The Endocannabinoid System and the Skin

young woman washing face

As a health professional, a significant number of your patients will experience skin issues that may impact the quality of their treatment—be it a massage with an oil or pressing on sensitive areas of skin in any other modality.

Acne, eczema, and psoriasis are three most common problems that can affect the largest organ of the body — the skin.

Acne is the most prevalent skin condition in the USA, with an estimated 50 million people afflicted annually.

The National Eczema Association reported that around 1 in 10 men, women and children experience eczema, with the toll high both in terms of reduced physical and psychological wellbeing. In fact, one-third of sufferers report that they spend up to 3 hours each day treating this condition.

Psoriasis occurs less frequently, affecting around 2% of Americans. As with acne and eczema, this condition may bring with it physical, mental and emotional sequela.

The challenges of living with skin problems are very real. Research shows depression, anxiety, low self-esteem and decreased quality of life often result. Maybe surprisingly, this condition can also result in lost productivity. Your patients need the right support and advice or they can find themselves down the rabbit hole, chasing relief.

With that said, cannabidiol (CBD) topical creams and ointments are flooding the market. Thus your patients may be curious about how it can affect cutaneous signs and symptoms. Before we look deeper at the reports, though, it’s important to understand the endocannabinoid system as it is here where the biological merit lies.

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The Endocannabinoid System (ECS)

The Endocannabinoid System (ECS) is a far-reaching neuro-modulatory system integral to central nervous system development, synaptic plasticity, and how well the body responses to internal and external insults. Intimately involved in physical and psychological responses, we believe this incredible system doesn’t receive nearly as much attention as it deserves!

The endocannabinoid system has 4 key elements: cannabinoid receptors (CB1 and CB2), endogenous cannabinoids, enzymes that lead to cannabinoid synthesis or degradation, and cannabinoid antagonists.

We are primarily interested in the first two as these provide insight into possible therapeutic benefits.

Cannabinoid receptors (CB1 and CB2)

Cannabinoid receptors are just like any other: specific. They are the lock that awaits their distinct cannabinoid key. Cannabinoid receptor one (CB1) and two (CB2) play different roles and appear in different tissues. CB1 is found throughout the central nervous system (CNS), as well as peripheral tissues. CB2 is expressed on immune cells and in the skin.


The body’s neurotransmitters are created “on-demand” and as required. When CB1 receptors are activated, transmitter release is inhibited. Many of these receptors are continually activated by our internal cannabinoids, contributing to homeostatic balance.

Surprising skin: The cutaneous endocannabinoid system

We often think of the skin as simply a barrier; a multilayer of cells that keeps the outside, out and holds the inside, in. However, as the review, The endocannabinoid system of the skin in health and disease: Novel perspectives and therapeutic opportunities, points out, “there is a cutaneous endocannabinoid system, too.”

Its role seems firmly rooted in cutaneous health. As the article points out the ECS here controls skin cell differentiation, immune competence, proliferation, and survival. It makes sense, then, that without a system that functions optimally damage and disease may result.

Endocannabinoid molecules, including anandamide (AEA) and 2-AG, are produced by skin cells in response to need. The epidermis, hair follicles, and sebaceous glands are all able to create these compounds. The resultant activation of epidermal cannabinoid receptors contributes to a healthy skin barrier.

Cannabinoid delivery systems

CB1 receptors are mostly found in the nervous system but are also present in the skin. It is through CB1 receptors that tetrahydrocannabinol (THC), the mind-altering cannabinoid found in marijuana, moderates its psychoactive effects.

CB2 receptors, on the other hand, are mainly found in the skin, other organs, and immune cells, and respond to cannabidiol and many other cannabinoids.

Whether from endogenous or exogenous sources, it is the response of the CB1 and CB2 receptors that bring about physiological change. This means that external cannabinoids can be delivered to bring about a therapeutic effect.

Endocannabinoid system and the skin

The skin is an incredible organ!

Able to cushion against damage, protect from infective agents, regulate body temperature, and allow us to sense our environment; a healthy dermis and epidermis are essential for us to survive and thrive. With its powerful cutaneous effects, the endocannabinoid system supports its healthy function.

A review published in Dermatology Online Journal called “Cannabinoids in Dermatology” found that products containing cannabinoids may confer remedial benefits for a range of skin issues. While noting, as most articles do, the need for larger-scale and controlled trials, the authors believe this compound could benefit the skin.

Endocannabinoid system and the skin infographic

Cannabidiol (CBD) and the skin

Some studies suggest that cannabinoids can support skin health, however, The Food and Drug Administration (FDA) has not yet received sufficient research to declare a stance on these claims. Instead, it is safe to advise your patients on CBD’s benefits as an emollient.

When a compound is taken orally, it must pass through the liver before becoming available systemically. This is called the first-pass effect. The incredible liver is efficient at breaking substances down resulting in a reduced concentration of available helpful compounds.

Conversely, when CBD is applied topically, it quickly comes into contact with the skin’s cannabinoid receptors where it can be of use.

Many people suffer from skin conditions that interfere with their everyday existence and quality of life. The good news is there is hope and relief. When recommending a product to a patient with porous, damaged skin, it is important to ensure the product is natural and safe.

CBD CLINIC™ topicals relieve pain with authorized active ingredients, menthol and camphor, while also soothing the skin with CBD hemp oil, jojoba oil, and other natural emollients.

Your patients can expect to not only treat their pain but keep their skin healthy in the process.

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Disclaimer: This information is for educational purposes only. It has not been approved by the FDA to diagnose, treat, prevent, cure, or mitigate any diseases or conditions. We use CBD in our products for cosmetic purposes only.

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