Cannabis topicals are products like lotions, salves and oils made for external use, and are most often used to treat inflammation, pain and skin conditions.When used on the skin, the effect of cannabis is localized to the area of application, unlike the widespread effect when it is eaten or smoked. Another key difference between topicals and other forms of cannabis is that topicals do not produce a mental high.
“If you have tennis elbow and your elbow hurts, you can eat a cannabis brownie and it’ll go through your digestive system and enter your bloodstream and reach all parts of your body,” explains Ramona Rubin, founder of the topical cannabis company Doc Green’s in California.
“Or you can rub lotion on your elbow where it hurts and almost instantaneously you get a localized effect—very quickly and very effectively, and without any psychoactive effect.”
Different forms of cannabis topicals have been used throughout history. In early Indian medicine, for instance, cannabis was mixed with other ingredients to make a surgical anesthetic.
According to the East West School of Planetary Herbology, other ancient examples include a Tibetan treatment for itchy skin and traditional Arabic remedies for skin ailments and hair growth.
Despite being one of the safest and easiest methods of using cannabis, topicals are also one of the lesser known and utilized.
“The prohibition mentality has shifted things,” Rubin says. “I think we’ve forgotten a lot of the common uses. So we see what we do as a big education campaign. [Topicals are] one of the first forms of cannabis people should be exposed to.”
How Do Topicals Work?
When topicals are used, the chemicals from cannabis are absorbed through the skin and garner a response from the endocannabinoid system, a biological system that helps regulate many of the body’s functions.
Cannabinoids are the chemicals that activate our endocannabinoid system. They include tetrahydrocannabinol (THC), cannabidiol (CBD), and other compounds found in the cannabis plant.
CB1 and CB2 Receptors
We have cannabinoid receptors throughout our body that receive these chemical signals.
“The body contains two main cannabinoid receptors: CB1, the psychoactive receptor that also mediates pain and many other functions, and CB2, a non-psychoactive receptor that mediates pain and inflammation,” says Ethan Russo, MD, a cannabinoid researcher and the former president of the International Cannabinoid Research Society (ICRS).
“Both are operative in the skin and affect pain, itch and inflammation associated with many dermatological conditions.”
CB1 and CB2 receptors are abundant in our skin’s epidermal cells and sensory nerves, according to a study in the Journal of Dermatological Science. They are also found on mast cells, which are linked to inflammatory and allergic responses.
When topicals are applied, cannabinoids bind to the receptors in the skin, muscle tissue and local nerves. THC binds to both CB1 and CB2 receptors in the skin, says Dr. Russo.
CBD does not work by binding to CB1 receptors, but rather by inhibiting production of the enzyme that breaks down an important endocannabinoid called anandamide, thus allowing that therapeutic neurotransmitter to flourish.
“THC and CBD work through independent mechanisms in a complementary fashion,” says Dr. Russo. “Both work well on the skin, but are poorly absorbed via this route.”
This is why topicals work differently in the body than cannabis that is eaten or inhaled, producing a targeted, localized effect on the afflicted area and not resulting in the user becoming stoned.
“The skin is a difficult barrier to broach with medications,” Dr. Russo explains. “There are layers that require a drug to be water-soluble and others that must be lipid (fat) soluble. Cannabinoids are lipophilic (fat-loving) and do not penetrate readily into the bloodstream.”
For THC to have a psychoactive effect, it needs to enter the bloodstream and pass the blood-brain barrier to reach the brain.
A study published in the journal Forensic Science International found that THC does not show up in blood or urine tests after consistent use of THC-based topical products.
Types of Cannabis Topicals
Topicals come in many forms, including body lotions, salves, balms, oils, body sprays, and transdermal gels and patches. They can be made with CBD, THC, or THCA (the non-psychoactive cannabinoid found in raw plants).
The most common types of topicals are fat-based products like oils and salves, or alcohol-based products, such as lotions and tinctures.
Heating methods, such as a process called decarboxylation, are typically used to heat and activate the THC in cannabis. However, some brands—like Doc Green’s—opt for a raw, heat-free extraction method.
Doc Green’s Healing Cream uses an ethanol, pure alcohol extraction. Its CannaBalm, which is about five times as potent, is made from a CO2 concentrate.
“Carbon dioxide is a gas in the air at normal temperatures and pressures, and when it’s warmed and pressurized it goes from a gas state to something more like a liquid state,” Rubin says of the process.
