How CBD Helps With Skin Disorders
A study showed that topical cannabidiol (CBD) application may help improve the skin conditions of individuals with inflammatory skin disorders, like psoriasis and atopic dermatitis(1).
CBD works by interacting with the body’s endocannabinoid system (ECS) to help provide therapeutic relief for chronic skin problems(2).
The ECS maintains the body’s homeostasis or internal balance. It helps regulate our daily bodily functions, including our immune system, metabolism, and anti-inflammatory response(3).
The ECS has receptors that are spread throughout the body. These receptors may be stimulated or triggered by endocannabinoids (cannabinoids produced by the body)(4).
Phytocannabinoids (plant-based cannabinoids), such as CBD and tetrahydrocannabinol (THC), may also influence ECS receptors to trigger specific responses.
The CB1 and CB2 receptors are the two main receptors of the ECS. These receptors are present in most body tissues(5).
CB1 receptors are abundantly found in the central nervous system. These receptors influence appetite, memory processing, sleep patterns, pain sensation, and motor function(6).
Meanwhile, CB2 receptors are more commonly found in the immune system. When CB2 receptors are activated, they may trigger anti-inflammatory effects and help relieve the symptoms of inflammation-related health issues(7).
Studies also noted the presence of the ECS and its receptors in the skin(8).
Moreover, findings showed that the ECS is involved in maintaining skin balance and forming the skin barrier, which may help treat skin health conditions(9).
CB1 and CB2 receptors are abundant in normal, healthy skin(10). These receptors are found in keratinocytes, sebaceous or oil glands, nerve fibers, and other parts of the skin.
Keratinocytes are the main type of skin cells found in the skin’s epidermis or outer layer(11).
Findings linked the dysregulation or abnormal expression of keratinocytes to chronic inflammatory skin diseases, like psoriasis, eczema, and allergic contact dermatitis(12).
Studies suggested that CBD may influence and trigger the ECS receptors in keratinocytes to prevent the excessive increase of these skin cells and help alleviate the symptoms of skin disorders(13).
Influencing and activating the skin’s CB2 receptors may also help stimulate sebum or oil production to combat dry skin(14).
Triggering the CB1 and CB2 receptors may also aid in inhibiting inflammation linked to dermatitis and help suppress skin tumors’ growth(15).
Benefits of CBD for Skin Disorders
Available studies suggested that the use of CBD oil and topical CBD products may help provide therapeutic relief for different symptoms of severe and common skin conditions.
Research also showed that CBD had high antioxidant properties(16). Antioxidants may help address several skin issues, such as melasma (a skin pigmentation disorder), skin aging, and psoriasis(17).
Findings also suggested that CBD had anti-bacterial benefits due to Cannabis sativa plants’ natural ability to help control bacterial infections(18).
CBD may also be used to help enhance the anti-bacterial effects of some antibiotics, which may help in treating skin problems and skin infections(19).
Psoriasis is a common chronic skin disease characterized by patches of thick, raised lesions or plaques covered by silvery scales(20). Other symptoms of psoriasis include itchiness, dry skin, and swollen joints.
According to a study, keratinocytes (epidermal skin cells) may be a potential trigger for psoriasis(21).
The abnormal proliferation or increase of keratinocytes contributes to an accelerated skin cell turnover, which may then cause the formation of psoriatic plaques(22).
A 2020 study published in the journal Molecules suggested that CBD and THC may influence the ECS to help suppress the proliferation of keratinocytes(23).
The researchers also noted that CBD and THC may also help modulate the inflammatory component in keratinocytes and reduce skin inflammation(24).
Contact Dermatitis and Itchiness
The study in Molecules also suggested that CBD’s anti-inflammatory properties may also help suppress the inflammatory reaction caused by allergic contact dermatitis(25).
Allergic contact dermatitis is a skin condition marked by itchy rashes due to hypersensitivity to certain substances or allergens(26).
The researchers observed that CBD reduced inflammation from allergic contact dermatitis without being toxic to the cells(27).
A 2017 study published in the Journal of the American Academy of Dermatology showed that applying CBD cream helped eliminate pruritus or severe itching in 8 out of 21 study participants(28).
Dr. Robert Dellavalle, an author of the study and an associate professor at the University of Colorado School of Medicine, stated that the treatment of itch may be the most promising role for cannabinoids(29).
Acne and Dandruff
CBD oil may also help with bad skin and acne problems. Researchers noted that CBD may help regulate sebum or oil secretion(30). Excessive sebum production is one factor that increases the likelihood and severity of acne(31).
