How to use CBD to reduce acne

Cómo usar CBD para reducir el acné
Acne is one of the most common skin diseases with a 90% prevalence in adolescents. (1) Although it is not a dangerous disease, it can negatively affect the quality of life, especially in its most severe forms, in which social stigma can cause negative consequences, especially at a psychological level. It is known that acne has a multifactorial pathogenesis , including:
  • Young age and family history
  • Psychological stress
  • Hormonal changes
  • Eating habits and medication intake
  • Hygiene factors
The first steps in the process are the increased production of sebum (the skin's natural oil) and the alteration of its composition. These changes facilitate the obstruction of hair follicles in which acne bacteria can grow, which inflame the sebaceous glands. The alteration in the composition of sebum worsens the inflammatory state which in turn stimulates the production of more sebum, closing a vicious circle. The symptomatic consequences are the appearance of small lesions and bumps on the skin (pimples, blackheads or comedones) that can be located both on the surface and in depth, causing pain, inflammation, pus secretion and spots or scars on the skin. Normally the outbreaks appear on the face and forehead, but they also appear on the upper chest and back and on the shoulders. The most commonly used pharmacological treatments (based on isotretinoin) can lead to a considerable improvement in symptoms, but they have severe side effects. The inability to study acne in animals complicates scientific research, but in vitro studies have observed the influence of the endocannabinoid system on the production of sebum in the sebaceous glands in hair follicles.

This is how CBD works for the skin

The ECS, the physiological system dedicated to maintaining the balance of the body by influencing and modulating most of our physiological functions, is present in almost all organs including the skin. Specifically, CB1 endocannabinoid receptors are present in cutaneous nerves, in hair follicles and less frequently in nerve fibers; CB2 receptors are present in the reticular and papillary dermis, in hair follicles and sometimes in cutaneous nerves. It is also worth remembering the diffuse presence of TRPV receptors, responsible for the sensation of pain and the expression in sebaceous cells of GPR1 receptors19. In the skin, the ECS regulates different mechanisms:
  • cell growth and differentiation in the skin
  • the production of sebum, the skin's natural fat
  • the inflammatory response
In particular, the stimulation of CB2 receptors leads to an increase in sebum production, so in the case of acne they should be inhibited to try to facilitate the exact opposite effect.

Effects of CBD on acne

Considering the importance of the ECS in the skin mechanisms involved in the pathogenesis of acne, the use of phytocannabinoids can significantly improve both the appearance of acne and its signs and symptoms. In particular, the use of CBD can bring greater benefits due to its ECS modulating activity and its anti-inflammatory properties. Recent studies (2)(5) in vitro (i.e. experimentation on cellular tissues) have shown that CBD can significantly improve acne symptoms through different mechanisms:
  • Modulates and normalizes the different agents that facilitate it, such as arachidonic acid
  • Reduces sebocyte proliferation through TRPV channels
  • Modulates and reduces the body's inflammatory response
  • Acts as an antibacterial against acne bacteria
These studies have shown that not only CBD, but also other phytocannabinoids such as CBC, CBDV and THCV show a clear anti-acne effect, while CBG, on the contrary, facilitates its appearance. However, the potential of CBD is broader due to its ability to improve other factors (especially at a psychological level) that can facilitate the appearance of acne or may appear as its consequences. In particular, CBD can act:
  • Facilitating an analgesic and sedative effect
  • Modulating and normalizing hormonal activity
  • Indirectly stimulating ECS ​​activity to reduce stress both mentally and physically ? Article on CBD and stress
  • Activating 5-HT1a dopamine receptors to improve mood and improve symptoms of anxiety and depression
  • Facilitating cellular regeneration of the skin and the disappearance of physical signs such as irritations, wounds and scars.
Thanks to these effects , CBD could also be useful for diseases whose pathogenesis is similar to acne, as in the case of psoriasis, in which psychological factors (stress and anxiety) play a fundamental role.

Examples of CBD effects on acne: Clinical cases

Various clinical trials are currently underway on the use of synthetic CBD in patients with acne (10) (11) (12). The first results have revealed above all an excellent safety profile and a very significant reduction (47%) of inflammatory lesions after only 4 weeks of treatment, as well as showing a significant improvement also in non-inflammatory lesions. These results are consistent with other studies with volunteers (3)

Precautions if you are going to take it for acne

The most appropriate way to use CBD to improve acne symptoms is topically , through which the effect is concentrated only in the area of ​​application using products such as creams, ointments and oils. The advantage of external use is the possibility of acting directly on the affected area, thus increasing bioavailability and effectiveness against symptoms at a physical level. The disadvantage of external use is the lack of a systemic effect, since CBD does not enter the bloodstream, therefore it does not act against psychological symptoms or in the modulation of the hormonal system. To deal with this type of symptoms, the most recommended is internal use , specifically through the sublingual route, although in Spain it is not yet permitted or regulated unlike in other countries.

