Medical cannabis for eczema
Eczema (dermatitis) is an inflammatory skin condition that can cause the skin to become dry, itchy, and red. Some people use cannabis to help ease eczema symptoms, including inflammation and discomfort.
What is eczema?
Eczema (aka “dermatitis”) is a condition that is usually triggered by allergens (contact dermatitis), skin irritation, stress, hot or cold weather, and poor blood flow from the veins. Atopic eczema is the most common form of eczema. Eczema is a common condition that usually starts in childhood and, in some, continues into adulthood. An estimated 245 million people worldwide suffer from dermatitis (as of 2015). In the U.S., dermatitis affects 10% and 30% of people. Other types of eczema include:
- Neurodermatitis
- Dyshidrotic eczema
- Nummular eczema
- Seborrheic dermatitis
- Stasis dermatitis
It is possible to have more than one type of eczema simultaneously.
Brief summary of current treatments
Antihistamines, oatmeal baths, coconut oil, moisturizers, manuka honey, and capsaicin cream may treat eczema.
How might medical cannabis help?
Cannabis may help eczema, as the skin contains endocannabinoid receptors which interact with phytocannabinoids and possibly help prevent itching.
Cannabinoids also have an immune system modulating effect, which could help prevent the release of cytokines and therefore prevent inflammation. Some suggest that THC may suppress allergic reactions by activating CB1 receptors. The cannabis plant also contains several cannabinoids and terpenoids that have antimicrobial properties.
Cannabinoids
- THC can help reduce pain.
- CBD has anti-inflammatory properties.
- CBG can calm inflammation
Cannabinoid ratios
There is little information on what THC:CBD ratios might be effective for eczema. Some may benefit from a more CBD-rich product like THC:CBD 1:2 or above, whereas others may require the opposite.
Terpenes and Terpenoids
- Pinene has antimicrobial properties that could help prevent skin infections.
- Beta-caryophyllene has stress-busting, painkilling (analgesic), and anxiolytic (anti-anxiety) effects.
- Myrcene: has relaxing and sedative effects that could aid sleep.
- Linalool: has relaxing and anti-inflammatory effects that could help reduce swelling.
Flavonoids
Evidence suggests that “flavonoids (plant molecules) can help to rebalance the immune system and be beneficial for people with eczema.” Quercetin may be particularly effective “through anti-inflammatory and antioxidant activities along with its acceleration of wound healing via ERK1/2 MAPK and NF-κB pathways.”
Effective ways of taking medical cannabis for eczema
Routes of administration
- Topical
- Sublingual
Special formulations
As the skin is the main target of phytocannabinoid treatment, using a topical or salve is unlikely to have an intoxicating effect. Using a THC-rich transdermal patch does have intoxicating and psychoactive effects, however.
Dosing methods
- Topical cream or salve
- Oil-based tincture
- Transdermal patch
What are the pros and cons of medical cannabis for eczema?
Potential Pros
- Cannabinoid-based medications – particularly topical creams – could be an adjunct or alternative to steroid-based creams and moisturizers and work well alongside treatments such as coconut oil.
- Pinene has significant antibacterial and anti-inflammatory properties, so it can help prevent skin infections in those with eczema.
- Alternatives to NSAID-based anti-inflammatories are needed for many.
- THC applied to the skin may help prevent contact dermatitis.
- CBD may help manage joint pain and inflammation.
Potential cons
- Some people may be allergic to cannabis (or, at least, one or more of the terpenes or other compounds in cannabis), meaning that contact dermatitis is possible with cannabis as well.
- So far, most studies are on animals and tissue samples in labs, not people.
Useful Anecdotal Information
Forand, Rebecca L. “Patients with eczema open to OTC cannabinoid products.” Healio, April 15, 2022
Downey, Andrea. “HIGH HOPES Medical CANNABIS could help ease the agony of psoriasis and eczema.” April 18, 2017
Scientific Data Overview and Studies
- Total Studies = 10 (eczema)
- Positive Studies = 9
- Inconclusive Studies = None
- Negative Studies = 1
- 4 Meta-Analyses (3 positive, 1 negative); 1 Animal Study (positive); 2 Human Trials (both positive); 3 Lab Studies (all positive)
- 3 studies include CBD (all positive)
- Possible Overall Efficacy: Moderate
- Total Studies = 18 (psoriasis)
- Positive Studies = 17
- Inconclusive Studies = 1
- Negative Studies = None
- 11 Meta-Analyses (10 positive, 1 inconclusive); 3 Animal Studies (all positive); 4 Lab Studies (all positive)
- 6 studies include CBD (all positive); 2 studies include THC (both positive); 2 studies include CBG (both positive); 1 study includes THCV (positive)
- Possible Overall Efficacy: Moderate
Quotes from Studies
“Phytocannabinoids are promising drugs in the treatment of psoriasis due to their effects of inhibiting the proliferation of keratinocytes while also modulating the associated inflammatory component [123]. In human skin cultures, synthetic CB1 agonist arachidonoyl-chloro-ethanolamide (ACEA) inhibited keratinocyte cell proliferation in situ, while decreasing K6 and K16 expression in organ cultured human skin samples [81]. The beneficial effects of phytocannabinoids THC and CBD in psoriasis are the conversion of the pro-inflammatory Th1 profile to an anti-inflammatory Th2 type expression, and the anti-proliferative properties on keratinocytes; however, these effects seem predominantly mediated through PPARγ, independent of CBs, demonstrated by sustained results in CB1 and CB2 blockades on human papilloma virus (HPV)-16 E6/E7 transformed human skin keratinocytes cultures [124].”
Source: Scheau, Cristian et al. “Cannabinoids in the Pathophysiology of Skin Inflammation.” Molecules (Basel, Switzerland) vol. 25,3 652. 4 Feb. 2020, doi:10.3390/molecules25030652
“The topical administration of CBD ointment, without any THC, is a safe and effective non-invasive alternative for improve the quality of life in patients with some skin disorders, especially on inflammatory background.”
Source: Palmieri B, Laurino C, Vadalà M. “A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars.” Clin Ter. 2019 Mar-Apr;170(2):e93-e99. doi: 10.7417/CT.2019.2116. PMID: 30993303.
Conclusion
Although there is promising evidence that medical cannabis could help manage skin conditions like eczema and psoriasis, there is little beyond lab studies, a small number of human trials, and a theoretical understanding of the ECS and its function in the skin to prove its efficacy. More research is needed.
Related Articles
Does CBD Provide Any Benefits for Skin?
Allergic Contact Dermatitis and Medical Cannabis
Systemic Scleroderma and Medical Cannabis
Xeroderma Pigmentosum (XP) and Medical Cannabis
Disorders of the Skin and Subcutaneous Tissue
Skin Cancer (Non-Melanoma) and Medical Cannabis
Please note that the information in this article does not constitute medical advice.
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