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This article is based on reporting that features expert sources including Matthew Halpert, PhDLuis Enrique Liogier-Weyback, MD

Do Topical CBD Products Work?More

EVERYWHERE YOU TURN these days, there seems to be a topical product with CBD. From lotions and creams to salves and serums, the addition of CBD appears to be the latest trend in health care and skin care. But are topical CBD products truly effective?

The answer is still not clear, although some people appear to find pain relief from them. Plus, it’s a buyer-beware situation, due to the explosion of CBD-containing topical products that may not have exactly what they advertise.

Short for cannabidiol, CBD is one of more than 100 cannabinoids in the cannabis sativa plant. (THC is the cannabinoid that gives marijuana its high.) Because of its purported health benefits, you can now find CBD in food, drinks, lotions and a whole host of other products. By definition, CBD products contain no more than a 0.3% concentration of THC – thus CBD products won’t cause a “high” feeling.

How Are Topical CBD Products Used?

One of the biggest uses for topical CBD products is for musculoskeletal complaints. A 2019 report from the Arthritis Foundation found that 79% of the 2,600 arthritis patients surveyed had considered using CBD or had already used it. Twenty-nine percent said they currently used it for arthritis symptoms; among those using CBD, 55% used a topical product applied to the joints.

That’s exactly why Eileen Donovan of Ayer, Massachusetts, uses her CBD lotion. She has osteoarthritis that causes regular aches and pains, and she tried a variety of other oils and pain-relieving patches. She also realized that she’s allergic to nonsteroidal anti-inflammatory drugs, or NSAIDs, which led her to find other sources for pain relief. “I’ll put it on and walk away and think, ‘I don’t have any pain,’” she says. Donovan applies her CBD lotion to her joints about twice a day.

In addition to arthritis, topical CBD products are geared to help people with eczema and psoriasis, says Samantha Morrison, a cannabis researcher at Glacier Wellness, a CBD company in Cedarhurst, New York.

You’ll also find CBD cropping up frequently in cosmetics and skin care products, says Dr. Luis Enrique Liogier-Weyback, an urgent care and men’s wellness physician in Boca Raton, Florida, and founder of the medical cannabis practice Mobile Medicine. These products may claim that the combination of CBD with the other ingredients fights skin aging or that they are anti-inflammatory.[ 

Do Topical CBD Products Work?

Topical CBD products can help address pain or inflammation that’s at a specific area of your body, such as on the joints. The product won’t enter the bloodstream. So a topical CBD product isn’t designed to address systemic problem, but it may help directly on the skin.

Reliable topical CBD products don’t just mask pain or inflammation as some over-the-counter topical pain relief creams do. They actually can make the pain go away for a certain time period, says Matthew Halpert, an instructor of immunology at Baylor College of Medicine in Houston. This is because of the high concentration of cannabinoid receptors on the skin. Cannibinoid receptors are part of the body’s endocannabinoid system, a body-wide system discovered in the 1990s that affects many important functions.

Cannabinoid receptors are present throughout the body and are associated with pain sensation, appetite, immune function, mood and more. The chemicals produced by the body that interact within the EC system are called cannabinoids, and like THC and CBD, they interact with cannabinoid receptors.

Research done by Halpert, in collaboration with the company Medterra CBD in Irvine, California, has found that CBD is able to turn down the production of inflammatory markers like tumor necrosis factor alpha, which is made in overabundance by people who have conditions like rheumatoid arthritis.

Another study published in the journal Pain in 2017 found that prophylactic treatment with CBD stopped pain and hindered the development of more pain in rats with osteoarthritis. However, a group of international rheumatologists concluded in a 2019 report in Expert Reviews and Clinical Immunology that more research is needed into the long-term effects of CBD and other cannabis-related products for rheumatological conditions.

