The skincare market has been flooded with lots of products containing cannabidiol (CBD), a compound derived from the cannabis plant. CBD is found in cannabis, along with tetrahydrocannabinol (THC). Both CBD and THC are considered cannabinoids. Cannabinoids are compounds that interact with our bodies’ endocannabinoid system. Now CBD is unique in that it has potential therapeutic benefits for conditions like epilepsy without causing the “buzz” or “high” that THC carries. Think of THC as the life of the party while CBD is the friend handing out water and snacks. The question is—which one are you?
The interesting thing is that most people don’t know the difference between CBD and TCH—even dermatologists. A survey of 531 dermatologists found that 64% of respondents did not know that CBD is not psychoactive and 29% did not know that THC is psychoactive. This fact might explain a tendency for some health professionals, including us derms, to shy away from a conversation regarding CBD and potential skin benefits. Many people have heard of hemp seed oil beauty products or seen them in the store. Hemp, aka cannabis sativa seed oil, contains less than 0.03% THC and doesn’t give you a high or have abuse potential. Hempseed oil does have omega-3 fatty acids, vitamins D, E and other antioxidants which offer possible therapeutic benefits for the skin. So what’s the difference between CBD and hemp? Hemp is the actual plant and CBD is extracted from the plant itself. You can get CBD from hemp, but not all hemp products (like hemp seed oil) contain CBD. However, many hemp seed oil products label themselves just as cannabis or add a marijuana leaf for marketing. This can be misleading and add to the misunderstanding of these ingredients or presumption that they offer a high.
Now the marijuana plant isn’t the only one capable of producing cannabinoids. Your body makes its own endocannabinoids, AEA, 2-AG, PEA, and OEA. These chemical messengers interact with cannabinoid receptors (CBR) throughout the body, including in the skin, and help regulate processes such as inflammation, immune function, and cell turnover. CB1 receptors in the nervous system affect sensations like pain and itch. Our immune cells have CB2 receptors which impact inflammatory mediators with the immune system. Research suggests that CBD CBD does not appear to exert effects through the binding of CB1 or CB2 receptors but rather targets the metabolism and re-uptake of endogenous cannabinoids thereby enhancing their effects.
Overall, CBD has three main properties that make it an attractive ingredient to treat skin conditions. First, it has a calming effect on the immune system. CBD works on pathways that decrease inflammation which make it a valuable player for atopic dermatitis (AD), psoriasis and acne. And my favorite feature—antioxidant power. You know my love affair with antioxidants. CBD can neutralize free radicals. This makes CBD a great candidate for treating photoaging and possibly preventing skin cancer. Lastly, CBD also works on nerve receptors telling them to calm itch and pain sensations, which may help in AD psoriasis and pain management. CBD can also help the skin barrier and increase dermal water content and skin turgor, an added bonus for dry skin. The challenge with CBD is the lack of robust studies surrounding its use in clinical dermatology. There are a few randomized controlled trials and case series with promising results for various conditions like acne.
Another challenge is the quality of CBD products on the market. They are not regulated by the FDA and labeling may be inaccurate or misleading. Third party verification on a label is a helpful tool when evaluating an CBD product. It’s also important to point out that CBD products have not been studied in pregnancy or with breastfeeding. CBD products are everywhere and heavily marketed to patients, especially as a natural alternative or complement to standard of care. You can even get a CBD-infused sports bra. Now only if it would motivate me to exercise more…Well, there is the runner’s high.
Trotter’s Take: CBD has anti-inflammatory properties and may provide a therapeutic benefit for several skin conditions but more robust research is needed to establish efficacy and safety. Riding a high after reading this? Then you need to hit play and listen to Dr. Adam Friedman as he gets stoked about CBD and skincare.