The combination of CBD’s sebostatic (sebum control) effect, anti-inflammatory properties, and anti-bacterial activity makes it a promising anti-acne agent(32).
Several skincare products containing CBD are currently available on the market, touting CBD’s alleged anti-acne and anti-inflammatory benefits to help calm the skin.
Findings indicated that influencing the CB2 receptors to inhibit sebum production may also help address seborrhea or seborrheic dermatitis, which causes redness and scaly skin patches(33).
Seborrheic dermatitis commonly affects the scalp and is also referred to as dandruff(34).
A separate study noted that sublingual (under the tongue) intake of pharmaceutical-grade CBD helped improve the quality of life of patients suffering from epidermolysis bullosa(35).
Epidermolysis bullosa is a group of rare diseases characterized by fragile, blistering, painful, and irritated skin(36).
All three epidermolysis bullosa patients that took CBD sublingually for the study reported better pain scores, less itching, and reduced overall analgesic drug intake(37).
Another small observational study involving topical CBD use for epidermolysis bullosa showed similar positive results(38).
The three patients that used topical CBD reported pain improvement, less blistering, and faster wound healing. One of the patients also stopped taking opioid analgesics for pain(39).
Although CBD holds promise as a treatment for skin disorders, findings regarding the benefits of CBD remain inconclusive. Researchers continue to call for more studies to be conducted on CBD.
Possible Risks of Using CBD for Skin Disorders
A study on the therapeutic effects of topical CBD administration showed that CBD is safe and effective in improving the condition and quality of life of patients with certain skin disorders(40).
The researchers did not observe any allergic reactions or adverse effects on the study participants during the treatment duration(41).
However, other studies noted possible risks when using CBD, particularly when it is ingested or smoked.
The possible side effects of using CBD oil include the following(42):
- Dry mouth
- Reduced appetite
- Drowsiness or fatigue
- Weight loss or weight gain
CBD may also adversely interact with other drugs, particularly blood thinners(43). CBD use may also affect the efficacy of some eczema medications.
Tacrolimus is an eczema ointment prescribed for patients whose eczema problems have not responded to other medications(44).
Using CBD together with tacrolimus may decrease the rate at which the body metabolizes the drug, possibly increasing the levels of tacrolimus in the body(45).
A high amount of tacrolimus in the body is ill-advised. Tacrolimus use has been linked to skin cancer and lymphoma cases, although there is no definitive proof that using tacrolimus causes cancer(46).
Another eczema medication that may interact with CBD is prednisone, an oral steroid prescribed for severe eczema flare-ups(47). Taking prednisone may affect how fast CBD gets broken down by the liver(48).
If you are taking other medications for your skin disorder, it is highly advised to consult your dermatologist before using oral or topical CBD.
Moreover, it is important to remember that CBD has not been approved by the US Food and Drug Administration (FDA) as a treatment for any health issue(49).
As of January 2021, the epilepsy medication Epidiolex is the only FDA-approved drug with CBD as a major component(50).
The FDA continues to warn consumers that extremely high CBD doses are linked to potential liver injury(51).
It is recommended to talk to a certified medical doctor or dermatologist familiar with CBD usage before taking CBD to help ensure optimal product effectiveness and your overall wellness.
How Soon Can CBD’s Effects Be Felt
You may start feeling the effects of CBD anywhere between a few minutes to a few hours, depending on the method of administration.
Different delivery methods, CBD potencies, and product formulations may affect the bioavailability of CBD.
Bioavailability is the speed and amount at which a product or drug gets absorbed into the bloodstream.
Inhaling or vaporizing CBD is generally regarded as the fastest delivery method for CBD. This method allows CBD to enter your bloodstream in as fast as 30 seconds(52).
The effects of vaping CBD may last from one to four hours, depending on the amount and potency of the CBD product. The fast onset (start of effect) and short efficacy duration make CBD inhalation advisable for acute issues, like nausea or acute pain(53).
However, take note that studies have associated vaping with cases of lung issues or respiratory complications(54).
While safety investigations are still ongoing, the FDA and the US Centers for Disease Control and Prevention also caution against vaping, particularly CBD products with THC(55).
Topical CBD administration is recommended for addressing skin problems and joint pain issues(56).
Online anecdotal accounts note that the effects of topical CBD products may take one or two hours to be felt.
The sublingual delivery method is also shown to be effective for some skin disorders(57).
Sublingual CBD administration requires letting the CBD oil sit underneath the tongue for 60 seconds or more before swallowing(58).
Users may start to feel the effects of CBD within 15 to 60 minutes, with the results possibly lasting between six and eight hours(59).
