QIs there a need for CBD in dermatology?

Aaron Farberg, MD

Aaron Farberg, MD

Dermatologist and Mohs Surgeon
Baylor University Medical Center
Dallas, TX

Cannabidiol (CBD) is a phytocannabinoid from the cannabis plant, without the hallucinogenic properties of delta(9)-tetrahydrocannabinol (THC). Cannabinoids exert effects via a series of G-protein coupled receptors, primarily cannabinoid receptor 1 (CB1, found in the stratum spinosum and stratum granulosum) and cannabinoid receptor 2 (CB2, found in stratum basale), resulting in inhibition or activation of keratinocyte proliferation, sebum production, hair production, and inflammation. There are also novel cannabinoid receptors known collectively as the non-CB1/CB2 receptors or orphan receptors. Over the last few years two important receptors have been identified—GPR55 and GPR18. Activation of GPR18 by N-arachidonoylglycine (a metabolite of the endocannabinoid anandamide) leads to apoptosis of inflammatory leukocytes thereby dampening local inflammation. GPR55 is expressed in the central nervous system and has been identified as a possible target for the treatment of inflammation and pain. 

Cannabinoids have demonstrated anti-inflammatory and antipruritic properties and may have a role in the management of atopic dermatitis, allergic contact dermatitis, and pruritis. One study found CB1 agonists decreased mast cell recruitment and histamine concentration in the bloodstream.1 CBD has also been shown to inhibit the migration, proliferation and cell maturation processes involved in Th12, Th1, and Th2 immune responses and induce a state of anergy via the Erg2 pathway leading to reduced T-cell activity. CBD may also inhibit inflammatory responses due to the addition of IL-17A or IFN-c, not only leading to decreased inflammation but also improved skin barrier adherence by reducing IFN-c mediated inhibition of long-chain fatty acid ceramide production in the skin. Another study found showed 38% of patients using a topical CBD-containing cream had complete resolution of itch and 81% had complete reduction of xerosis2 while another study found that a CBD-derivative reduced erythema, pruritus, lichenification, and dryness associated with atopic dermatitis by 58.6% in pediatric patients with atopic dermatitis after 4-6 weeks of use.3 

Certainly, more studies are needed to better understand how and where CBD can be used in dermatology. CBD may prove to be a more “natural” therapeutic option for dermatology patients seeking a holistic approach to their skin health needs. 


  1. Nam G, Jeong SK, Park BM, et al. Selective cannabinoid receptor-1 agonists regulate mast cell activation in an oxazolone-induced atopic dermatitis model. Ann Dermatol. 2016;28(1):22–29 
  2. Szepietowski JC, Szepietowski T, Reich A. Efficacy and tolerance of the cream containing structured physiological lipids with endocannabinoids in the treatment of uremic pruritus: a preliminary study. Acta Dermatovenerol Croat. 2005;13(2): 97–103. 
  3. Eberlein B, Eicke C, Reinhardt HW, et al. Adjuvant treatment of atopic eczema: assessment of an emollient containing Npalmitoylethanolamine (ATOPA study). J Eur Acad Dermatol Venereol. 2008;22(1):73–82.