CBD is best known from oil under the tongue, but topical applications exist too: ointments, balms and creams for the skin. Does that work? What do we actually know about the role of CBD in skin conditions? In this article, an honest overview of what research shows so far, and what we do not know.
The endocannabinoid system in the skin
To understand why research is being done into CBD in relation to the skin, it helps to know first what the endocannabinoid system (ECS) is.
The ECS is a system of the body’s own that was discovered in 1992 and has been researched worldwide ever since. It consists of receptors (CB1 and CB2) spread throughout the body, and of signalling compounds the body makes itself. The receptors occur in the brain, the immune system, the digestive tract and in the skin, among other places.
Cannabinoids from the hemp plant, including CBD, can act on this system. That the ECS in the skin plays a role in processes around inflammation and skin cell function has by now been reasonably well described in research. What this means exactly for the topical use of CBD in skin problems is the subject of active research.
CBD and acne: what does research say?
Acne is the most common skin condition, especially in young adults. It arises through a combination of overproduction of sebum, blocked sebaceous glands, bacteria (particularly Cutibacterium acnes) and local inflammation.
Pre-clinical studies (on laboratory cultures of sebaceous gland cells) suggest that cannabinoids can influence both sebum production and inflammatory processes. The best-known paper on this is by Oláh and colleagues (2014, published in The Journal of Clinical Investigation). Clinical studies in people with acne are still limited and small-scale. A review in JAMA Dermatology (2019) concluded that the current body of evidence is still too thin to recommend CBD as an acne therapy.
Anyone with acne who is considering treatment would do well to consult a GP or dermatologist first. For moderate to severe acne, proven treatments are available.
Eczema and psoriasis
Eczema (atopic dermatitis) and psoriasis are chronic, partly hereditary skin conditions that can lead to dry, itchy or flaky patches. Neither can be cured, but both can be kept under control with the right treatment. A dermatologist is the appropriate healthcare professional here.
Research into topical CBD in eczema and psoriasis exists, but is still limited. An Italian pilot from 2019 among people with these conditions reported improvements in self-reported hydration and itch scores after applying CBD ointment twice a day for three months. The study had no control group, so it is difficult to attribute the effects to CBD specifically as opposed to the ointment base or other factors.
As with acne: do not use CBD as a replacement for regular treatment. Discuss with your dermatologist whether something can be an addition and what you can expect.
Skin ageing and collagen
Skin ageing arises among other things through declining production of collagen and elastin, two proteins that keep the skin firm and elastic. UV radiation, smoking and oxidative stress speed up this process.
Research into topical CBD and skin ageing is still at an early stage. Pre-clinical studies suggest antioxidant properties of cannabinoids, but large-scale human studies comparing CBD creams with existing anti-ageing treatments are lacking at this point. Anyone looking for effective anti-ageing would do better to look at proven ingredients such as retinol, vitamin C and sun protection.
Skin infections: see a doctor first
With skin infections such as impetigo, ringworm or an inflamed hair follicle, CBD is not an alternative to medical treatment. Bacterial, viral or fungal infections of the skin belong with a GP or dermatologist. Do not try to treat these yourself with supplements.
What if you want to try CBD skincare?
CBD products for topical use are legally available in the Netherlands. They are cosmetic products or food supplements, not medicines. If you want to try something for mild skin complaints and you do not have an active skin condition that needs treatment:
- Test on a small patch of skin before you use it on a larger area, to rule out any irritation.
- Choose products that are transparent about their composition: percentage of CBD, carrier ingredients, any additions.
- Keep your expectations realistic. CBD ointment is not a miracle cure, and what one person experiences, another does not.
- If in doubt or with active skin problems: go to a GP or dermatologist first.
Frequently asked questions
What does research say about CBD and acne?
May I use CBD ointment for eczema or psoriasis?
What does research say about CBD and skin ageing?
Can I use CBD ointment on a skin infection?
Does CBD ointment have side effects?
Sources and further reading
- Oláh A. et al. (2014). Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. The Journal of Clinical Investigation: jci.org
- Eagleston L.R.M. et al. (2018). Cannabinoids in dermatology: a scoping review. Dermatology Online Journal: escholarship.org
- Dutch Society for Dermatology and Venereology: nvdv.nl
This article is informative and not medical advice. For complaints or questions about your skin, consult your doctor or dermatologist. CBD is a food supplement or cosmetic product and not a replacement for medical treatment.
