Can CBD cure my acne? Here’s the science
By Jillian Jastrzembski
Introduction
If you’ve ever dealt with acne, then you’re familiar with the frustration of finding effective solutions – the hype, the expense, the side-effects, and the profound blow to your self-esteem.
Acne vulgaris, colloquially known as acne, is one of the most prevalent skin conditions worldwide. Consequently, there is a great deal of interest in novel, alternative acne solutions, with an emphasis on plant-based natural products. One emerging area of interest is the use of cannabinoid isolates and extracts, especially CBD.
But wait a minute – lately, it feels as if we’re being told to slap some CBD on everything: from seizures, to migraines, insomnia, autoimmune diseases, and yes, skin conditions like acne. If you’re skeptical of this “panacea,” we don’t blame you. Afterall, cannabis was only recent legalized, and there is still limited research on its therapeutic actions.
Instead of subscribing to the hype, let’s take a look at the science. What factors contribute to acne formation, and how might CBD or cannabis interfere? Here’s your objective run-down on the measurable, proven effects of CBD from the scientific literature.
What causes acne
Treatment of acne is notoriously challenging, particular because causes are multifactorial. Risk factors include genetic, hormonal, and lifestyle components, and may vary widely across individuals.
Three factors prevalent in the pathogenesis of acne are:
- Hyperkeratinization: This refers to the outer layer of dead skin cells that formed on the surface of skin to protect the tissues underneath. Individuals prone to acne often experience abnormal keratinization, which can result in blockage of hair follicles.
- Hyperseborrhea: Sebum is the natural oil produced by the skin, helping to protect and moisturize the skin. However, excessive sebum production, termed hyperseborrhea, has also been causally linked to acne. Sebum production is triggered by androgens like testosterone, the male sex hormone, which in part explains the hormonal component of acne.
- Accumulation of c. acnes bacterium: Although the presence of cutibacterium acnes is normal in healthy individuals, accumulation of this bacterium may lead to an imbalance that can contribute to acne. That’s why antibacterial agents, like benzoyl peroxide, can sometimes help to control acne. [Peyravian]
These three factors contribute together to the formation of comedones and the release of inflammatory mediators. Inflammatory hallmarks of acne include redness and swelling.
Why we’re desperate for alternative acne treatments
Conventional acne treatments are problematic due to widespread inefficacy and adverse side effects. Topical treatments, including chemical exfoliants, bactericidal agents, and retinoids, are often inadequate for moderate to severe cases of acne, and may further induce irritation to the skin. For moderate to severe acne that does not respond to topical agents, oral treatments such as isotretinoin, hormonal contraceptives, or other androgen-blockers, may be prescribed. However, many individuals are deterred from these solutions due to adverse side-effects associated with hormonal contraceptives, as well as known embryotoxic properties of medications like isotretinoin.
Can CBD cure my acne?
According to preliminary studies, CBD has the potential to modulate acne proliferation through three major mechanisms:
- antimicrobial action
- reduction of sebum
- anti-inflammatory action
Antimicrobial action
Remember how we said that accumulation of c. acnes bacterium is one key factor in acne formation? This is one reason why antibacterial agents like benzoyl peroxide can help to control acne. Well, CBD and/or cannabis extracts may have a similar action.
Researchers have investigated the antimicrobial action of CBD in isolation against several bacteria, demonstrating that CBD can inhibit growth of even highly resistant strains, purportedly via membrane impairment of the bacteria [Cohen].
Specifically with respect to acne, we have in vitro studies in which a cannabis extract reduced the inflammatory markers of skin cells challenged by c. acnes [Martinelli]. This suggested to the authors an antimicrobial effect of the cannabis extract.
Reduced sebum production
Another major factor in acne we mentioned above is the over-production of sebum, the skin’s natural protective and moisturizing oil. Sebum is produced by highly specialized skin cells called sebocytes, triggered in part by androgens (“male” sex hormones, present in both sexes) like testosterone.
One study has already shown that CBD can reduce sebocyte production in vitro; the authors also showed that CBD could inhibit lipogenesis even in cells stimulated by androgens [Cohen]. Furthermore, in clinical trials, a mixture of phytocannabinoids based on cannabis extract was able to reduce sebum production [Martinelli].
Anti-inflammatory action
Perhaps the best known – and least understood – action of CBD is its anti-inflammatory action. Part of the reason for this is that the bioactivity of CBD and cannabis is complicated, and still has not been fully elucidated. For example, CBD has limited affinity for the best studied cannabinoid receptors in the body, CB1 and CB2, so it is likely that other receptors are implicated in the anti-inflammatory action of cannabinoids [Peyravian].
To investigate the anti-inflammatory action of CBD or cannabis extracts, researchers look for inflammatory markers called cytokines, for example TNF-α and IL-1β. CBD and other components of cannabis have been shown to reduce the expression of these inflammatory markers under acne conditions, both in vitro and in vivo [Peyravian].
Ok great – what now?
If you’re convinced enough to try a little experimentation on yourself, here’s some practical advice for application.
- Use topically instead of orally: The chemistry of the skin allows for relatively easy diffusion of cannabis salves across the skin barrier [Martinelli]. This means that topical application is probably better as an acne treatment compared to oral administration.
- Experiment with formulation: The fact of the matter is, because of the limited research available, we still don’t know for sure if there is an ideal formulation for resolving acne. Out of the hundreds of compounds – and over 100 cannabinoids – found in cannabis, CBD is currently the most thoroughly researched in the context of acne treatment. That said, many of the studies discussed here were performed using cannabis extracts for which the cannabinoid profile was not fully described. Look for extracts designed for facial application, avoid comedogenic add-ins like coconut oil, and pay attention to how your skin responds.
The take-away
The (albeit, limited) research on CBD and other cannabis extracts should give plenty of hope to sufferers of acne. From what we know, CBD and other components of cannabis may inhibit acne through bactericidal properties, inhibition of sebum production, and anti-inflammatory action.
Keep in mind that many of the mechanistic studies mentioned here were performed in vitro – in other words, in a petri dish. Actual clinical research in humans is even scarcer, yet still promising. Preliminary evidence suggests that topical application from whole plant extracts may be more effective than single-cannabinoid isolates.
Though we are still short of a clinically-proven, optimal formulation, current evidence suggests that topical CBD is a safe and effective alternative acne treatment.
References
- Cohen, G., Jakus, J., Baroud, S., Gvirtz, R., & Rozenblat, S. (2023). Development of an Effective Acne Treatment Based on CBD and Herbal Extracts: Preliminary In Vitro, Ex Vivo, and Clinical Evaluation. Evidence-based complementary and alternative medicine : eCAM, 2023, 4474255. https://doi.org/10.1155/2023/4474255
- Martinelli, G., Magnavacca, A., Fumagalli, M., DellʼAgli, M., Piazza, S., & Sangiovanni, E. (2022). Cannabis sativa and Skin Health: Dissecting the Role of Phytocannabinoids. Planta medica, 88(7), 492–506. https://doi.org/10.1055/a-1420-5780
- Peyravian, N., Deo, S., Daunert, S., & Jimenez, J. J. (2022). The Anti-Inflammatory Effects of Cannabidiol (CBD) on Acne. Journal of inflammation research, 15, 2795–2801. https://doi.org/10.2147/JIR.S355489
