Scientific Confidence Grade	Effect Size Rating	Editorial Note
C	**	CBD might reduce acne by addressing its underlying causes, such as sebum overproduction and inflammation. However, there’s a lack of conclusive, high-quality evidence.
There are only two human studies.	CBD may significantly improve acne.

 

CBD for Acne: Can It Help? (January 2021)

Researchers believe CBD may be able to treat acne. However, its benefits have only been demonstrated in two relatively small human studies.

 

Cannabidiol (CBD) products are most commonly used to relieve pain, calm anxiety, and improve sleep. Yet, many people also take it for other conditions, including acne.

 

This isn’t surprising as there’s growing interest in natural alternatives to prescription medications, which are often ineffective or come with notable side effects.

 

Evidence from test-tube and early clinical studies suggests that CBD may help reduce acne when applied directly to the affected skin.

 

Does CBD work? What’s the ideal way to use it? Here’s a closer look at CBD for acne, the research evidence, dosage recommendations, and other helpful tips.

 

Acne Overview

Acne (acne vulgaris) is a common skin condition where your hair follicles become clogged with sebum and dead skin cells, causing pimples to form. Sebum is the oily, waxy substance produced by your sebaceous glands to protect and moisturize the skin.^[1]

 

Acne typically affects the face and forehead but can also occur on other parts of the body that have many sebaceous glands, such as your chest, upper arms, and upper back.

 

Acne can be caused by bacteria, inflammation, and excess sebum (oil) production. It’s most common in teenagers because puberty causes a rise in androgen (sex hormone) levels, which stimulate sebum production, but can also occur in other age groups.

 

It’s estimated to affect about 9.4% of the world’s population, making it the 8th most common health disorder in the world.^[2]

 

Acne Subtypes

Acne can vary in severity from mild to severe. Generally speaking, you can divide it into two types based on the kind of blemishes it produces: noninflamatory and inflammatory.^[3]

 

• Noninflammatory acne: the most common type of acne, which produces noninflammatory pimples: whiteheads and blackheads.
   
• Inflammatory acne: a more severe type of acne which produces inflammatory lesions: papules, pustules, nodules, and cysts. It can also be called cystic acne when cysts are the primary type of lesion involved.

 

Acne Symptoms & Pathology

Most commonly, acne causes pimples which can either be whiteheads or blackheads.

 

Whiteheads form when sebum and dead skin cells clog up the opening of a pore, creating a white or flesh-colored blemish. Blackheads are similar, except the opening of the pore doesn’t get clogged, so the material inside reacts with oxygen and turns into a black color.

 

Meanwhile, more serious forms of acne can cause inflammatory lesions marked by visible redness:

 

• Papules, which look like small, tender red bumps
• Pustules, which are papules filled with pus
• Nodules, which are large, solid, painful lumps under the skin
• Cysts, which are soft, painful, pus-filled lumps under the skin

 

Can CBD Help With Acne?

Early findings from test-tube studies suggest that CBD may help reduce different kinds of acne.

 

In the most notable study on the subject, researchers applied CBD to isolated human sebocytes: the skin cells that produce sebum.

 

CBD reduced the production of lipids that form sebum, proliferation (increase in number) of sebocyte cells, and inflammation. The combination of the lipostatic, antiproliferative, and anti-inflammatory effects led the researchers to conclude that “CBD has potential as a promising therapeutic agent for the treatment of acne vulgaris.”^[4]

 

Other studies have also reported that CBD can affect the differentiation and proliferation of keratinocyte cells.^{[5] [6]} Since keratinocytes also play a role in acne formation by contributing to plugging pores, this suggests another way that CBD might be beneficial.

 

Additionally, research has shown that CBD has specific yet mechanistically elusive antibacterial effects.^[7] Further studies may reveal how its antibacterial properties work which could potentially be used against P. acnes, a bacteria that can play a role in acne.^[8]

 

Further, CBD has well-documented anti-inflammatory effects,^[9] which may be particularly helpful for more serious, inflammatory types of acne.

 

It’s also important to note that applying CBD for acne topically rather than using CBD oil or other internal products (i.e. CBD edibles) seems to be the best way to use it. That’s because topical application allows CBD to interact directly with the affected parts of the skin.

 

The Endocannabinoid System and Your Skin

Ongoing research continues as scientists are examining how CBD can help with acne and other skin conditions by interacting with your endocannabinoid system (ECS).

 

The ECS is a network of cannabinoid receptors, endocannabinoids made in the body (anandamide and 2-AG), and special enzymes.

