By Dr. Demetria Bates, DNP, FNP-BC, CCE, and Health Coach

Cannabis topicals are products infused with cannabinoids derived from the Cannabis plant, such as CBD (cannabidiol) and THC (tetrahydrocannabinol). These topicals are designed for external use that offer medicinal therapeutic properties of Cannabis without the intoxicating effects commonly associated with its consumption.

Cannabis topicals are available in the form of creams, lotions, balms, oils, or patches that are applied directly to the skin, allowing the active compounds to interact with the endocannabinoid receptors on the skin. Cannabis topicals are gaining popularity for their potential to alleviate various skin conditions.

In this article, we are going to focus on acne and how Cannabis topicals are a promising addition to the world of natural skincare products.

The Prevalence and Impact of Acne

Acne is a common skin condition that affects people of all ages and backgrounds. Its prevalence is particularly high among adolescents and young adults. The American Academy of Dermatology Association (2023) (1) reports that at least 85% of individuals between the ages of 12 to 24 have had minor acne and acne appearing in adults age 30+ is affecting up to 15% of women.

Acne can manifest in various forms, including blackheads, whiteheads, pimples, and cysts which often lead to physical discomfort. Acne can significantly impact self-esteem and mental well-being, causing stress and anxiety for many individuals.

This skin disorder highlights the importance of innovative solutions to alleviate its physical and psychological burden.

Understanding Types of Acne

Non-Inflammatory Type

• Comedones are clogged hair follicles that contain dead skin cells, bacteria, or other materials within open (blackhead) or closed (whitehead) lesions on the skin’s surface.

Inflammatory Types

• Papules are small, red, raised lesions that are less than 1cm in diameter. 
• Pustules are closed, raised, inflamed, and filled with white or yellow-tinged pus.
• Cysts are deep, painful, inflamed, and pus-filled lesions. The primary components of acne development include excess sebum (oil) production, shedding of skin cells, the presence of acne-causing bacteria, and inflammation.

While conventional acne treatments such as topical creams, antibiotics, and oral medications have been effective for many people, they still have their limitations, including potential side effects and the need for ongoing maintenance.

If acne is left untreated, scarring may occur which results in body imaging issues, and emotional and mental distress.

Cannabis and Acne

Given these challenges in acne management, alternative approaches like Cannabis topicals have gained attention for their potential to address inflammation, regulate sebum production, and provide antimicrobial effects to manage acne and promote healthier skin.

Cannabis components such as CBD, THC, and terpenes, hold the potential for treating acne due to their interactions with the body's endocannabinoid system. CBD has demonstrated anti-inflammatory properties that can help reduce inflammation and swelling associated with acne lesions by calming the skin's inflammatory response via the endocannabinoid receptors on the skin.

The endocannabinoid system plays a significant role in maintaining skin homeostasis, barrier function, and dysregulation (Baswan et al, 2020) (2). The endocannabinoid, anandamide (AEA), has the potential to stimulate lipogenesis in human sebocytes at low concentrations and in contrast, at high concentrations can cause sebocyte cell death (Baswan et al, 2020) (2). This evidence allows us to understand that CBD may have the potential to stop sebum production in the presence of endogenous anandamide.

Endocannabinoid Receptor Distribution in Skin Structures

Research depicts that CB1 and CB2 receptors are found in epidermal keratinocytes, cutaneous nerve fibers, dermal cells, melanocytes, eccrine sweat glands and hair follicles (Baswan et al, 2020) (2). Endocannabinoids primarily bind to CB1 and CB2 receptors, however, evidence shows that these components also bind to transient receptor potential (TRP) receptors which are responsible for forming and maintaining the skin barrier, cellular growth, cell differentiation, immunity, and inflammatory regulation (Baswan et al, 2020) (2).

Therapeutic Potential: Cannabis Topicals and Their Antibacterial and Anti-Inflammatory Properties

Cannabis topicals come in various forms, such as creams, lotions, and oils making them accessible for topical application. Importantly, they do not produce the intoxicating effects typically associated with Cannabis consumption.