Types of acne that can be treated with CBD

External route
  • Creams, ointments: it is advisable to use a small amount (the size of a bean...) applied directly to the affected area 3-4 times a day, massaging gently to facilitate absorption.
  • Facial oil and serum: it is advisable to use a low concentration oil (maximum 3%), applying 2-3 drops directly to the affected area 3-4 times a day and massaging gently to facilitate absorption, which may be slower than with creams and oils.
Domestic route (not regulated in Spain)
  • Sublingual oil: internally, there is an optimal dosage for each person as it depends on many factors, therefore the best way is to start with a minimum dose (1-2 drops) of a low concentration oil (3% or 5% depending on the case) applied and held under the tongue for 60-90 seconds and gradually increasing the dose until the effects appear.

How to use cannabis oil for acne

CBD is a very safe substance, although when administered in high doses and continuously, the side effects are usually mild to moderate. Internally, it is important to be able to check for possible drug interactions, while with external use, it is only necessary to check that no allergic reactions occur. Therefore, it is very important not to exceed the indicated dosage to prevent such reactions from occurring. In general, it is highly advisable to consult health professionals specialized in the therapeutic use of Cannabis. Literature 1 - https://www.elmundo.es/elmundosalud/2009/03/11/pielsana/1236798867.html 2 - Oláh, Attila & Markovics, Arnold & Szabó-Papp, Judit & Szabó, Pálma & Stott, Colin & Zouboulis, Christos & Bíró, Tamás. (2016). Differential effectiveness of selected non-psychotropic phytocannabinoids on human sebocyte functions implicates their introduction in dry/seborrheic skin and acne treatment. Experimental dermatology. 25. 10.1111/exd.13042. 3 - Palmieri, Beniamino & Laurino, Carmen & vadalà, Maria. (2019). A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars. The therapeutic clinic. 170. e93-e99. 10.7417/CT.2019.2116. 4 - https://www.niams.nih.gov/es/informacion-de-salud/acne#tab-overview 5 - Oláh, Attila & Toth, Balazs & Borbíró, István & Sugawara, Koji & Szöllõsi, Attila & Czifra, Gabriella & Pal, Balazs & Ambrus, Lídia & Hundt, Jennifer & Camera, Emanuela & Ludovici, Matteo & Picardo, Mauro & Voets, Thomas & Zouboulis, Christos & Paus, Ralf & Biro, Tamás. (2014). Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. The Journal of clinical investigation. 124. 10.1172/JCI64628. 6 - Sheriff, Tabrez & Lin, Matthew J. & Dubin, Danielle & Khorasani, Hooman (2019). The potential role of cannabinoids in dermatology, Journal of Dermatological Treatment, 31:8, 839-845, DOI: 10.1080/09546634.2019.1675854 7 - Kupczyk, Piotr & Reich, Adam & Szepietowski, Jacek. (2009). Kupczyk P, Reich A, Szepietowski JC.Cannabinoid system in the skin - a possible target for future therapies in dermatology. Exp Dermatol 18:669-679. Experimental dermatology. 18. 669-79. 10.1111/j.1600-0625.2009.00923.x. 8 - Eagleston, Lauren & Kuseh Kalani Yazd, Nazanin & Patel, Ravi & Flaten, Hania & Dunnick, Cory & Dellavalle, Robert. (2018). Cannabinoids in dermatology: A scoping review. Dermatology online journal. 24. 10.5070/D3246040706. 9 - Dobrosi, Nóra & Toth, Balazs & Nagy, Georgina & Dozsa, Aniko & Géczy, Tamás & Nagy, Laszlo & Zouboulis, Christos & Paus, Ralf & Kovács, László & Biro, Tamás. (2008). Endocannabinoids enhance lipid synthesis and apoptosis of human sebocytes via cannabinoid receptor-2-mediated signaling. FASEB journal: official publication of the Federation of American Societies for Experimental Biology. 22. 3685-95. 10.1096/fj.07-104877. 10 - Zouboulis, C.(2020) Endocrinology and immunology of acne: Two sides of the same coin Experimental Dermatology 29: 840 - 859. 11 - Kircik, Leon H. (2019) What's new in the treatment of acne vulgaris. Cutis 104(01):48-52 12 - Spleman, L. & Sinclair, Rodney & Freeman, M. & Davis, M. & Gebauer, K.. (2018). 1061 The safety of topical cannabidiol (CBD) for the treatment of acne. Journal of Investigative Dermatology. 138. S180. 10.1016/j.jid.2018.03.1074.