Science findings are encouraging and suggest that CBD may benefit a number of dermatological diseases and be used in personal care products.
“Cannabinoids continue to be of interest as they possess many characteristics that would seemingly make them a great fit for multiple dermatologic conditions: They are potentially anti-inflammatory, anti-pain, and anti-itch; can alter hair growth; can regulate epidermal proliferation; and can even decrease sebum production. In atopic dermatitis, acne, psoriasis, and hidradenitis suppurativa, there is a potential role for them, at least in theory,” said Peter A. Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine in Chicago, Illinois, and also the author of the article “Cannabinoids in Dermatology: Hope or Hype?” featured in the Journal of Cannabis and Cannabinoid Research.
CBD and Acne
The pathophysiology of acne is a permutation of follicular hyperkeratinization, microbial colonization, sebum production, and inflammation. The endocannabinoid N-arachidonoylethanolamine glycerol (AEA) has been shown to cause sebocyte apoptosis at higher levels, thus targeting one of the key pathophysiological mechanisms of acne.7 Several in-vitro studies indicate that CBD could be a possible treatment option for acne through its regulatory effects on sebum production and sebocyte proliferation.8
One key study, conducted by Olah et al, investigated the effects of CBD on sebaceous glands in vitro. The researchers found that AEA (a type of endocannabinoid) was able to inhibit lipogenic actions of sebaceous glands in a dose-dependent manner by inhibiting lipogenic compounds such as arachidonic acid and a mixture of linoleic acid and testosterone. CBD was also found to prevent pro-acne mediators from elevating TNF-a mRNA expression and normalize the lipopolysaccharide-induced expression of IL-1β and IL-6. Furthermore, in a small, split-face study, male subjects applied 3% cannabis seed extract cream to 1 side of their face twice daily for 12 weeks. At the end of the study, researchers found skin sebum production and erythema were significantly decreased compared with placebo, with no notable adverse effects.
These preliminary studies show promise in the use of CBD as an individual or adjunctive therapy for acne vulgaris. This may prove popular with patients who are seeking alternative, complementary, or “natural” therapies.
CBD and Atopic Dermatitis/Eczema
CBD have been studied for the treatment of eczema and atopic dermatitis, which affects about 10% of the US population.11 Eberlein et al studied more than 2000 eczema patients in a large, multinational cohort study and found that applying a cream containing CBD resulted in a significant reduction in dryness, excoriation, pruritus, and erythema across the population. Impressively, 56% of patients stopped using topical corticosteroids by the end of the study. This study is promising for the use of CBD in the treatment of eczema, as another randomized, double-blind, comparative trial of 60 patients with eczema found that CBD was associated with improved scaling, dryness, and itching at day 28 of therapy.
Oral CBD has also been studied for this inflammatory skin disease. Callaway et al found that oral CBD oil improved AD in a randomized crossover study demonstrating a significant decrease in skin dryness, itchiness, and use of topical medications compared with olive oil.
CBD: Emollients and Skin Care
CBD has been gaining popularity as a cosmetic material because of its reported emollient and anti-inflammatory properties. Through an examination of online search trends, a recent study found that consumer interest greatly increased in topical CBD products from 2015 through 2022. CBD has been shown to increase dermal water content and skin turgor.
Research may support its use here, as well. A mouse model investigating the emollient effect of CBD found that a 1% CBD solution applied to the skin increased the dermal water content through upregulation of aquaporin-3.An in vitro study using normal human epidermal keratinocytes found that CBD is able to penetrate keratinocytes and reduce the oxidative stress caused by UVB irradiation and hydrogen peroxide.
An ideal property of a moisturizer is to treat the pruritus associated with xerosis, and multiple studies have found that anandamide, an endocannabinoid, possesses antipruritic properties via inhibition of TRPV1 (an ion channel expressed mainly in nociceptive neurons of the peripheral nervous system).20
Future Directions
CBD represents an exciting area of pharmacology in the treatment of skin disease and for use in skin care and cosmetics products. CBD has been studied for the treatment of eczematous eruptions, skin cancer, pruritus, fibrotic skin diseases, acne, seborrheic dermatitis, psoriasis, and skin rejuvenation. “It is certainly possible that formulations of cannabinoids can be highly effective, and I remain cautiously optimistic about this,” Lio concluded.
