Seth Singer of Salem, Oregon, was diagnosed with psoriasis at 18. After years of topical steroids, phototherapy, and countless dermatologist appointments, he decided to try a different approach to managing the condition.
“Treatment was tedious, and I was constantly looking in mirrors to see if my eyebrow had a huge flake in it,” says Singer, now 27. “It felt like insanity — three years of using ointments every day and being a regular at the dermatologist’s office and I only achieved a heightened sense of paranoia and insecurity.”
Singer turned to products derived from CBD, the component of cannabis that does not produce a “high.” Today, he uses topical and ingestible CBD products as part of his daily psoriasis treatment routine and is CEO and founder of Muddy Boot Botanicals, a wellness company based in Salem that sells CBD products.
As a treatment for certain skin disorders, CBD has been drawing a lot of attention. “There’s general interest in the dermatology community — and more and more patients in recent years are asking about CBD,” says Adam Friedman, MD, professor and chair of dermatology at George Washington School of Medicine and Health Sciences in Washington, DC.
Studies echo a growing interest in both prescribed and over-the-counter CBD for dermatology and research shows a high level of support among dermatologists.
Although CBD products are widely considered safe, “few studies have been performed on humans using CBD, which makes it challenging to determine whether or not CBD can offer improvement,” says Geeta Yadav, MD, a dermatologist and the founder of Skin Science Dermatology, in Toronto, Ontario. “And while there are many potential benefits to CBD treatment, further study is needed, as is regulation.”
How CBD Works to Help Treat Psoriasis
CBD is a nonintoxicating cannabinoid (a compound found in cannabis and hemp) that has been studied for years for its medicinal properties.
CBD interacts with the endocannabinoid system in the body which, among other functions, is involved in regulating inflammation, according to Dr. Friedman. The body continuously produces endocannabinoids, and CBD, as a similar cannabinoid, can bind to the same receptors.
“We know certain cannabinoids bind to receptors in the human endocannabinoid system that are responsible for inflammation and can downregulate an inflammatory response,” says Dr. Yadav. One endocannabinoid in particular, anandamide, can help inhibit the rapid growth of skin cells in the epidermis called keratinocytes, which is a key aspect of psoriasis, she adds.
??Research points to the idea that CBD may help reduce inflammation and relieve overall joint pain and discomfort. “[CBD] is a promising adjuvant or supplementary treatment,” says Yadav. “CBD may help reduce plaques and improve the quality of life for those managing psoriatic disease, and in some cases reduce the discomfort caused by psoriatic arthritis.”
CBD may also help relieve stress and anxiety. Studies show a strong relationship between psoriasis and anxiety and depression, with the relationship often causing a damaging cycle of flares caused by emotional stress and emotional stress being worsened by successive flare-ups.
In a study published in September 2020 in Cannabis and Cannabinoid Research, CBD was shown to decrease anxiety, which can trigger physical symptoms of psoriasis. “We know cannabinoids can have a positive effect on wound healing, and it’s possible if you improve someone’s skin disease, anxiety and frustration goes down overall,” says Friedman. “Chronic inflammation can make you feel down and low energy and have an impact on almost every organ system — so when you remove inflammation, you may feel better.”
How to Choose and Use CBD for Psoriasis
Friedman notes people who may be the best fit to try CBD for treating psoriasis are those who haven’t seen results with conventional therapies, have a fear of other invasive treatments, or are looking for a natural alternative or complement to conventional treatment.
“Psoriasis can be challenging to treat because it can affect so many aspects of a person’s life,” says Yadav. “Newer targeted prescription therapies like biologics can be safe and clear the skin, but that doesn’t take away the lifestyle factors that can trigger psoriasis like anxiety and stress.”
CBD comes in many forms — edibles, oils, ointments, tinctures, and more. Each has different potential physical and mental benefits that cater to individual needs in regards to the percentage of CBD, type of product, and frequency of use.
It’s crucial to note not all products marketed as CBD treatments are made of pure CBD, nor do all products accurately list their percentages and ingredients.
Concern arises from the lack of current approval from the U.S. Food and Drug Administration and related oversight. “CBD is not regulated in the United States, meaning products formulated with CBD are not subject to testing, including testing that would accurately determine the percentage of CBD in the formula,” says Yadav. “This makes it challenging to find products that are of medical quality.”
Another problem arises with companies that add other ingredients to their products that may trigger a negative reaction. Some people, for example, may experience an allergic reaction to vapors or contact dermatitis from topicals.
“It’s important to make sure there are no impurities in what you buy,” says Friedman. He recommends checking the Department of Health website in your state that covers medical marijuana and cannabis to learn more about products and companies.
Some clinical trials have also found evidence that high concentrations of CBD may have the potential to damage the liver. But these are preliminary findings and the doses of CBD found to affect the liver were extremely large, according to Friedman. “Over-the counter CBD or what’s sold or recommended from an oral CBD perspective — usually 500 milligrams once or twice a day — is well below the threshold where they saw liver complications in clinical trials.”
There’s little doubt CBD has potential as a supplementary or alternative treatment for psoriasis. That said, it’s important to do your own research, speak to your doctor, and only use well-researched products that fit your lifestyle and treatment goals.
“It’s not buyer beware, it’s buyer be mindful,” says Friedman. “Be a conscientious buyer — know what you need to ask and think about when you’re buying these products.”
Seth Singer stresses that while CBD has not been a cure-all, it’s become an important part of his treatment. “I do my best to learn about my own body and approach treatment from a holistic, guided approach. I believe it is a variety of good choices, not just CBD, that’s fueling my ability to ward off flare-ups and heightened achiness.”