 

The main role of this recently discovered system is to maintain homeostasis, a healthy state of balance in your body.^[10] Researchers are continuing to shed light on how this state of balance is achieved. They speculate on the many possible processes that the ECS could have a hand in regulating such as inflammation and skin function. ^[11]

 

In particular, research indicates that the ECS influences the growth and activity of many different types of skin cells, including sebocytes, the cells that make up the sebaceous glands which play a central role in acne.^[12]

 

For example, a cell culture study showed that the CB2 endocannabinoid receptor is expressed in certain sebocytes and plays a role in the regulation of the lipids (substances that make up sebum). They also revealed that the endocannabinoids anandamide and 2-AG were present in their sebocyte cell cultures and concluded that, through the CB2 receptor, these endocannabinoids dose-dependently promoted sebum production and cell death.^[13]

 

There’s also evidence that ECS dysfunction may be involved in numerous skin conditions, including acne.^[14]

 

All in all, we can see that the ECS may play an important role in skin health. Other clinical studies have already shown some of the ways that CBD interacts with our ECS (e.g., suppressing an enzyme that breaks down the endocannabinoid anandamide).^[15] More research will continue to unveil how CBD can support the ECS in therapeutic treatment for various conditions including acne.

 

What Does the Research Say?

There are few human studies of CBD for acne but the findings are optimistic.

 

In one study, 20 people with psoriasis, eczema, or scarring from these conditions applied CBD ointment daily for 90 days. Some of the study participants also had scarring from acne.

 

After 90 days, one of the reported effects of the gel was the improvement of acne scars. The researchers attributed this to CBD’s anti-inflammatory and anti-proliferative effects.^[16]

 

Unfortunately, this study didn’t have the most rigorous design and was primarily focused on other skin conditions.

 

Aside from that, there’s an active clinical study looking at the effects of a pure, synthetic topical CBD preparation called BTX 1503 on people with acne.

 

Preliminary clinical findings from a 4-week safety trial in 21 people with moderate-to-severe acne reported that this CBD-based drug was well-tolerated and significantly reduced the number of both nonimflammatory and inflammatory acne lesions as effectively as other FDA-approved drugs.^[17]

 

These findings are promising and seem to confirm the results of research done on isolated cells. Still, larger and more high-quality research is needed before confirming that CBD can be used effectively and safely across populations suffering from acne.

 

How Much CBD Should I Take for Acne?

Due to the scarcity of research, there’s no recommended CBD dosage for acne. On top of that, the ideal amount of CBD to take can vary between individuals based on body weight, genetics, acne severity, and the type of product being used.

 

That’s why health experts recommend to “start low and go slow” with cannabinoids like CBD.^[18]

 

You can begin with a CBD dose of 10-15 mg (or the amount recommended by your product) and see how you respond.

 

If there’s no improvement after several days, you can try gradually increasing the dose and assessing the effects until you find the amount that works for your acne.

 

Having said that, this is a bit more tricky to do when dealing with topical CBD products — the preferred way to use CBD for acne.

 

For one thing, it can take longer than other conditions to see if the product is having a positive effect. Also, it’s not as easy to increase your dosage when using a topical product.

 

You may have to try out CBD products with varying potencies before you settle on one that has a positive effect on your acne.

 

You will also need to estimate how much CBD you’re using by either checking the product label or dividing the total amount of CBD in the product by its volume.

 

For example, if a 30 ml cream contains 300 mg of CBD, that means one ml of product will provide a 10 mg dose.

 

Are There Any Side Effects?

According to extensive research, CBD is a very safe, well-tolerated skin care substance.

 

Although researchers have noted that CBD can cause side effects, most of them are considered mild and only occurred in studies using relatively high doses of pure cannabidiol.^[19]

 

More importantly, when you apply CBD topically, it’s highly unlikely to absorb deep enough to enter your blood vessels.

 

This means topical CBD products have a very low chance of causing the same side effects reported in studies of oral CBD preparations such as capsules.

 

Still, it is theoretically possible for other ingredients in topical CBD preparations, like terpenes or fragrances, to cause allergic reactions or other side effects.^[20]

 

Conclusion

Early research demonstrates CBD’s potential to reduce acne.

 

In particular, there’s some evidence that CBD may target the underlying causes of acne, such as overproduction of sebum and inflammation.

 

Coupled with CBD’s apparent safety, that’s great news for people with both moderate and more severe, inflammatory types of acne.

 

It’s best to apply topical CBD in the form of creams and other products when dealing with acne, although finding the right dosage may take some experimentation.

 

Still, rigorous clinical research is lacking, so we can’t say for sure that CBD can improve acne. We’ll need to wait for results from more high-quality studies, such as the trial of the synthetic topical CBD preparation that’s currently underway.

 

If you plan to take CBD for acne, it may be in your best interest to do so alongside traditional acne medicines. However, be sure to speak to your dermatologist prior because hemp extract may have negative interactions with these substances.

 

References