In this “supercritical CO2 state,” it acts as a solvent on the cannabis—passing through the plant material, dissolving the cannabinoids, terpenes, resinous compounds, polyphenols, and more, before passing into another chamber where the CO2 is restored to a gas form.
“You’re leaving behind the chlorophyll, the ligands, and the plant structural elements, and getting a very pure, very clean, concentrated resin of the cannabis medicine,” explains Rubin.
Another benefit of using raw THCA is that there is no cannabis smell in the end product.
The topicals market is expanding, and Doc Green’s is joined by popular brands including Colorado’s Mary’s Medicinals, which is best known for its transdermal patches and transdermal gel pens that offer a slow, constant release of cannabinoids.
The company offers CBD and CBN-based products which are non-psychoactive. The THC versions of these products, on the other hand, do have a psychoactive effect.
Although topicals are non-psychotropic, they are still largely treated like other cannabis products under the law. As such, availability and legal status depend on the laws in the state/country in which they are being sold.
Legalization in the U.S. would likely boost the use of topicals. In a survey, 79 percent of American Herbal Guild members said they would use cannabis clinically if federal law didn’t prohibit it.
Benefits and Uses of Topicals
Alicia Rose, with HerbaBuena, says the company has found THC to be most helpful for pain relief and THCA for fighting inflammation.
During the decarboxylating process, THCA becomes THC. Rubin, with Doc Green’s, explains that THCA products are still medicinally active, even though they are not psychoactive.
“They are so amazingly versatile,” Rubin says, adding that customers use Doc Green’s for treating injuries, aches, pains, cramps, spasms, sore muscles, headaches, insect bites and stings, pain from gout, menstrual cramps, and more.
Research on the efficacy and mechanization of topicals is lacking due to cannabis’s classification as a Schedule 1 drug in the United States and its status as only medicinally legal in Canada.
While a spike in this research in recent years has demonstrated the promising health potential of topical cannabis, there is still, in Rubin’s words, “a real need for more research and understanding.”
Studies on Cannabis Topicals
Existing research has focused on their potential for treating inflammation, pain and uncomfortable skin conditions (such as psoriasis and dermatitis).
A study on THC’s use for allergic inflammation out of the University of Bonn’s Department of Dermatology and Allergy concluded that cannabinoids should be “harnessed …for the treatment of inflammatory skin diseases.”
A 2009 study published in the journal Experimental Dermatology found that cannabinoids “seem to have immunosuppressive properties and could be considered as potential anti-inflammatory drugs.”
Additionally, the researchers concluded that topically administered cannabis has potential for its antipruritic (anti-itching) effect and pain relief.
“On the basis of the current knowledge, therapeutic possibilities of cannabinoid usage in skin diseases seem to be unquestionable,” wrote the study’s authors. “Possibly, in the future, cannabinoids will be widely applied to treat pruritus, inflammatory skin diseases and even skin cancers.”
According to the organization Americans for Safe Access, in addition to pain relief and reducing inflammation, “anecdotal reports on topical treatment efficacy” include superficial wounds, herpes, hemorrhoids, menstrual pains, migraine pain and more.
For links to additional studies, see MJCreams.ca’s list.
How To Use Cannabis Topicals
Topicals should be used as directed on a product-by-product basis, but, generally, they can be used liberally and often because there is no risk of overuse or abuse.
Doc Green’s recommends new users start with a small fingertip of its Healing Cream to gauge how much they need.
The effects last one to four hours, but Rubin says it can be reapplied as much as needed thanks to “a complete lack of side effects”—unless you count “very soft skin” as a side effect.
Since every person’s endocannabinoid system is unique, reactions may vary.
“Each person has an endocannabinoid tone that is a function of the number of cannabinoid receptors, levels of endocannabinoids, and prior experience with cannabinoids drugs, if any,” explains Dr. Russo, the researcher and former ICRS president. “On the skin, they may also have different reactions.”
Many cannabis lotions, oils and balms are made with a variety of other essential oils and ingredients. With this in mind, people with allergies and sensitive skin should take caution when trying a new topical.
Additionally, people with sensitivity or allergic reactions to airborne plant pollens may develop hives or itchy skin from contact with cannabis. Individuals who cannot use alcohol-containing products should avoid those made with pure alcohol extracts.
For everyone else, Rubin says the most important directive for using topicals is to remember to use them. Rose, of HerbaBuena, gives similar advice: “Use them liberally when and where it hurts.”
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