Effect of Cedar Honey in the Treatment of Oral Lichen Planus

Document Type: Original


1 Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of veterinary and biotechnology, Razi vaccine and serum institute, Mashhad, Iran.

3 Undergraduate student of dentistry, Szeged Dental School, Budapest, Hungary.

4 General Dentist, private clinic, Tehran, Iran

5 Department of Statistics, Payame Noor University, Tehran, Iran.


Introduction:Oral Lichen Planus(OLP)is a chronic mucocutaneus disease with an immunological etiology. This study was conducted to evaluate the effect of Cedar honey in treatment of erosive- atrophic OLP.
Materials and Methods: Thirty patients with confirmed clinical and histopathologic of OLP participated in a randomized clinical trial in Mashhad Dental School.Patients were randomly allocated in two groups. Both groups received the standard treatment of OLP (dexamethasone mouthwash 0.5mg 3 times daily and fluconazole capsule 100 mg daily).Intervention group received Cedar honey (20 ml 3 times daily , swish and swallow technique)in addition to standard treatment. The patients were followed for 4 weeks.The pain and severity of the lesions were recorded at the initial visit and follow ups. All recorded data were analyzed with chi- square, T test, ANOVA using SPSS version 11.5and p-value less than 0.05 was considered significant.
Results: Thirty patients were included in the study. Both groups had markedly reduction in pain, size of erosive area and atrophic lesions specially in first follow up but there was not a significant different between two groups (p>0.05). Honey was effective in healing of ulcerative lesions.(The average recovery in experimental group was 69% while the average relief of ulcerative lesion in control group was 50%).but this difference was not significant(p=0.896)
Conclusion :No significant difference was found in the treatment of atrophic and erosive lesions of OLP by using honey as an alternative treatment, but it may be effective in ulcerative lesions of OLP , although more research with larger sample size is necessary.


1. McCartan B, Healy C: The reported prevalence of oral lichen planus: a review and critique. J Oral Pathol Med  2008;37:447–53.

2. Ismail SB, Kumar SK, Zain RB: Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci 2007;49:89–106.

3. Gonzalez‐Moles M, Scully C, Gil‐Montoya J: Oral lichen planus: controversies surrounding malignant transformation. Oral Dis  2008;14:229–43.

4. Srinivas K, Aravinda K, Ratnakar P, Nigam N, Gupta S: Oral lichen planus-Review on etiopathogenesis. National J maxillofac surg  2011; 2: 15.

5. Farhi D, Dupin N: Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: facts and controversies. Clin in dermatol  2010;28:100–8.

6. Sugerman P, Savage N, Walsh L, Zhao Z, Zhou X, Khan A, et al :The pathogenesis of oral lichen planus. Crit Rev Oral Biol  Med  2002;13:350–365.

7. Tonks A, Cooper R, Jones K, Blair S, Parton J, Tonks A: Honey stimulates inflammatory cytokine production from monocytes. Cytokine 2003; 21:242–7.

8. Bilsel Y, Bugra D, Yamaner S, Bulut T, Cevikbas U, Turkoglu U: Could honey have a place in colitis therapy? Effects of honey, prednisolone, and disulfiram on inflammation, nitric oxide, and free radical formation. Digest Surg 2012;19:         306–12.

9. Motallebnejad M, Akram S, Moghadamnia A, Moulana Z, Omidi S: The effect of topical application of pure honey on radiation-induced mucositis: a randomized clinical trial. J contemp dent pract  2008;9:40–47.

10. Andreasen J: Oral lichen planus: I. A clinical evaluation of 115 cases. Oral Surg Oral Med Oral PathoL 1968;25:31–42.

11. Jaganathan SK, Mandal M:Antiproliferative effects of honey and of its polyphenols: a review. J Biomed  Biotech 2009 Article ID 830616, 13 pages, 2009. doi:10.1155/2009/830616 .

