H09 Is cannabis use in dermatology topical? Reviving the historical highs

Abstract

Abstract Cannabis refers to product derived from a plant species known as Cannabis sativa. The plant contains cannabinoids, two of the most prominent being tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive component in cannabis, while CBD, discovered by chemist Roger Adams in 1942, is nonpsychoactive. Cannabis with high THC levels is referred to as marijuana. With global policy changes and government approvals, CBD has recently garnered significant interest due to increased awareness of its therapeutic potential. This surge in demand has fuelled the multi-billion-dollar global CBD market with projections of sustained growth in the future. The use of cannabis for medicinal purposes has a rich history, dating back to ancient civilizations. From traditional Chinese medicine using cannabis preparations for rashes to ancient Egyptians using it for wounds to Arab traditional medicine using it to treat lichen planus, the therapeutic benefits of cannabis have been widely recognized throughout history. Sir William O’Shaughnessy, an Irish physician, discovered the therapeutic properties of cannabis in India in the 19th century and led to its widespread use in Europe and North America. However, in the early 20th century, cannabis was banned in many countries as part of a movement to control the use of addictive substances. The discovery of the endocannabinoid system in the late 20th century marked a turning point in the understanding of how cannabinoids interact with our bodies. This intricate network, made up of endocannabinoids, cannabinoid receptors and enzymes, regulates pain perception, metabolism, circadian rhythm, immune system, and more. Preclinical evidence supports the therapeutic potential of topical CBD for dermatological inflammatory diseases such as acne and eczema, as well as skin cancer (Lowe H, Toyang N, Steele B et al. The endocannabinoid system: a potential target for the treatment of various diseases. Int J Mol Sci 2021; 22:9472). The accumulation of evidence supporting its therapeutic potential has led to a change in societal and cultural perspectives toward cannabis, resulting in the UK government’s approval of limited medicinal use in 2018, as well as the opening of the nation’s first legal cannabis farm in 2021. In 2018, Epidyolex® (cannabidiol) became the first US Food and Drug Administration-approved medical-grade CBD for treating rare forms of epilepsy. Cannabis’ potential therapeutic properties offer a promising outlook for cannabis-based medicine in dermatology. While CBD’s lipophilic nature and its instability in solution pose challenges for its transdermal delivery, ongoing research and study may offer solutions. It is imperative that dermatologists stay informed about CBD advancements as its growing availability and potential indications are likely to drive its popularity.