The range of conditions that can benefit from cannabis-related treatments is truly remarkable. Among others, the effects on skin disease deserve special attention, as skin conditions can often be difficult to address and have a huge impact on our quality of life. It is also worthwhile to gain an understanding of the unique relationship between cannabinoids and human skin in order to understand how deep the connection between these healing agents and our bodies runs.
Discovery of tetrahydrocannabinol, or THC, in 1964 led to the discovery of the endocannabinoid system (ECS). ECS is a very complex and comprehensive system present in all vertebrates. It controls and modulates such diverse functions as digestion, memory, cognition, mood, immune response, inflammation, pain, appetite, bone growth, sleep, blood pressure, protection of neural tissue, among many others. The ECS includes chemicals called endocannabinoids, like anandamide (AEA) and 2 AG, enzymes involved in the manufacturing and breaking down of these endocannabinoids and receptors like CB1, CB2, etc. Chemicals which act on these same receptors, but are produced by plants, are called Phyto cannabinoids. Cannabis is a Phyto cannabinoid. Man-made, synthetic cannabinoids also act on the same receptors of the ECS.
Studies show there is a fully functional ECS in our skin. This skin ECS is implicated in functions like production, maturation and programmed death (apoptosis) of various types of skin cells; production of sebum or lipid from the sebaceous gland in the skin; hair growth; and it is linked to hormones and other chemicals involved in the protection not only of skin, but also the underlying tissues and cells. Skin ECS therefore controls the proper balance between different components of our skin, to prevent or fix any pathological or disease-causing issue. Disruption of this delicate balance leads to diseases of the skin like acne, dermatitis, psoriasis, systemic sclerosis and cancer.
Skin is made up of different layers. The outermost layer is called the epidermis. This layer is made of cells which provide the waterproofing and barrier to infection, there are other cells which make us feel the sensation of touch and pressure, and cells of the immune system. The second layer is called the dermis. This contains the connective tissue and is composed of collagen, elastic fibers and other fibers that are part of the architecture of skin. This layer is also home to hair follicles, sebaceous glands and sweat glands. It is rich in blood vessels and nerves. The third layer is the hypodermis. This layer has fat cells, fiber producing cells and cells to fight infection.
Preclinical studies (done on animals) have shown very exciting results. Using those results and data, we can say that cannabis-based medicines or medicines affecting the ECS can be very helpful for many skin-related problems. Here are a few of the highlights, separated by disease type:
Cancer: Data shows ECS inhibits excessive cell growth, induces programmed cell death and prevents formation of new blood vessels. All of these features can make cannabis-based medicines increase the level of ECS, which are very effective against skin cancers.
Psoriasis: ECS blocks excessive production of skin cells and therefore increases the levels of ECS by using Phyto cannabinoids or synthetic cannabinoids. These can potentially be a very good therapy for psoriasis, which is characterized by uncontrolled, excessive production of keratinocytes.
Dermatitis and other Inflammatory conditions: ECS decreases inflammation and calms down the immune response. Increasing ECS tone would therefore be really beneficial for these skin conditions.
Dry Skin: Application of formulations containing cannabinoids which stimulate the CB2 receptors in the sebaceous glands or augmenting the skin production of endocannabinoids might act as novel therapeutic tools to fight abnormally dry skin by increasing the production of sebum or lipid from sebaceous glands.
Hirsutism or unwanted hair growth: ECS suppresses hair shaft growth. So, more ECS might be helpful for removing excessive and unwanted facial hair.
Alopecia or hair loss: For these conditions’ compounds working to block the ECS and decreasing its tone might be beneficial.
Acne: Decreasing the endocannabinoid levels, decreases or inhibits the production of sebum or lipid and as excessive sebum is the main reason for acne, agents blocking the CB2 receptor in the sebaceous gland can be healing.
As mentioned, most of these findings are from animal studies, but nevertheless they give us plenty of data to work on and think about. In the near future when more human studies are available, I’m certain medicines which modulate the endocannabinoid system will change the way we treat skin disorders.
Dr. Sayed Shah is a Board-Certified Integrative Medicine/Functional Medical Doctor and is a Medical Cannabis Expert. He is the Co-Founder of Mandala Integrative Medicine.