile, certified dressings — tubes of honey gel, impregnated tulle dressings, alginate fibres saturated with honey, and hydrocolloid pads. The most widely used products in the UK and Europe are Activon (Advancis), Medihoney (Derma Sciences / Integra) and Algivon.
Chronic wounds — Venous leg ulcers, pressure ulcers and diabetic foot ulcers benefit from honey’s combined debriding, antibacterial and moist-healing effects. NICE guidance recognises honey dressings as an option for sloughy or malodorous wounds.
Surgical and trauma wounds — Used to manage dehisced surgical wounds, skin tears and infected post-op sites where antibiotic stewardship matters.
Bioburden control — Reduces malodour and bacterial load, often within the first 2–3 dressing changes, and works against organisms including MRSA without driving resistance.
On burns, the antimicrobial argument is even more directly relevant. Burn wounds are a high-risk infection environment, and silver-based dressings — long the default — have well-documented downsides including pain on removal and cytotoxicity at high concentrations. Randomised controlled trials of sterile honey dressings on partial-thickness burns have reported:
Faster re-epithelialisation than silver sulfadiazine in several head-to-head studies.
Lower bacterial colonisation at day 7.
Comparable or better pain scores during dressing changes.
MGO 100+ / 250+ / 550+ / 850+ — Minimum methylglyoxal content in mg/kg. Higher = more non-peroxide activity. Below ~MGO 100 the non-peroxide activity is negligible.
UMF 5+ / 10+ / 15+ / 20+ — New Zealand certification mark combining MGO, leptosperin and DHA tests. Roughly: UMF 10+ ≈ MGO 250+, UMF 15+ ≈ MGO 550+, UMF 20+ ≈ MGO 850+.
K-Factor, TA, “Active” — Brand-owned terms with looser standards. Treat as marketing unless backed by an MGO or UMF number.
CE / UKCA mark + lot number + “sterile” — The only labelling that means the product is safe for use on broken skin.
Frequently asked questions
Is Manuka honey actually antimicrobial?
Yes. Laboratory and clinical evidence shows authenticated Manuka honey is active against a wide range of wound pathogens including Staphylococcus aureus, MRSA, Pseudomonas aeruginosa and Streptococcus pyogenes. The activity is driven by methylglyoxal (MGO), low pH, high osmolarity and — in non-Manuka honeys — hydrogen peroxide released by the enzyme glucose oxidase.
Why don't supermarket Manuka jars say 'antimicrobial' on the label?
Because in the EU, UK, US and Australia, any health, medicinal or antimicrobial claim on a food product is strictly regulated. Saying 'kills bacteria' or 'antibacterial' on a food jar reclassifies the product as a medicine or medical device, which requires a completely different regulatory pathway (MHRA, FDA, TGA, CE/UKCA). Food brands avoid the legal risk and stick to allowed descriptors like 'MGO 250+' or 'UMF 10+'.
What is the difference between food-grade Manuka and medical grade Manuka honey?
Food-grade Manuka is graded for MGO or UMF but is not sterile and is not certified for use on broken skin. Medical grade Manuka honey is gamma-irradiated to eliminate Clostridium botulinum spores and other microbes, manufactured under ISO 13485, and CE/UKCA marked as a medical device for wound care and burns.
Can I put food-grade Manuka on a wound or burn?
No. Even high-MGO food honey is not sterile and can introduce bacteria, yeast or spores into broken skin. For any open wound, ulcer or burn, use a CE/UKCA-marked medical grade honey product such as Activon, Medihoney or Algivon as directed by a clinician.
Does MGO equal antimicrobial strength?
MGO is the main non-peroxide antibacterial compound in Manuka, so a higher MGO usually means stronger in-vitro activity. But total wound-relevant activity also depends on pH, sugar content, hydrogen peroxide (in blended products) and the dressing format. MGO alone is not the full picture.
Is medical grade honey only Manuka?
No. Several medical grade honey products use non-Manuka floral sources where antibacterial activity comes mainly from hydrogen peroxide. Manuka-based products (e.g. Activon, Medihoney) are the best known because MGO activity is heat- and enzyme-stable, but other certified medical honeys are also used successfully in wound care.
