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Adam Friedman, MD, is well-versed in the latest and greatest in skin care. The professor of dermatology at George Washington University School of Medicine and Health Sciences is responsible for the department’s translational research program, which means he’s tasked with turning the latest dermatological science into real-world treatments or therapy.
But when people ask him about using cannabidiol (CBD) — one of several hundred chemical compounds derived from the cannabis plant — to treat their skin issues, Friedman occasionally defers to the expertise of some unlikely co-practitioners: the folks who work at marijuana dispensaries.
“I think the people working at dispensaries have anecdotal experience that allows them to make recommendations, whereas I have limited scientific evidence on which to base any recommendations,” he says of CBD-infused oils and other cannabis-derived therapies, some of which are now being promoted for skin care.
Friedman says he’s written letters of recommendation — basically, a note that allows a person to legally purchase products from a medical marijuana dispensary, so long as they have a medical cannabis card — for people with skin wounds that won’t heal or skin conditions that are not responding to conventional therapies. He says he’s not always sure what his patients are using. “But I’ve heard from many of them that it works,” he says.
“For all intents and purposes, the safety concerns for these CBD products are nil.”
It seems every week brings news that CBD may have the power to treat another medical complaint. Studies have linked CBD to anti-pain and anti-anxiety benefits, and doctors are exploring its use as a therapy for depression, irritable bowel syndrome, and many other diseases.
Friedman says he buys some of the hype. Like THC — the high-inducing molecule found in marijuana — CBD is categorized as a “cannabinoid” because it can bind to two specific receptors found in the human nervous and immune systems. Among their many jobs, these receptors play a role in communicating pain, inflammation, and itch signals throughout the body, Friedman explains.
While it’s not yet clear how best to use CBD and other cannabis compounds to treat conditions like acne, rosacea, and eczema, Friedman says he’s comfortable with some of his patients trying CBD products because the research he’s reviewed suggests the chemical is safe. “You see some case reports of allergic contact dermatitis” — basically, a skin rash — “but that’s true of any possible thing your skin could come into contact with,” he says. “For all intents and purposes, the safety concerns for these CBD products are nil.”
Friedman does note, however, that many CBD skin products — especially if sold over the counter, as opposed to through a licensed dispensary — are unlikely to contain enough active CBD to have much effect. “The likelihood that those are going to do a whole lot is very low,” he says. Fortunately, these are just the start. “CBD and THC are the two compounds we know the most about, but there are hundreds of active chemicals derived from the cannabis plant,” he says.
Cannabinoids like CBD were first identified in the cannabis plant. But experts now recognize that many of these same chemicals are produced naturally in the human body. They can also be synthetically produced in a lab, says Rukiyah Van Dross-Anderson, an associate professor of pharmacology and toxicology at East Carolina University’s Brody School of Medicine.
Van Dross-Anderson is studying the effect of cannabinoids on skin cancer cells. “These cannabinoid molecules have the ability to cause many different kinds of cancer cells to die,” she says. Specifically, certain cannabinoids seem to trigger a form of stress that kills cancer cells while sparing normal ones.
While her work is on a synthetic cannabinoid metabolite — a chemical compound that forms when a cannabinoid breaks down in the body — Van Dross-Anderson says CBD has also shown promise as a skin cancer therapy. “CBD is a great candidate for the treatment of some aggressive cancers, including melanoma,” she says. A lot more work is needed, but the promise is there.
While CBD cancer therapies are probably a long way off, Friedman says he expects the first CBD- or cannabinoid-based prescription skin treatments to target autoimmune disorders for which there are currently no good options. “I know there’s one company in phase three trials for a drug to treat scleroderma, which is an autoimmune disease where the skin becomes rock hard,” he says. Some of his own research is looking into the use of nanoparticle technology to better deliver cannabinoids to specific locations in and on the body. “I think we could also see a topical cannabinoid product hit the market soon,” Friedman says. “Something for inflammatory conditions like eczema.”
It’s possible that rubbing a CBD-infused oil on your skin could do some good, and this sort of self-treatment doesn’t seem to pose any significant risks. But it’s going to take more time and research for dermatologists to harness the full power of these cannabis compounds.
In the meantime, ask your local dispensary owner what they recommend.