One study investigating the antibacterial effect of Cannabis seed extract against Propionibacterium acnes revealed complete inactivation at 20% hemp extract which indicates its ability to inhibit microbial growth (Jin & Lee, 2018) (3). Another study found that CBC (Cannabichromene), CBDV (Cannabidivarin) and THCV (tetrahydrocannabivarin) reduced lipogenesis unlike CBG (cannabigerol) and CBGV (cannabigerovarin) increased lipogenesis however, all of the phytocannabinoids demonstrated anti-inflammatory effects (Eagleston et al, 2018) (4).

Terpenes: Skin Healing and Permeation Enhancers in Acne Management

Terpenes also serve as an important component of acne management. Terpenes can be applied topically which provide wound healing, antiseptic, anti-fungal, or anti-inflammatory effects (Lasoń, 2020) (5). Terpenes act as skin permeation enhancers, meaning they facilitate the passage of cannabinoids and other components across skin layers. Click here (6) to review terpenes that are helpful for potential skin care.

How to Choose the Right Cannabis Topical for Acne

1. Identify the specific acne type and severity
2. Understand the cannabinoid profile of the product (THC, CBD, etc.)
3. Check for third-party lab testing/Certificate of Analysis
4. Identify potential side effects and precautions, especially: a. Allergies or skin sensitivities to the product ingredients b. Any interactions with other skin care products or medications used by the individual
5. Consult with a certified Cannabis educator
6. Consult with a healthcare professional or certified Cannabis educator or coach

Cannabis Topicals Represent an Exciting Frontier In The Treatment of Acne

The medicinal effects of cannabinoids offer the benefit of reducing inflammation, regulating sebum production, and combating acne-causing bacteria. These effects offer hope for individuals seeking alternative solutions to manage this common skin condition.

While more research is needed, the future looks promising for the integration of Cannabis-based skincare products for the treatment of acne and other skin conditions.

References

1.“Skin Conditions by the Numbers.” American Academy of Dermatology, www.aad.org/media/stats-numbers. Accessed 31 Oct. 2023. https://www.aad.org/media/stats-numbers#:~:text=Acne%20usually%20begins%20in%20puberty,experience%20at%20least%20minor%20acne.

2. Baswan, S. M., Klosner, A. E., Glynn, K., Rajgopal, A., Malik, K., Yim, S., & Stern, N. (2020). Therapeutic potential of cannabidiol (CBD) for skin health and disorders. Clinical, Cosmetic and Investigational Dermatology, 13, 927–942.

3. Jin, Solee, and Mi-Young Lee. “The ameliorative effect of hemp seed hexane extracts on the Propionibacterium acnes-induced inflammation and lipogenesis in sebocytes.” PloS one vol. 13,8 e0202933. 27 Aug. 2018, doi:10.1371/journal.pone.0202933

4. Eagleston, L. R., Kalani, N. K., Patel, R. R., Flaten, H. K., Dunnick, C. A., & Dellavalle, R. P. (2018). Cannabinoids in dermatology: A scoping review. Dermatology Online Journal, 24(6). Jin, S., & Lee, M. Y. (2018).

5. Lasoń E. (2020). Topical administration of terpenes encapsulated in nanostructured lipid-based systems. Molecules, 25(23), 5758.

6. Lasoń, Elwira. “Topical Administration of Terpenes Encapsulated in Nanostructured Lipid-Based Systems.” Molecules (Basel, Switzerland) vol. 25,23 5758. 7 Dec. 2020, doi:10.3390/molecules25235758

About Dr. Demetria Bates, DNP, FNP-BC, CCE

Dr. Demetria Bates, DNP, FNP-BC, CCE, is a distinguished healthcare professional with a passion for bridging the gap between Cannabis medicine and Western medicine. She is the founder and CEO of Bates Virtual Health & Consultants, LLC which provides medical card services exclusively for Virginia residents. She works with individuals seeking to understand the integration of Cannabis medicine for health and wellness.  

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Effective Cannabis Newsletter is a platform to educate on the vital role of the Endocannabinoid System (ECS) in one's health. The information is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. All content, including text, graphics, images, and information, contained in or available through this newsletter is for general information purposes only. It is not medical advice; it is health awareness.