How to Use CBD for Skin Disorders
The rule of thumb for first-time CBD users is to start with a low CBD dosage and concentration. You may slowly increase the dosing until you achieve your desired effects.
More severe skin disorders may require a more potent CBD product, particularly CBD topicals.
Always remember that CBD is not an approved FDA medication for any skin disorder. As such, there is no official dosage guideline.
It is highly advised to talk to a dermatologist knowledgeable on CBD use for a more accurate dosage recommendation.
Researchers suggested that topical CBD administration may be ideal for addressing localized symptoms of skin conditions, arthritis, and neuropathic pain(60).
A recent study published in October 2020 indicated that a hydrophilic gel consisting of propylene glycol was highly effective for CBD absorption and retention through the skin(61).
Other topical products, such as CBD lotions, CBD creams, CBD salves, and CBD balms, are also recommended for addressing skin disorders.
CBD skin care products, such as face creams and facial oils, are gaining popularity as companies and brands promote the purported anti-bacterial, anti-acne, and anti-inflammatory benefits of CBD oil.
When using topical CBD, it is recommended to apply the cream or gel liberally to help ensure that the affected area gets enough product(62).
Additionally, make sure to clean the affected area before applying topical CBD(63). Bacteria and other invisible contaminants on the skin may affect the product’s effectiveness.
How to Choose CBD Products for Skin Disorder
Full-spectrum CBD products have a complete range of phytocannabinoids naturally found in cannabis plants, including THC, terpenes, flavonoids, and fatty acids.
Terpenes (aromatic plant compounds) may offer added relaxation and therapeutic benefits(64). Meanwhile, flavonoids may provide additional antioxidant and anti-inflammatory relief(65).
Full-spectrum CBD produces an entourage effect, in which all the cannabinoids and compounds work together to enhance each other’s therapeutic effects.
Broad-spectrum CBD contains almost the full range of phytocannabinoids and other compounds, with the exception of the psychoactive (mind-altering) THC.
Meanwhile, CBD isolates contain pure CBD only.
People with skin disorders may benefit most from full-spectrum CBD, as studies showed that the combination of THC and CBD may help improve skin diseases(66).
Here are other tips when choosing high-quality CBD products for skin disorders:
- Choose brands that are transparent about their hemp sources, extraction process, and third-party laboratory testing results.
- Always make sure that the CBD products have certificates of analysis (COAs) and are tested for CBD potency and harmful contaminants, like pesticides and solvents.
- Look for active ingredients offering additional moisturizing and hydrating benefits that may help reduce dryness and itchiness.
- Essential oils and plant oils may help improve skin conditions. For instance, coconut oil has anti-bacterial properties, good moisturizing effects, and properties that help with eczema(67).
- Aloe vera and omega-3 are also excellent skincare ingredients that may help improve skin elasticity and reverse the signs of skin aging(68).
Legality of CBD
The passage of the 2018 Farm Bill or Agriculture Improvement Act of 2018 legalized industrial hemp and hemp-derived products, including CBD oil, on a federal level in the USA(69).
The 2018 Farm Bill defined industrial hemp as Cannabis sativa plants that have less than 0.3% THC on a dry weight basis(70).
Any Cannabis sativa plant or product derivative with THC levels exceeding 0.3% is recognized as marijuana. Thus, it is still prohibited in most parts of the US.
Medical marijuana and THC-rich CBD products are available to patients with qualifying medical conditions, such as Parkinson’s disease or epilepsy, under some states’ medical cannabis programs.
The 2018 Farm Bill permits the cultivation, processing, handling, and selling of hemp plants and hemp derivatives, such as CBD products(71).
The bill also removed industrial hemp and CBD from the Schedule I drugs category(72). Schedule I drugs are substances with no approved medical use and a high possibility for abuse(73).
While CBD products are no longer restricted substances, the FDA still cautions consumers on buying and using CBD oil.
The FDA has approved one CBD-based medication (Epidiolex) only for treating seizures due to rare forms of epilepsy(74).
Moreover, the sale of any food products and beverages, including animal feed, with CBD additives are restricted under FDA regulations(75).
CBD use is legal on the federal level, though states may still impose their own rules and restrictions on the purchase and sale of CBD within their jurisdiction.
Some states, like South Dakota, continue to consider all forms of industrial hemp and CBD products as illegal substances(76).
There are also states, like Washington, that abide by the FDA’s regulations and restrict the sale of food and drinks infused with CBD(77).
CBD users who plan to travel and take their CBD oil with them are advised to read up on their destination state’s CBD laws to help avoid legal complications.