12. Jaganathan S, Mandal M: Honey constituents and its apoptotic effect in colon cancer cells. J Apiproduct Apimedical Sci. 2009;1:29–36.

13. Cribier B, Frances C, Chosidow O:Treatment of lichen planus: an evidence-based medicine analysis of efficacy. Arch Dermatol. 1998;         134: 1521.

14. Saawarn N, Shashikanth M, Saawarn S, Jirge V, Chaitanya N, Pinakapani R: Lycopene in the management of oral lichen planus: A placebo-controlled study. Ind J Dent Res  2011;22:639.

15. Alvarez-Suarez JM, Tulipani S, Díaz D, Estevez Y, Romandini S, Giampieri F, et al: Antioxidant and antimicrobial capacity of several monofloral Cuban honeys and their correlation with color, polyphenol content and other chemical compounds. Food Chem Toxicol 2010;48:2490–99.

16. Mehrabani M, Hosseini M, Karimloo M:Comparison of Honey dressing with Hydrocolloid dressing effects on pressure ulcer healing of ICU hospitalized patients. J Health Promot Manag 2012;1:37–45.

17. Tan MK, Adli H, Sharifah D, Tumiran MA, Abdulla MA, Yusoff KM: The efficacy of Gelam honey dressing towards excisional wound healing. Evid Bas Complement Alternat Med vol. 2012, Article ID 805932, 6 pages, 2012. doi: 10. 1155/ 2012/ 805932.

18. Molan P: The potential of honey to promote oral wellness. Gen Dent 2001;49:584.

19. El-Gendy M: In vitro, Evaluation of Medicinal Activity of Egyptian Honey from Different Floral Sources as Anticancer and Antimycotic Infective Agents.J Microbial Biochem Technol 2010;2:118–23.

20. Nazari F. [Effect of propolis in prevention of recurences of recurent apthus stomatitis].  Post graduate Dissertation. Mashhad: Mashhad University of Medical Sciences, Faculty of Dentistry, 2011: 470. (Persian)


21. Chainani-Wu N, Collins K, Silverman Jr S: Use of curcuminoids in a cohort of patients with oral lichen planus, an autoimmune disease. Phytomed  2012;19:418–23.

22.Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P: The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Brit J Dermatol 2008;158:573–7.

23. Reddy RL, Reddy RS, Ramesh T, Singh TR, Swapna LA, Laxmi NV: Randomized trial of aloe vera gel vs triamcinolone acetonide ointment in the treatment of oral lichen planus. Quint Internat   2012;43:793–800.

24. Mansourian A, Momen-Heravi F, Saheb-Jamee M, Esfehani M, Khalilzadeh O, Momen-Beitollahi J: Comparison of treatment efficacy of daily use of aloe vera mouthwash with triamcinolone acetonide 0.1% on oral lichen planus: A randomized double-blinded clinical trial. Am J Med Sci. 2011;342: 447–51.

25. Salazar-Sanchez N, Lopez-Jornet P, Camacho-Alonso F, Sanchez-Siles M: Efficacy of topical Aloe vera in patients with oral lichen planus: a randomized double-blind study. J Oral Pathol Med  2010;39:735–40.

26. Mousavi F, Sherafati S, Mojaver YN: Ignatia in the treatment of oral lichen planus. Homeopathy  2009;98:40–4.

27. Taheri JB, Anbari F, Maleki Z, Boostani S, Zarghi A, Pouralibaba F: Efficacy of Elaeagnus angustifolia topical gel in the treatment of symptomatic oral lichen planus. J Dent Res Dent Clin Dent  Prospects  2010;4:29.

28. Delavarian Z, Javadzadeh-Bolouri A, Dalirsani Z, Arshadi HR, Toofani-Asl H: The evaluation of psychiatric drug therapy on oral lichen planus patients with psychiatric disorders. Medicina oral patologia oral y cirugia buca. 2010;15:e322–7.