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dermatologist in cbd

Dermatologist in cbd

Safety is an important consideration for patients using CBD oil. Using CBD topically is unlikely to cause any problems, but it is hard to know which products have the purest CBD. Taking CBD orally could result in a positive drug test. Altough CBD itself will not cause a positive drug test, CBD products can be contaminated with trace amounts of THC—too low cause psychotropic effect, but enough to cause a positive test.

Chances are that at least one patient has asked you about cannabidiol or CBD oil lately, and it’s likely that even more are using CBD oil to treat or prevent a host of ailments, including some skin conditions. But what, if anything, do we know about these uber-popular products?

CBD Oil and Skin Conditions

If a patient says that a friend or family member is using a product and it is working great for them, I advise the patient to try that product if they wish. A website called independently tests supplements and recently published a report on CBD oil. These tests are looking at what is in the product—not whether it “works”—but they did identify some top picks (see sidebar).

CBD or cannabidiol is found in both marijuana and hemp (two varieties of the same plant species: Cannabis). Unlike the better known compound in Cannabis, tetrahydrocannabinol (THC), CBD is not psychoactive, meaning it cannot get you “high.” Cannabis that is bred to have high THC levels is known as marijuana, while cannabis bred to have low to no THC is called hemp. Put another way: CBD is found both in hemp (CBD concentration varies from low to high, THC concentration is less than 0.3%) and marijuana (CBD concentration varies from low to high, THC concentration is greater than 0.3%).

CBD 101

Evidence suggests it is theoretically possible that CBD oil does something for skin; most of the optimism is based on the recognition that there are Type 2-cannabinoid receptors in the skin. These cannabinoid receptors have demonstrated numerous in vitro activities on keratinocytes. However, CBD has not been shown to activate the Type 2-cannabinoid receptor. Any activity in the skin is likely driven by activating or blocking receptors in the Transient Receptor Potential vanilloid (TRPV) family.

Dermatologist in cbd

24. Ward SJ, McAllister SD, Kawamura R, Murase R, Neelakantan H, Walker EA. Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT(1A) receptors without diminishing nervous system function or chemotherapy efficacy. Br J Pharmacol. 2014;171(3):636-645.

The mind-body connection is especially relevant to dermatology. There is ample evidence that sleep disorders, anxiety, and depression can adversely impact dermatologic disorders. A vicious cycle can occur because the dermatologic disorders can exacerbate anxiety, depression, and sleep. Several studies demonstrate CBD’s utility in these psychological conditions.

There is a current lack of evidence that CBD is effective for the treatment of anxiety. However, one small study of 24 individuals with Social Anxiety Disorder (SAD) (compared with 12 control patients) was conducted where participants were treated with CBD (versus placebo in the control group) prior to a simulated public speaking task. 41 The CBD treatment group performed better than controls with significant decrease in anxiety, cognitive impairment, and hyper-alertness. Pretreatment with CBD reduced the anxiety level in the patients with social anxiety to near that of healthy controls during the simulated public speaking task. In addition, there is a single case report of a 10-year-old child with post traumatic stress disorder who was refractory to traditional psychiatric medications and was treated with 25mg of CBD orally at night to help with sleep as well as 6-12mg of CBD orally during the day for her intermittent anxiety with dramatic symptom reduction. 42

The Mind-Body Connection

29. Gaikwad R, Deshpande S, Raje S, Dhamdhere DV, Ghate MR. Evaluation of functional impairment in psoriasis. Indian J Dermatol Venereol Leprol. 2006;72(1):37-40.

Sleep: Sleep disorders are very common in inflammatory dermatoses. 25 For patients with atopic dermatitis, sleep disturbance—most commonly due to nocturnal pruritus—correlates with disease severity, and adequate disease control needs to address the sleep disorder. 26 Additionally, approximately 60 percent of patients with psoriasis have sleep disorders. 27-30 Patients with hidradenitis suppurativa (HS) were also found to have sleep disturbances; 40 percent had insomnia and 70 percent were considered poor sleepers. The presence of itch and pain were correlated with their sleep disorders, 31 which demonstrates the complex interaction between itch, pain, and sleep.

A Brief History of Cannabis

When an online survey was given to over 500 dermatologists in October 2019, more than 50 percent of respondents described patient-initiated cannabis discussion. However, 81 percent of dermatologists were uncomfortable with their knowledge of cannabinoid biology. Older dermatologists were more willing to prescribe cannabinoids. 1 The visible (inflammation, redness, and sun damage) and invisible (pain, itch, sleep, and anxiety/depression) impacts of dermatologic diseases are common reasons patients inquire about CBD, as there are many sources (both reliable and unreliable) endorsing the effectiveness of cannabidiol for these maladies. This paper serves to bridge the gap between dermatologists’ knowledge and patients’ curiosity.

33. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.