What is Acne
Acne is a type of skin condition that occurs when hair follicles become plugged with sebum, dead skin cells, and debris. Acne is most common among teenagers, although it affects people of all ages.
The most common types of acne include:
- Acne Vulgaris (common acne) includes the presence of blackheads, whiteheads, and other types of pimples on the face, chests, shoulders, and back.
- Severe Nodulocystic Acne includes multiple inflamed cysts and nodules on the face, chests, shoulders, and back, that often turn a deep red or purple, and leaving scars.
- Acne Conglobata is one of the most severe forms of acne. It involves many inflamed nodules that are connected under the skin to other nodules and can affect the neck, chest, arms, and buttocks. This type of acne is more common in men and is sometimes caused by taking steroids or testosterone.
- Acne Mechanica, sometimes called “sports-induced acne”, is caused by heat, friction, and pressure against the skin, often the result of wearing sports gear such as a helmet or baseball cap.
There are several risk factors, issues, and circumstances that can trigger or exasperate acne. These include:
- Hormones and hormonal changes like increased androgen production during puberty can cause the sebaceous glands to enlarge and make more sebum
- Certain medications like hormonal contraceptives and those including containing corticosteroids, testosterone, or lithium
- Foods including skim milk, chocolate, and carbohydrate-rich foods, such as bread, bagels, and chips may worsen acne.
- Stress is known to make acne worse, possibly due to hormonal changes.
- Age with acne being most common in teenagers.
- Genetics plays a role in acne. If both parents had acne, you’re likely to develop it, too.
- Contact with greasy or oily substances like oily lotions and creams can cause the development of acne where your skin comes into contact with them.
- Friction or pressure on your skin with items such as telephones, cellphones, helmets, tight collars, and backpacks can cause acne outbreaks.
Symptoms of Acne
Acne symptoms can vary depending on the type and severity of the condition and can include one, or any of the following:
- Blackheads are comedones with a black plug of excess oil and dead skin cells that are open at the surface of the skin Whiteheads
- Whiteheads are comedones with white puss from oil and dead skin cells just under the closed surface of the skin.
- Papules are comedones that become inflamed, forming small red or pink bumps on the skin that is sensitive to the touch.
- Pustules are another kind of inflamed pimple filled with white or yellow puss, that resembles whiteheads, but with a red ring around the bump.
- Nodules are large, inflamed bumps that develop deep within the skin, are often painful, feel firm to the touch, and are considered being a more severe form of acne.
- Cysts are large, pus-filled lesions that look similar to boils can be painful, and are also considered being a more severe form of acne.
Acne Medications & Treatments
There are several treatments available for acne, but it is a condition that can be persistent. Often, as the pimples and bumps start to heal slowly, new ones seem to crop up. And depending on its severity, acne and scarring of the skin can lead to social isolation that can cause additional issues like emotional distress, social anxiety, depression. The earlier treatment is started, the lower the risk of the patient developing these additional problems.
For more severe acne conditions, pharmaceutical interventions are
- Topical therapies include acne medications like gels or creams that are applied directly to the skin. Over-the-counter topical products that contain ingredients like benzoyl peroxide, resorcinol, salicylic acid, retinol, azelaic acid, and/or sulfur can often help mild acne. Prescription products such as antimicrobial or retinoid creams can treat mild to moderately severe acne and can be prescribed alone or in combination with other ingredients.
- Systemic therapies are acne medications that are taken by mouth and include antibiotics like tetracycline, minocycline, doxycycline, or erythromycin to treat moderate, to severe, acne by targeting bacteria and reducing inflammation. Other systemic therapies include oral contraceptives (for women) and spironolactone (anti-androgen hormone pill). In certain severe, cystic acne cases, or in cases where other treatments don’t work, isotretinoin (high-dose prescription vitamin A) is prescribed under the supervision of a dermatologist.
Certain dietary and lifestyle changes, including avoiding certain foods, regular exercise, and stress reduction, can help reduce certain milder forms of acne. In addition, although not always proven as effective, or routinely recommend, some other non-pharmaceutical treatments include:
- The use of comedone extractors (a small pen-shaped instrument) can be used to clean out blackheads and whiteheads
- Chemical peels where a chemical solution is applied to the face, causing the skin to peel off and new skin to replace it
- Photodynamic therapy where light is applied to the skin in an attempt to improve symptoms of acne
CBD for Acne
Research & Scientific Evidence
The skin contains cannabinoid receptors with which Cannabidiol (CBD) interacts to calm, smooth, and repair skin. In addition, CBD also has several properties that have the potential to help treat acne, including anti-inflammatory, anti-bacterial, and skin-balancing effects.
In 2014, an in-vitro study published in the Journal of Clinical Investigation, scientists explored the effects of topically applied CBD on human sebaceous gland function.
They found that the administration of CBD to cultured human sebocytes and human skin organ cultures inhibited the lipogenic actions of various compounds, including arachidonic acid and a combination of linoleic acid and testosterone. In addition, they found that CBD suppressed sebocyte proliferation and lipogenesis via the down-regulation of nuclear receptor interacting with protein-1 (NRIP1). The data also showed that CBD exerted complex anti-inflammatory actions.
They concluded that CBD has potential as a promising therapeutic agent for the treatment of acne vulgaris due to its combined hypostatic, antiproliferative, and anti-inflammatory effects.
In another in-vitro study published in the journal Phytotherapy Research in 2019, researchers investigated the potential effect of CBD as an anti-inflammatory agent in the skin to isolate its molecular mechanisms in human keratinocytes and fibroblasts.
The researchers applied CBD isolate suspended in an oil base of medium-chain triglycerides (MCT) to cell cultures which were treated with a pro-inflammatory stimulus for 6 or 24 hours. After 72 hours, the cell cultures were then analyzed for various pro-inflammatory mediators and markers as well as their effects on wound healing genes.
They concluded that CBD has the ability to not only down-regulate the genes involved in wound healing but also reduce skin inflammation and promote wound healing, especially in dry skin that is accompanied by cracks and wounds.
In a 2019 clinical trial, researchers investigated the therapeutic effects of a CBD-ointment on severe skin chronic diseases and its outcome on scar formation. They published their results in the journal for Clinical Therapeutics.
In a retrospective study, the researchers collected anecdotal data from 20 patients with two of the most frequent skin disorders: psoriasis (n: 5 patients) and atopic dermatitis (n: 5) that resulted in scarring (n: 10). The subjects were instructed to administer topical CBD-enriched ointment to lesioned skin areas twice daily for a total of a three-month treatment course.
The results showed that topical treatment with CBD-enriched ointment significantly improved symptoms and reduced scar formation. They also found that there were no irritant or allergic reactions during the period of treatment.
CBD as a Complementary Treatment
As mentioned, because acne being so “visible”, it can often cause social isolation that can lead to additional issues such as emotional distress, social anxiety, and depression. CBD can be an effective complementary therapy to help reduce symptoms of depression and anxiety with one particular study concluding that CBD’s anxiolytic properties and minimal adverse side effects make it a particularly good treatment option for a variety of symptoms associated with social anxiety.
Acne is a problematic and persistent skin condition that affects numerous people of all ages and genders. CBD has been shown to help treat acne and support skin health in a variety of ways, including regulating oil production, reducing inflammation, promoting wound healing, and reducing scar formation. If you are interested in using CBD for acne, speak to your treating physician or dermatologist first when using either over-the-counter and/or prescription medications. He or she can help monitor dosages, track improvements in symptom severity and scar formation while also monitoring other clinical parameters such as potential interactions with other medicines and treatments they have prescribed.