In a small study with 20 patients published in 2019 in Clinical Therapeutics, a CBD ointment used over three months for psoriasis, atopic dermatitis and scars significantly improved symptoms and signs of the skin disorders. As with any small study, larger studies could help confirm results.

The effect of CBD may also vary from person to person. Some find it helps, while others don’t. For instance, a February 2019 study published in Scientific Reports found that cannabis products with higher THC levels were associated with greater symptom relief among more than 3,000 people, but CBD products (with no THC) were not.

Yet overall, more research needs to be done to find out how effective all CBD and cannabis-derived products are, according to conclusions from a large 2017 report done by the National Academies of Sciences, Engineering, and Medicine.[ 

Are CBD Topical Products Legal?

Although the 2018 Farm Bill legalized the growing of hemp, which is used to make some CBD, confusion over CBD remains in many states. It’s best to check with your state government’s website to find out CBD’s exact status in your state.

Additionally, CBD is not currently regulated by the FDA. In September, Senate Majority Leader Mitch McConnell asked the FDA to issue temporary guidance on how it will enforce sales of CBD products. For now, the only CBD-containing product approved by the FDA is a drug for epileptic seizures in those with Lennox-Gastaut syndrome or Dravet syndrome.Play Video

A Buyer’s Guide for Topical CBD Products

If you’re looking to give a CBD salve, cream, patch or other topical product a try, here are a few tips to make sure you get a reliable, quality product. “The truth is that consumers have to be extremely vigilant when it comes to buying CBD products, especially since the industry is still largely unregulated,” Morrison says.

1. Be wary of outrageous claims. Just like makers of other health products not regulated by the FDA, CBD product makers are not allowed to say that their product will treat or cure a health problem. “If a company is brazen enough to say, ‘This will cure your cancer,’ I’d steer clear of it,” Liogier-Weyback advises.

2. Ask for a certificate of authenticity. One way to identify a reliable CBD product is by looking online or asking the company for its certificate of authenticity. This multipage document will tell you the product has been tested in a lab and will give a per-lot or per-batch breakdown of how much CBD the product contains as well as other ingredients, Liogier-Weyback says. The report should be done by an independent, third-party lab.[ 

3. Know what you want to buy in advance. If you make an impulse purchase of a CBD cream or other topical product, you may not get what you hoped. In research done with a local law firm, Liogier-Weyback and colleagues found that a third of CBD products they bought in the Miami area did not have any CBD in them. “You have instances where people are spending $150 or $200 on a small vial of canola oil,” he says.

4. Talk to your doctor in advance. It’s always a good idea to let your doctor know if you plan to try a CBD product, but it’s especially important if you have an underlying condition that requires you to take medicine daily. This is because CBD can affect other medications you use, although this is a bigger concern for ingested CBD rather than a product just used on the skin, Halpert says. In the survey from the Arthritis Foundation, 66% of respondents had talked to their doctor about CBD.

5. Read the label carefully. First, you’ll want to make sure that you aren’t allergic to the other ingredients that are part of the topical product. (There are no reports in the medical literature of CBD allergy, Liogier-Weyback says). Second, there may be other ingredient considerations that are important to you, including cruelty- and paraben-free, American-made and no GMOs, Morrison says.

6. Isolate or full spectrum? Another label note: You can find out if the CBD contained in the product is what’s called an isolate or full spectrum. “This is important because isolates typically need to be administered in significantly higher doses to be effective,” Morrison says. “On the other hand, full-spectrum CBD is generally more beneficial and more effective at much lower doses.”

7. How often? The label also can tell you how often to use the topical product, says Jay Hartenbach, CEO of Medterra CBD. His company’s customers typically use its topical products in four- to six-hour intervals.

8. Watch for side effects (not necessarily from CBD). Topical CBD products are not associated with any particular side effects. However, you could experience irritation from another ingredient in the product. “The rare side effects of CBD typically come from ingestibles, not topicals,” Morrison says. No side effects have been found from the studies done by Medterra of their topical products, Halpert says.

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