Do CBD Products Belong in Therapeutic Dermatology?

CBD, an abbreviation for cannabidiol, is showing up everywhere in skin care products. In 2025, the CBD skin care market is expected to hit $1.7 billion, which is more than the annual sales of most prescription dermatology drugs. Are patients spending their money wisely on CBD products or wasting valuable resources?

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What is CBD?

Cannabidiol is a compound naturally found in the Cannabis sativa plant, whose family includes hemp plants and marijuana. Hemp plants contain abundant CBD and almost no THC, or delta-9-tetrahydrocannabinol, which is the psychoactive drug in marijuana. For this reason, most CBD is derived from industrial hemp plants.

Are CBD skin care products legal?

Yes, CBD products are legal. In 2018, the Farm Bill that was passed removed hemp from the legal definition of marijuana.¹ This made hemp-based CBD products with less than 0.3% THC federally legal. CBD products with more than 0.3% THC may be federally illegal, but they are legal under some state laws; however, the federal government does not habitually enforce the law against these products.

Is hemp seed oil the same as CBD oil?

No, hemp seed oil is not the same as CBD. CBD oil is extracted from the leaves and flowers of the hemp plant, but hemp oil is extracted from the seeds of the Cannabis sativa plant. CBD oil is lighter than hemp seed oil, which is much greasier.

How can patients find safe CBD skin care products?

Finding safe CBD products can be challenging as most are manufactured by small companies. The following recommendations might help patients avoid CBD issues:

• Look for company testing that verifies the products contain no more than 0.3% THC.
• Be sure the products have third-party testing performed for potency and safety.
• Look for certificates of analysis that indicate tests were passed for heavy metals, microbes, and pesticides.
• Ensure the manufacturing company has not received a warning letter from the FDA.

What terminology is used to describe CBD skin care products?

Several essential industry terms are used to describe CBD products to the consumer. Those that dermatologists should understand are listed below:

• Isolate: CBD isolate products contain a purified crystal CBD precipitate with no THC.
• Broad-spectrum: This means the THC has been reduced to the lowest possible amount. CBD products labeled broad-spectrum are likely to meet state requirements and can cross state lines without difficulty. These products contain a range of cannabinoids, terpenes, and flavonoids derived from hemp without THC.
• Full-spectrum: This wording means the extracts in the skin care product contain mostly CBD but can include other cannabinoids such as THC, but only at levels of 1% or less. THC in this concentration is not thought to be psychoactive.

What are the dermatologic benefits of CBD?

It is amazing to think that the human body contains a highly conserved network of endocannabinoid molecular signaling that is important in bodily homeostasis. Endocannabinoid dysregulation is thought to lead to atopic dermatitis, itch, pigmentation, hair growth, and acne. Cannabinoid 2 receptors are found in keratinocytes, nerves, melanocytes, eccrine glands, and hair follicles. The main benefits of CBD are purported to include the following:

• Sebum regulation: CBD may decrease sebum production and improve acne due to an anti-inflammatory effect on sebocytes.
• Anti-inflammatory: CBD may reduce redness in eczema and psoriasis due to anti-inflammatory effects.
• Skin hydration: CBD is an oil and may be an occlusive moisturizer, improving skin hydration.

However, CBD is difficult to deliver into the skin due to its molecular weight (314.46 Da), and much of topically applied CBD may reside on the skin surface unless a carrier system is utilized.

Zoe Diana Draelos, MD, is a consulting professor of dermatology at Duke University School of Medicine in Durham, North Carolina, and Dermatology Times’ editor in chief emeritus.

Reference

1. US Congress passes the Farm Bill and removes restrictions on hemp. Covington. December 13, 2018. Accessed February 3, 2025. https://www.cov.com/-/media/files/corporate/publications/2018/12/us_congress_passes_the_farm_bill_and_removes_restrictions_on_hemp.pdf