Topical cannabis products are used to relieve pain, inflammation, and localized soreness that come both with everyday common injuries as well as more chronic, lifelong complications such as arthritis. Cannabis infused products are also used for cosmetic purposes making use of the synergistic effects of hemp oil, flavonoids, B vitamins, minerals, and natural essential fatty acids (omega 6 and omega 3) that make up the hemp plant.
Everyday uses might include an application to the skin for the itching and inflammation of a bug bite or to a wound to expedite healing. Chronic uses might be for the pain and inflammation of bursitis of the knee or shoulder or even more chronic pain that comes from old sports injuries or musculoskeletal problems. Topical uses of CBD lotions and THC infused creams are gaining wider popularity with the easing of legal restrictions of CBD products nationally under the Farm Bill and with the sales in licensed states that sell medical marijuana recreationally.
A report from the Arthritis Foundation indicates that 79% of its survey respondents from a pool of 2,600 individuals with arthritis had tried a CBD topical for relief of symptoms. Twenty-nine percent indicated that they currently used a CBD topical and 55% used a topical for their joints.
The cannabis topical industry is estimated to be worth $580 million with projections to increase to $1.7 billion by 2025.
What are Topicals?
Topicals refer to cannabis filled lotions, creams, balms, oils, bath bombs, cosmetics and transdermal applications designed to use the skin as a carrier for cannabinoid and synergistic compounds to achieve a medical or cosmetic effect. Topicals are used to relieve pain and inflammation and are said to reduce the signs of aging
Topicals come in many forms similar to oral products. Topicals can be made from full spectrum products, broad- spectrum or isolates. They may also be combined with synergistic essential oils that work with the cannabinoids to achieve the desired effects.
Topical CBD creams, muscle rubs and roll on sticks may be found here.
Strain Specific
Strain-specific topicals attempt to harness the panorama of entourage effects specific to the chemical make-up or chemovar of the strain. The cannabinoids, terpenes, fatty acids, vitamins, and minerals are all left in the topical to match the strain it is extracted from. Such strains include OG Kush, Granddaddy Purple, Blackberry Kush, Permafrost or Blueberry, for example.
Essential Oils
To add to the synergy of one chemical enhancing the effect of another chemical, frequently essential oils are added to topicals to enhance the effects desired. For example, tumeric, camphor, peppermint, and wintergreen are common synergistic additives. Not only do they penetrate the skin to create such effects as anti-itching, they can be used for aromatherapy activating a whole different set of senses. For example, inhalation of camphor dilates the bronchial tubes and makes it easier to breathe thus aiding anti-inflammatory effects.
Wintergreen, for example, increases blood circulation to an area and promotes toxin removal. It alleviates muscular and joint pains when applied to the skin. Aromatherapy of wintergreen improves asthma attacks.
Tumeric, while poorly absorbed through the gastrointestinal tract (g.i.) is better absorbed through the skin. Tumeric has the unique ability to inhibit an enzyme called phosphorylase kinase. This is an enzyme that plays a pivotal role in the injury pathway. Phosphorylase kinase is released within 5 minutes of injury and plays an integral role in wound formation and scar development. Tumeric causes a rapid replacement of damaged cells with healthy cells. Topical tumeric can heal skin injuries rapidly with little scarring. Inflammatory skin conditions such as rosacea improve (with a lactose free diet) with the use of tumeric. Suppression of the phosphorylase kinase enzyme has also been shown to be effective in resolution of psoriasis. The effects of tumeric on inflammation, scarring and psoriasis compliments those of topical cannabis.
Camphor is a terpene used for anti-inflammatory conditions A 2015 study found camphor to be effective in treating wounds and UV-induced wrinkles, thus showing its value in anti-aging cosmetics. Camphor is also effective in treating the pain of arthritis. As an aromatherapy, it can relieve coughs and congestions of a cold or flu. It may also be used for acne, hair loss, poor circulation, and muscle spasms.
What Types of Pain Can Cannabis Topicals Treat?
CBD filled topicals can treat neuropathic pain, a pain pathway governed by glutamate. CBD inhibits glutamate release which makes it neuroprotective against those prickly, tingly sensations so characteristic of neuropathic pain. Using magnesium glycinate alongside CBD may help ease these sensations even more creating a synergistic effect.
CBD also inhibits inflammatory pain as from arthritis or an injury. Cannabinoids are up to twenty times more potent than aspirins as an anti-inflammatory.
Many people choose CBD products because they are non-intoxicating, but topicals with THC in them have their benefit as well. The regular use of cannabis decreases the mind-altering effects of THC as the body gets accustomed to it and regular use potentiates an anti-inflammatory action.
A preparation of CBD was used to heal and alleviate the pain associated with the blistering of epidermolysis bullosa. In all 3 cases the patients were able to be weaned from their opioid medications.
