Wouldn’t it be nice if pain relief were as simple as applying a cannabidiol (CBD) ointment topically? Transdermal delivery of CBD through the skin has been gaining scientific and consumer interest.
CBD is the non-psychoactive component of the hemp plant, Cannabis sativa. The human body has cannabinoid receptors throughout the central and peripheral nervous system, as well as in organs and tissues.
Administering CBD topically is appealing because it skips first-pass metabolism in the liver and degradation in the intestine. Instead, the CBD is absorbed directly into the bloodstream, where it could potentially help support a normal response to pain and inflammation.
Exploring Topical CBD for Peripheral Neuropathy
Peripheral neuropathy is a common type of chronic pain. Symptoms include numbness, tingling sensations, pain, and weakness, which usually starts in the hands and feet. Diabetes, alcohol dependence, and chemotherapy are among the top causes of peripheral neuropathy.
Current therapies for peripheral neuropathy are limited, which has inspired the exploration of alternative therapies. A small study suggests that CBD might help relieve neuropathic pain by interacting with cannabinoid receptors in the dorsal spinal cord.
In a randomized, double-blind trial, 29 adults with symptomatic peripheral neuropathy were given a CBD cream (250 mg CBD per 3-oz jar) or a placebo cream for 4 weeks. They applied the cream topically to painful areas up to four times per day. The CBD group had a significant decrease in pain and itchy sensations when compared to the placebo group.
Other Potential Uses of Topical CBD
Research exploring the use of transdermal CBD for other types of pain and inflammation is limited. However, preliminary studies suggest potential benefits of topical CBD for multiple reasons:
Joint pain — In an animal model of arthritis, CBD gel was applied topically to rat paws for 4 days consecutively. The transdermal CBD gel significantly reduced joint swelling, inflammation, and pain.
Back pain — In two published patient case reports, a transdermal CBD cream (400 mg CBD per 2-oz jar) provided significant relief from acute and chronic back pain.
Epidermolysis bullosa — This rare blistering skin condition causes itching and pain. In a review of three cases of epidermolysis bullosa, the use of topical CBD reduced blistering and pain. One patient was able to wean completely off opioid analgesics.
Palliative care — When 58 outpatients receiving palliative care were surveyed, 24% reported using CBD. Topical products and oral sprays were the most common forms used. Approximately 50% of CBD users reported less pain.
Skin conditions — In a retrospective analysis of 20 patients with psoriasis or atopic dermatitis, all patients experienced some benefits from the topical use of CBD ointment twice per day for 3 months. The benefits included reduced inflammation and improved skin hydration, elasticity, and scar appearance.
Future studies could add further support for the targeted use of transdermal CBD in inflammatory conditions. Providing topical CBD as part of a full-spectrum blend of cannabinoids, rather than using it in isolation, may enhance the benefits, which is an area also worthy of research.
By Marsha McCulloch, MS, RDN, LN
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