Jason E. Hawkes, associate professor of dermatology at UC Davis Health, sees more patients with psoriasis interested in cannabidiol (CBD) as an alternative or complementary treatment for their condition.
Are skin creams with cannabis extract and infused CBD oil safe alternative skin care treatments? In this Q&A, he answers questions about the safety and effectiveness of using CDB to treat psoriasis or reduce its symptoms.
What is psoriasis?
Psoriasis is a chronic, inflammatory condition related to the body's immune system. When immune cells become disrupted in psoriasis patients, they cause red, scaly patches on the skin and inflammation throughout the body.
Up to 30% of patients with psoriasis also have psoriatic arthritis with symptoms such as morning stiffness, fatigue, swollen fingers and toes, joint pain and nail changes. Psoriasis patients also have an increased risk of other conditions such as heart disease, stroke, kidney disease, sleep and breathing problems, depression and anxiety, high blood pressure, diabetes and obesity.
What is CBD and can it help with psoriasis?
Cannabis is a plant that contains more than 80 biologically active chemical compounds known as cannabinoids that have a range of biological activities in the body, including anti-inflammatory, antioxidant and psychological effects.
Despite many highly effective topical and systemic treatments for psoriasis, many patients still suffer from chronic itching and pain. They also face the stigma and psychosocial consequences of having a highly visible skin condition. It is therefore not surprising that patients with this disease have sought relief through a variety of alternative treatment options, including cannabis-based products such as CBD.
The medical community has only just discovered the tip of the iceberg regarding the potential benefits and risks of cannabis-derived products. The biochemical impact of CBD on the body must be carefully considered. The effects are determined by many variables, including the method of delivery to the body (topical application, inhalation, oral ingestion), dose or concentration of the cannabinoid, or the specific chemical(s) isolated from a particular plant strain.
Still, it's a very reasonable assumption that the potentially beneficial psychological (e.g., anxiety reduction) and anti-inflammatory effects of cannabinoids could help alleviate psoriatic conditions.
How do cannabinoids like CBD affect the body?
Like CBD, delta-9-tetrahydrocannabinol (THC) is a common cannabinoid isolated from the cannabis plant. However, CBD and THC have different properties and vary greatly in their perceived effects on the human body. Both compounds can act in place of the body's own cannabinoid system – known as the endocannabinoid system.
THC and CBD interact with receptors in specific tissues or the nervous system to influence a wide variety of physiological effects. Cannabis products can help reduce the impact of symptoms and complaints such as pain, itching or sleeping problems in psoriasis patients. Medical research can help unravel the complex mechanisms by which cannabinoids such as CBD or THC affect health and modulate biological systems such as the immune response.
Overall, CBD seems to retain many of the biological effects of THC, without the "high" most people associate with THC or marijuana. This key difference has led many companies or research groups to study and develop pure CBD products that may be more desirable for patients who wish to avoid or cannot tolerate the stronger psychoactive effects of THC-based products. This difference has also made CBD a popular choice among consumers trying cannabis-based products for the first time.
What are the risks of using CBD products?
The risks of CBD and other cannabis-derived products in patients with psoriasis and other inflammatory skin diseases have not been carefully studied. This is an unmet need that deserves continued attention and research. Nevertheless, previous clinical studies are informative and suggest that psoriasis patients should be aware of possible risks.
Several studies have linked CBD and other cannabis-derived products to worsening heart disease, obesity and diabetes, fatty liver disease, or an increased risk of surgery to treat inflammatory bowel disease. Psoriasis patients should be aware of the psoriasis-related symptoms and possible aggravation with cannabis products. Side effects are more likely with systemic or high dose intake.
Are there clinical studies on the use of CBD in psoriasis and other skin inflammations?
No. There is a need for controlled clinical trials or at least prospective patient registries or databases to collect information. This allows monitoring of the potential risks and benefits of CBD and other cannabis products for the treatment of psoriatic disorders.
The medical community needs to think creatively about ways to evaluate and determine the safety and effectiveness of CBD products for specific conditions. We need to increase our knowledge of CBD and other cannabinoid derivatives.
What should patients with psoriasis do when considering CBD?
Doing research is important. Patients considering holistic or alternative forms of medical treatments for their chronic conditions should have open conversations with their healthcare provider to better navigate the cannabis landscape. Looking for transparent ingredient lists and products with a good brand reputation is also important before trying CBD.
Until we have more substantial, comprehensive information about the potential effects cannabis products have on human physiology, we encourage psoriasis patients to seek resources from established medical organizations and patient advocacy groups to make informed decisions. The National Psoriasis Foundation (NPF) is currently working on issuing guidelines for psoriasis related to cannabis use.
Read more health.ucdavi.edu (Source, EN)