Treating Pain with Transdermal Patches
Transdermal application of THC is a good way to relieve pain with minimal central nervous system effects. CBD administration transdermally has also shown good anti-inflammatory, pain relieving effects. A 5:1 transdermal salve can be found here. When THC is left in its acid form and combined with CBD the two work together to get rid of inflammation and the pain that comes with it.
Transdermal patches are available with a variety of cannabinoids present, CBN, THCA, CBN, and/or THC and can come in split ratios such as 5 parts CBD and 1-part THC. For example, a person with inflammation may want a high CBD content while someone with insomnia will want a high CBN product. This is another reason to become familiar with the minor cannabinoids and their medicinal effects.
Transdermal doses allow a steady state of doses to be delivered over a prescribed course of time.
Transdermal patches take the medication through the skin’s barrier and into the bloodstream thus affecting the endocannabinoid system more directly. Transdermal delivery routes have shown better bioavailability than oral or other forms of topical doses. And, there is not the peak drug value as with orals, it is more of a steady state delivery system.
Types of Cannabis Topicals
Full Spectrum: Full spectrum products contain all the chemicals from the original plant including THC, CBD, minor cannabinoids, terpenes, etc.
Broad Spectrum: Contains the full spectrum product without the THC.
Isolate: Product contains the purified CBD and/or THC without the rest of the plant. It is the purest formula but not necessarily the best.
How Does Cannabis Work Topically?
The cosmetic and skin care industry is interested in cannabis care because the keratocytes (specialized skin cells) present in the skin have both CB1 and CB2 receptors for phytocannabinoid interaction. Theories are that cannabinoids affect the wheal and flare in inflammatory conditions or by reducing pain and discomfort associated with a wide range of skin conditions.
Cannabinoids suppress excess keratinocyte growth and differentiation and promotes the sloughing of dead skin cells. They also effect the suppression of damage-induced keratins that may have relevance to psoriasis.
CB2 stimulation in keratinocytes evokes the release of analgesic opioid peptides.
Cannabinoids exert anti-inflammatory effects in the skin through both their actions on keratinocyte cytokine production and their regulation of immune cells. But not all the anti-inflammatory effects depend on CB1 and CB2. For example, THC can inhibit both T cell production of interferon induced keratinocyte release of the cytokines and chemokines even when CB1 and CB2 receptors are not present in an animal model. T-cells are involved in immune responses.
CB1 and CB2 receptors are also found on hair skin follicles, and skin nerve fibers. Receptors are like doorways for chemicals to attach to and create changes by binding to these receptors like a key fitting into a lock. Once the receptor is “activated” by binding to it or changing it in some way, a cascade of events may occur.
The Endocannabinoid System and the Skin
We know that CB1 and CB2 receptors are in the skin, nerve fibers, keratocytes, and sebaceous glands, but so is the entire endocannabinoid system (ECS) consisting of the receptors, endocannabinoids and enzymes that regulate them. Endocannabinoids are the natural cannabinoids the body makes as opposed to phytocannabinoids that come from plants. Phytocannabinoids can modify and interact with the ECS creating change. THC is a CB1 and CB2 receptor agonist. CBD is a CB1 and CB2 antagonist.
The various functions the ECS are involved in involve the control of the growth of the epidermis (outer skin layer), cell survival, inflammatory processes, the transmission of signals of pain and itching to the central nervous system, and the production of fats among others.
The ECS regulates epidermis differentiation and suppresses the formation of a crop of cross-linked proteins of dead cell tissues which tend to pile up on the skin surface. These dead cells lead to eczema and psoriasis.
The localized hair follicle and the sebaceous gland can be regarded as the brain of the skin because it controls a wide array of biological functions of this organ as does the ECS. Recent studies have suggested that the ECS may even regulate the hair follicle/sebaceous gland unit.
We speak frequently of agonists of the ECS system and antagonists. Agonists refer to those substances that enhance a receptor’s activity and antagonism is when you have a substance that blocks the receptor and its actions. THC is a CB1 agonist and causes decreased hair growth. CBD modifies the CB1 receptor making THC less effective. For example, a CB1 antagonists may cause hair to grow giving a potential role for CBD in stimulating hair growth and THC for hirsutism or excess hair growth.
ECS and Tumor Growth
CB1 and CB2 agonists inhibit tumorigenesis. This suggests that the cutaneous ECS, as in other organs, may affect tumor or malignant cell growth and death. These offer a promising area of research but for now, cannabis topicals are used to treat the pain of cancer rather than the growth of cancer cells.
ECS in Allergic, Inflammatory and Fibrotic Functions
The ECS has many immune functions such as the suppression of inflammatory cytokines, chemokines, pro-inflammatory chemicals, and nitric oxide during the inflammatory process. Despite controversies, the general consensus is that the ECS has a protective function in acute and chronic inflammatory diseases. THC applied topically inhibits inflammation. Decreased skin fibrosis and inflammation was observed in another study.
