Cannabis is a promising alternative treatment for eczema, but perhaps not in the way you may think. Rather than using preparations derived from the cannabis plant, much of the research has focused on compounds similar to the cannabinoids produced by our bodies, known as endocannabinoids.
Studies show that topical products containing these cannabinoid-like substances are surprisingly effective at relieving various types of eczema and itching.
These findings underscore the critical role of a well-functioning endocannabinoid system in maintaining skin health. Moreover, emerging research suggests that malfunctions in this system contributes to eczema and many other skin disorders.
Research on eczema and cannabis
Topical preparations based on compounds related to our body’s cannabinoids can improve different types of eczema and itching. Here’s a look at the key findings.
- One 2014 study looked at the effects of two endocannabinoid-like compounds, PEA and AEA, on 60 people with asteatotic eczema. These substances are produced by the body alongside endocannabinoids and can also be derived from other natural sources. Compared to standard cream, one infused with PEA/AEA resulted in significant improvements in itching, hydration, dryness, scaling, redness, and other measures of skin health.
- A similar 2008 study involving 2,456 children and adults found that PEA cream significantly improved the symptoms of eczema. Study participants also reported better sleep, and 56% completely stopped using steroid creams.
- Meanwhile, a 2007 study of 43 children and adults with eczema compared the effects of steroid cream plus moisturizer to steroid cream plus a PEA cream. The participants applied both treatments on different sides of the body. The PEA treatment cleared up eczema faster than the steroid-only group and prolonged the time until a new eczema flare-up.
- Another 2005 study compared the effects of dietary hemp seed oil (which doesn’t contain cannabinoids) or olive oil on eczema. The hemp seed oil treatment improved symptoms of eczema and increased body levels of essential fatty acids, while the olive oil did not.
- Furthermore, a 2007 study reported that a PEA cream significantly reduced itching in nearly two-thirds (64%) of the 22 participants with lichenified eczema and other itch-related conditions.
Finally, there’s anecdotal evidence from eczema sufferers who smoke cannabis, but the results are mixed. Some have reported an improvement of inflammation and other symptoms, others noted no significant effect, and some have reported increased itching.
CBD and Eczema
Cannabidiol (CBD) may also help with eczema.
One 2019 study looked at the effects of a topical CBD-infused ointment on 20 people with psoriasis, eczema, and scarring resulting from these conditions. They used the ointment daily for 90 days, resulting in the improvement of skin elasticity, hydration, psoriasis symptoms, scarring, blemishes, papules, pustules, and other measures of skin health.
There’s also evidence from cell culture studies that CBD can affect the immune system responses involved in eczema.
Additionally, CBD is known to increase anandamide levels in the body. Since anandamide has been shown to reduce itching and has other beneficial skin effects, such as lowering inflammation, this suggests another way CBD can potentially alleviate symptoms of eczema.
Aside from this, multiple studies show that CBD can reduce anxiety, depression, and sleep problems. These issues are more likely to occur in people with eczema and can also cause flare-ups and worsen existing symptoms.
How cannabis works on eczema
The endocannabinoid system (ECS) exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.
The ECS is present throughout the body, including the skin. Research suggests that it plays an important role in skin health by regulating key processes, including inflammation, skin cell growth, proliferation (replication), and differentiation (changing from one type of cell to another).
There’s also evidence that endocannabinoid system dysfunction may contribute to skin disorders such as eczema.
This was illustrated by a 2007 mouse study of allergic contact dermatitis. Whereas healthy mice showed no signs of an allergic reaction to nickel, those without endocannabinoid receptors had an intense reaction characterized by scratching and skin ulceration.
Similarly, mice missing one of the two cannabinoid receptors (CB1 or CB2) had a more severe reaction to an allergen than healthy mice. Furthermore, mice lacking the enzyme that breaks down the endocannabinoid anandamide had an even milder reaction.
In addition, compounds that activated cannabinoid receptors reduced the allergic reaction, but those that blocked the receptors made it worse.
The researchers concluded that “these results demonstrate a protective role of the ECS in contact allergy in the skin and suggest a target for therapeutic intervention.”
Meanwhile, the researchers of a 2006 study applied an irritant to the ears of mice to simulate irritant contact dermatitis.
The resulting swelling was accompanied by a significant increase in levels of the endocannabinoid 2-AG. However, applying a compound that blocked the CB2 receptor decreased ear swelling. The scientists concluded that the CB2 receptor and 2-AG play an important role in the skin’s response to allergens and irritants.
Research also suggests that the endocannabinoid anandamide reduces itching, as demonstrated by a 2009 mouse study.
Combined with the endocannabinoid system’s regulation of stress and immune system function, two other processes involved in eczema, this evidence helps explain why cannabinoid-based topical products can be so effective.
Using cannabis for eczema
There’s great promising evidence that cannabinoid-based preparations can relieve eczema, but what’s the best way to use them? There’s no evidence that smoking cannabis or using pure tetrahydrocannabinol (THC) has any benefits for eczema.
Instead, the main option supported by clinical research is topical products containing palmitoylethanolamide (PEA) and other endocannabinoid-like compounds.
Topical CBD products, which are more widely available, can also be used, but there’s less research evidence available. The option with the least evidence is adding hemp seed oil to your daily diet.
Nonetheless, more research needs to be done to figure out the ideal formulation and dose of cannabis and cannabinoids to treat eczema.
Potential side effects of cannabis use
None of the major human studies of cannabinoid-based topical preparations for eczema have reported any serious side effects. In fact, the only mention of a side effect was mild skin stinging in two children noted in a 2007 study.
This is likely because topical cannabinoids cannot penetrate deep enough into the skin to reach the bloodstream.
Similarly, the only study of dietary hemp seed oil did not report any negative effects.
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