This article was Medically reviewed by Roni Sharon, MD and originally published by The Cannigma.
Acne is a painful and emotionally challenging skin condition, but research suggests that cannabis may be able to help. While the data is still limited, studies show that the endocannabinoid system is actively involved with the health of skin, and in regulating factors involved in acne such as inflammation, pain, and sebum production.
In addition, research suggests that stress may both cause and be caused by acne, creating a vicious cycle. Since medical marijuana can also help reduce stress, it can potentially aid in acne treatment through this route as well.
How cannabis works on acne
When it comes to acne, the endocannabinoid system definitely seems to play a role. For one thing, receptors from the endocannabinoid system, called CB1 and CB2, can be found throughout our skin, so both our internal cannabinoids, and those found in cannabis are likely to have an impact on the skin.
In studies on the endocannabinoid system, researchers have noted many ways in which this system can impact our skin, such as regulating certain skin cells, reducing or increasing inflammation, production of hair, and production of sebum (that oily stuff produced by your skin).
Regulating the production of sebum is one particularly relevant function for the treatment of acne, since overproduction can cause acne. Some studies show that endocannabinoids like anandamide, which stimulate CB1, can both increase sebum production at low levels, and decrease it at higher levels. Other studies looking at whether endocannabinoids can help in treating acne have found that stimulating CB2 receptors can also suppress sebum production.
Another important aspect of acne is inflammation. And some have noted that manipulating CB2 receptors can both exaggerate or inhibit inflammatory responses in the skin. This could mean that targeting CB2 could be an effective strategy for reducing skin inflammation.
The endocannabinoid system is also able to regulate pain sensation throughout all the stages of pain processing. Activating CB1 reduces pain signals and our perception of pain. Stimulating CB1 receptors can even modify the emotional pain component of suffering. This could be extremely helpful for the pain associated with acne — as it can be both physically and emotionally painful to endure.
To add to this, the endocannabinoid system also plays a key role in regulating stress response, and stress is another factor associated with acne. Stress can cause worsening acne, and then acne can cause worsening stress. It’s a vicious cycle. Still, stimulating CB1 receptors may help to reduce stress and thus help make acne more manageable.
Research on acne and cannabis
While the research on how the endocannabinoid system impacts acne shows that cannabinoids do have the potential to effect important acne factors, we need to look at the research on cannabis for acne to see what it can really do.
Unfortunately, the research on medical marijuana and acne is limited at this time. We don’t have the kind of clinical studies we’d like to see — but we do have some information that suggests cannabinoids may be able to help with acne. We just need more research to confirm these findings.
One area that has been studied is cannabis’ impact on inflamed and itchy skin. And happily, researchers have found that cannabinoids in cannabis have the ability to reduce these symptoms. For example, THC, the most common and plentiful cannabinoid in the plant was able to reduce inflammation in both animal and human models, when applied topically to the skin. This both reduces inflammation and eases itch.
Cannabis also contains terpenes, chemicals responsible for the smell and flavor of cannabis, as well as some medicinal effects. And certain terpenes may contribute to cannabis’ anti acne effects. For example the terpene limonene (which is also found in citrus) and pinene (which is also found in pine needles) have been shown to inhibit Propionibacterium acnes, a key pathogen in acne. Linalool (a terpene also found in lavender) is also able to help by providing anti-inflammatory effects. When used topically, these could provide additional support for acne — but more research is needed to learn the best and most effective ways to utilize these terpenes.
As mentioned above, stress can also cause worsening acne, and then acne can cause worsening stress. So cannabis’ ability to relieve stress can be a key factor in how it might help.
In studies on cannabis and stress, researchers have even found that cannabis intake can cause blunted stress reactions for those undergoing stressful stimuli. It should be noted that with THC varieties of cannabis, researchers found that using low dose options worked best to relieve stress, while high doses of THC left people feeling more stressed. This might be due to the potential biphasic effect of cannabis, where a substance (such as THC) can produce opposite effects — depending on the dose consumed.
To add to this, multiple reviews of the literature on cannabis and pain have found that cannabis is extremely effective as a pain reliever. While there aren’t studies on acne pain specifically, it is likely it could reduce the pain from acne as well.
CBD and acne
When it comes to CBD, research also suggests that it might be helpful in treating acne. It turns out that CBD may help to reduce sebum production — a root cause of acne. CBD has also been shown to reduce inflammation of the skin, and aid in pain relief. Since it is able to be absorbed directly into the skin, this could make it an ideal topical solution for acne.
To add to this, CBD can help to reduce stress when taken in edible or inhaled forms. In one study on CBD, researchers gave some participants with social anxiety CBD before a public speech, and others a placebo. Those who used CBD had significantly reduced anxiety, cognitive impairment, and discomfort during their performance — suggesting that CBD is also able to blunt anxiety and stress responses.
While the evidence above suggests that cannabis can help with acne, some researchers have pointed out that cannabinoids may also have negative impacts on skin. Since the endocannabinoid system works by maintaining homeostasis — or balance — in our system, it often has biphasic effects. This is no different. While cannabinoids can have anti-inflammatory effects, they have also been able to increase inflammation in some studies. THC may also cause reduced hair growth.
Other than that, the side effects of cannabis are generally mild and can include symptoms like impaired coordination, light-headedness, mild difficulties in concentration and memory, racing heart, increased appetite, nausea, dry mouth and eyes, and fatigue.
In addition, cannabis may interact negatively with some drugs — slowing their metabolism and thus increasing the amount present in the bloodstream. Those taking other medications should consult with a doctor before beginning cannabis use.