INTRODUCTION
Cannabidiol (CBD), a non-psychostimulatory compound from Cannabis sativa, has gained increasing attention in dermatology over the past decade.1 Despite its growing popularity and clinical evidence for dermatologic applications, CBD-containing topical products have struggled to gain retailer acceptance.2 This review aims to provide an update on the clinical applications of CBD in dermatology and to discuss barriers that restrict its marketability.
Background
CBD primarily acts on G-protein-coupled cannabinoid receptors CB1 (CB1R) and CB2 (CB2R), found on cutaneous nerves, mast cells, and keratinocytes.3 When activated, these receptors initiate an intracellular cascade that modulates an immune response, most notably, enhancing adenosine A2A receptor activity, which downregulates immune cells and reduces inflammation.3
Existing literature has supported CBD’s role in the treatment of acne vulgaris, chronic pruritus, asteatotic eczema (AE), and atopic dermatitis (AD). For instance, Olah et al demonstrated CBD’s role in acne vulgaris management by demonstrating its inhibition of sebocyte lipogenesis and NF-κB-driven inflammation in vitro.3 Additionally, a small split-face trial revealed that topical 3% cannabis seed extract reduced sebum production and erythema over a 12- week study period.3 Other studies focused on CBD’s role in AE and AD primarily due to its antipruritic properties.3 It is postulated that these effects result from the inhibition of inflammatory mediators via NF-κB attenuation and the modulation of peripheral nerve function. Current literature supports CB1Rs’ role in reducing inflammation, but further investigation is warranted.3
Recent literature has focused on the antioxidant, UV-protective, and wound-healing properties of CBD, as well as the application of nanoformulated CBD products. We herein provide an update on the application of CBD in these recently studied areas and discuss the hurdles to promoting and accessing CBD-based skincare.
Antioxidant and UV-Protective Effects
CBD’s antioxidant properties have further enhanced its public appeal and application in skincare. Antioxidants protect the skin from oxidative stress, which causes premature aging and environmental damage.4 Studies have demonstrated that CBD activates regulators of the cellular antioxidant response, such as nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase 1, and peroxisome proliferator-activated receptor gamma.4,6 Nrf2 reduces UV-induced cell death in keratinocytes and melanocytes, decreases reactive oxygen species (ROS), and enhances the levels of antioxidants, vitamins A and E.4
In 2024, the first human clinical trial demonstrated the UVprotective properties of topical nanoformulated CBD, providing evidence that supports CBD’s potential to mitigate damage from photocarcinogenesis, inflammation, and oxidative stress.6 Among nineteen participants, the trial identified a significant reduction in observed erythema, histologic epidermal hyperplasia, and nuclear and mitochondrial DNA mutations on CBD-treated skin compared to vehicle cream after UV-A irradiation.6
Wound Healing/Surgical Application
Kong et al. present recent evidence supporting CBD’s role in wound healing and highlight its potential benefits in post-surgical recovery and the management of chronic wounds.7 CBD influences fibrinogenesis, re-epithelialization, and inflammation modulation.7 In murine models, CB2 receptor expression during wound healing suggests an intrinsic role for the endocannabinoid system in skin repair.7
Case reports in patients with epidermolysis bullosa reveal accelerated wound closure, decreased blister formation, and reduced pain with topical CBD, further highlighting its regenerative and analgesic potential in dermatologic surgery.7
Nanoformulated Delivery Systems
To enhance topical efficacy, advanced formulations are exploring the encapsulation of CBD within nanoparticles, such as lipid nanoparticles and nanomicelles. These delivery systems improve dermal penetration, provide sustained release, and enhance bioavailability.1
Nanoformulated CBD has shown promise in treating acne, psoriasis, and eczema, with studies demonstrating improved absorption, decreased inflammation, and enhanced patient compliance.1
A 2025 analysis of sixteen studies from 2014 to 2019 identified improved skin delivery, tolerability, and sustained release in nanoformulated CBD compared to traditional formulations.1
Background
CBD primarily acts on G-protein-coupled cannabinoid receptors CB1 (CB1R) and CB2 (CB2R), found on cutaneous nerves, mast cells, and keratinocytes.3 When activated, these receptors initiate an intracellular cascade that modulates an immune response, most notably, enhancing adenosine A2A receptor activity, which downregulates immune cells and reduces inflammation.3
Existing literature has supported CBD’s role in the treatment of acne vulgaris, chronic pruritus, asteatotic eczema (AE), and atopic dermatitis (AD). For instance, Olah et al demonstrated CBD’s role in acne vulgaris management by demonstrating its inhibition of sebocyte lipogenesis and NF-κB-driven inflammation in vitro.3 Additionally, a small split-face trial revealed that topical 3% cannabis seed extract reduced sebum production and erythema over a 12- week study period.3 Other studies focused on CBD’s role in AE and AD primarily due to its antipruritic properties.3 It is postulated that these effects result from the inhibition of inflammatory mediators via NF-κB attenuation and the modulation of peripheral nerve function. Current literature supports CB1Rs’ role in reducing inflammation, but further investigation is warranted.3
Recent literature has focused on the antioxidant, UV-protective, and wound-healing properties of CBD, as well as the application of nanoformulated CBD products. We herein provide an update on the application of CBD in these recently studied areas and discuss the hurdles to promoting and accessing CBD-based skincare.
Antioxidant and UV-Protective Effects
CBD’s antioxidant properties have further enhanced its public appeal and application in skincare. Antioxidants protect the skin from oxidative stress, which causes premature aging and environmental damage.4 Studies have demonstrated that CBD activates regulators of the cellular antioxidant response, such as nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase 1, and peroxisome proliferator-activated receptor gamma.4,6 Nrf2 reduces UV-induced cell death in keratinocytes and melanocytes, decreases reactive oxygen species (ROS), and enhances the levels of antioxidants, vitamins A and E.4
In 2024, the first human clinical trial demonstrated the UVprotective properties of topical nanoformulated CBD, providing evidence that supports CBD’s potential to mitigate damage from photocarcinogenesis, inflammation, and oxidative stress.6 Among nineteen participants, the trial identified a significant reduction in observed erythema, histologic epidermal hyperplasia, and nuclear and mitochondrial DNA mutations on CBD-treated skin compared to vehicle cream after UV-A irradiation.6
Wound Healing/Surgical Application
Kong et al. present recent evidence supporting CBD’s role in wound healing and highlight its potential benefits in post-surgical recovery and the management of chronic wounds.7 CBD influences fibrinogenesis, re-epithelialization, and inflammation modulation.7 In murine models, CB2 receptor expression during wound healing suggests an intrinsic role for the endocannabinoid system in skin repair.7
Case reports in patients with epidermolysis bullosa reveal accelerated wound closure, decreased blister formation, and reduced pain with topical CBD, further highlighting its regenerative and analgesic potential in dermatologic surgery.7
Nanoformulated Delivery Systems
To enhance topical efficacy, advanced formulations are exploring the encapsulation of CBD within nanoparticles, such as lipid nanoparticles and nanomicelles. These delivery systems improve dermal penetration, provide sustained release, and enhance bioavailability.1
Nanoformulated CBD has shown promise in treating acne, psoriasis, and eczema, with studies demonstrating improved absorption, decreased inflammation, and enhanced patient compliance.1
A 2025 analysis of sixteen studies from 2014 to 2019 identified improved skin delivery, tolerability, and sustained release in nanoformulated CBD compared to traditional formulations.1