A recent 2019 study showed the application of a topical CBD ointment to an inflammatory skin condition where scarring had taken place improved the appearance of the skin and the quality of life for the patient.
An effect on the genes governing inflammation was found in another study that used CBD topically to treat inflammatory skin diseases. The extract used in this study inhibited inflammatory chemicals from being released.
ECS and Pain and Itch
Synthetic CB agonists and/or endocannabinoids exert potent analgesic effects in both humans and animals by activation of CB1 and or CB2 and possibly TRV1 at sensory nerve cells and/or inflammatory cells. The best CBD lotions for inflammation can be found here.
Research on 21 patients with chronic itching who applied cannabis cream twice per day had significantly less itch in 8 patients.
ECS and Psoriasis
Data shows that the ECS manages skin tone and inhibits cell growth while inducing cellular death therefore it is logical to think that it has a role in psoriasis. At present there is little evidence that cannabinoids can cure psoriasis, but the fact that some phytocannabinoids (cannabinoids from plants) inhibit the growth of keratinocytes independent of the CB1 and CB2 receptors gives inspiration that further study is warranted.
ECS and Acne and Seborrhea
In a recent study CBD exerted a unique “trinity of cellular anti-acne actions.” Namely, it
- Normalized the pathologically elevated fat generation induced by “pro-acne” agents
- Suppressed cell proliferation and
- Prevented the activation of proinflammatory cytokines in a type of universal anti-inflammatory effect.
Besides the above, it showed a significant anti-bacterial effect.
The effects on acne in this respect are not considered to be necessarily of ECS origin but of universal origin such as in the case of having excess testosterone as a pro-acne agent.
ECS and Dry Skin
Applications of topical formulations containing cannabinoids that stimulate CB2 and/or augment the local production of endocannabinoids or inhibit their breakdown (such as CBD) might act as novel therapeutic tools in treating dry skin due to enhancing fat production in the sebaceous glands. It is also important to note that dry skin is a major problem in many inflammatory skin conditions, and psoriasis.
ECS and Dermatitis
Topical formulations that enhance the cutaneous ECS tone may have therapeutic values in dermatitis. A recent pilot study on 20 children suffering from atopic dermatitis showed an 80% increase in symptom resolution after application of a topical emulsion containing an endocannabinoid analog.
The TRP Ion Channel, Cannabinoids and Skin
Every cell in the body expresses at least one TRP channel subtype. TRP channels have been implicated in many physiological processes ranging from pain, temperature sensation, and regulation of neurotransmitter release. Accordingly, TRP dysfunction has been led to many disease states. TRP channels are like microscopic thermometers. TRPV1, V2, V3, V4 and V8 are all receptors involved in cannabinoid balance and regulate everything from dermatitis to pain temperature, to itch perception, to pain perception and hot/cold sensations. Not all actions of topical cannabinoids can be explained by CB1 and CB2 interactions and some of the mechanistic effects of cannabinoids act through the TRP ion channels either through activation or inhibition.
TRPV1
TRPV1 is a predominant receptor in the peripheral sensory neurons and is probably one of the best known TRP channels. It is activated by painful stimuli as well as itching. Animal studies have linked TRPV1 to both atopic dermatitis and allergic contact dermatitis. CBD acts via these
receptors and TRPV4 receptors to have an anti-seborrheic, anti-proliferative activity in acne prone individuals.
How Does Topical CBD Reduce the Signs of Aging?
Research has shown CBD and THC to be powerful antioxidants, more powerful than vitamins C and E. Antioxidants can help to halt the aging process by interrupting the damage caused by free radical generation, almost impossible to avoid in todays environment filled with pollution, second-hand smoke and just oxidation of lipids naturally occurring on the skin.
Cannabinoids also interfere with the deposit of melanin, a darkening pigment. Cannabinoid products can be used to lighten and brighten the skin.
Free radicals cause collagen to break down faster so ultimately antioxidants help to prevent the breakdown of collagen. The ECS is partially responsible for this oil production that promotes skin breakdown which is why some evidence suggests that cannabinoids are beneficial in managing dry skin but an overactive ECS may not be beneficial to acne.
Hemp seed oil, often included in cannabis infused topicals, also come with a host of antioxidants and skin boosting nutrients. They are rich in omega-3 fatty acids and vitamins A, C, and E. Hemp seed oil does not contain any phytocannabinoids.
Beauty and skincare products especially designed with anti-aging in mind may be found here. These products are designed to have a non-comedogenic effect (blocked pores that lead to acne). Many have synergistic moisturizers in them such as shea butter and grapeseed oil. Some products have additional collagen for a plumping effect and an added anti-wrinkle action.
The choice of a unique cannabinoid product depends on what you want to use the product for, the type of product you want to use and the dose you want to achieve. For example, with a transdermal patch it is easier to control a large dosage than it is with a topical ointment and the effects are faster and steadier with the transdermal.
