It has been known that the human endocannabinoid system (ECS) modulates cutaneous biology. Receptors from the ECS have been identified in the skin, and systemic misuse/abuse of synthetic cannabinoids has also been associated with the manifestation of dermatological disorders, indicating the effects of the ECS on skin biology. Preclinical evidence suggests topical application of CBD products may be beneficial for skin disorders such as eczema, psoriasis, pruritis, and inflammatory conditions. However, confirmed clinical efficacy and the underlying molecular mechanisms of CBD on cosmetic improvement have yet to be fully identified. Research indicates that both Cannabinoid 1 (CB1) and Cannabinoid 2 (CB2) receptors are found in epidermal keratinocytes, cutaneous nerve fibers, dermal cells, melanocytes, eccrine sweat glands, and hair follicles. Endocannabinoids are involved in various dermatological functions, such as formation and maintenance of the skin barrier, cell growth, and cell differentiation, as well as immunological and inflammatory processes.
Because the ECS plays an important regulatory function in the skin, it is reasonable to suggest that treatment with topical cannabinoids could be efficacious for certain disorders, or for skin health in general. Not surprisingly, there is lacking research investigating the therapeutic potential for topical applications of cannabinoids. Historically, there is evidence to suggest applying CBD topically may be a viable route of administration for certain skin conditions. For example, researchers previously investigated the efficacy of topically applied CBD (1–10%) in a gel format, specifically for reduction of inflammation-associated symptoms in a monoarthritic rat model, and found that it was well absorbed - the plasma concentration directly correlated with the dose applied (dose-dependent reaction). As of 2020, no clinical trials investigating the topical absorptive capability of CBD in humans have been identified. Further work is warranted to better understand the appropriate doses and delivery methods for therapeutic CBD skin applications. The authors of this study conclude that while there is absolutely potential for CBD in the treatment of acne, seborrhea, eczema/dermatitis, and skin barrier function is promising, larger and more structured studies are needed to fully validate its efficacy.
Resources:
1) Baswan SM, Klosner AE, Glynn K, et al. Therapeutic Potential of Cannabidiol (CBD) for Skin Health and Disorders. Clin Cosmet Investig Dermatol. 2020;13:927-942. Published 2020 Dec 8. doi:10.2147/CCID.S286411
Cannabidiol (CBD) is a non-psychoactive compound derived from the cannabis plant that has gained widespread popularity in topical formulations marketed for skin health, including treatment of acne, eczema, psoriasis, inflammation, and general skin hydration. CBD interacts with the endocannabinoid system (ECS), which plays a role in maintaining skin homeostasis, including regulation of inflammation, barrier function, and sebaceous gland activity. Topical CBD products are available in the form of oils, creams, balms, and serums, often marketed as “natural” alternatives for skin soothing and anti-aging.
Mechanistically, CBD exerts anti-inflammatory, antioxidant, and sebostatic effects through interaction with CB1 and CB2 cannabinoid receptors, TRPV channels, and PPAR-gamma receptors. In vitro and small-scale studies suggest that CBD can reduce inflammatory cytokine release and lipid production in human sebocytes, indicating potential benefit in conditions such as acne vulgaris. Additionally, the antioxidant properties of CBD may protect keratinocytes from oxidative stress, theoretically supporting its use in inflammatory dermatoses and photoaging.
Despite the growing interest, robust clinical data on the efficacy of topical CBD in dermatologic conditions are still limited. A few small trials and case reports have demonstrated improvements in pruritus, eczema severity, or psoriasis-related symptoms, but most available data are preclinical or observational. Regulatory oversight of cosmetic-grade CBD products is also minimal, and product labeling can be inconsistent, with significant variability in CBD concentration, purity, and the presence of other cannabinoids (including trace THC).
From a pharmacy perspective, it is important to critically evaluate product quality, confirm the presence of third-party testing, and assess for potential interactions — particularly in patients using systemic cannabinoid therapy or immunosuppressants. While systemic absorption from topicals is generally low, cumulative exposure from multiple sources (e.g., oral, topical, inhaled) could have clinical relevance. Pharmacists should also be aware of legal status variations by state or country, especially when advising patients on travel or online purchases.
Patient counseling should emphasize realistic expectations, potential skin irritation or allergic reactions, and the importance of choosing reputable brands with certificate of analysis (COA) documentation. Patients with moderate-to-severe inflammatory skin conditions should be advised that CBD should not replace evidence-based medical treatments but may be considered as a complementary approach under appropriate supervision. As interest in cannabinoid-based dermatologic care continues to grow, pharmacists are well positioned to guide safe, evidence-informed use of CBD products while staying current with emerging clinical data and evolving regulatory frameworks.
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