In recent years, patients’ interest in the potential benefits of medical cannabis has been on the rise. In response, a wide range of new and innovative products containing CBD have become available which include capsules, oils, topical creams, and food supplements. CBD is one of the main chemical compounds found in the Cannabis Sativa plant and is nonintoxicating. Tetrahydrocannabinol (THC), on the other hand, can produce the “high” typically associated with cannabis but is also known medically for its pain and sleep assistance capabilities. These compounds occur naturally and at varying potencies in cannabis plants, and they can be extracted and used in product development.
Because of the ability of these cannabinoids to work naturally within our body and endocannabinoid system, medical cannabis is used to help with many different conditions. Here we look to explain the potential benefits when helping to treat psoriasis with medical cannabis.
What is psoriasis?
Psoriasis is an autoimmune chronic condition that causes cells to develop rapidly on the skin. Typically, new skin cells grow monthly, but with psoriasis, new cells grow every 3 to 4 days. This overgrowth can lead to thick scaly plaques that may itch and cause discomfort. Environmental triggers can also cause the emergence of symptoms.
There are different forms of psoriasis which can include: Plaque psoriasis, inverse psoriasis, erythrodermic psoriasis, guttate psoriasis, pustular psoriasis and psoriasis arthritis.
Common symptoms often seen in psoriasis patients include:
- Itchy, raised patches of skins
- Loose, flaky scales on top of the dry patches
- Skin pain
In severe forms of psoriasis, symptoms can include edema, fluid retention, pneumonia, inflammation, joint pain, and more.
Triggers of a flare in each person are different, but the most common are:
- Stress and anxiety
- Skin injuries
- Infection
- Hormonal changes
Certain medications can also trigger a psoriasis flare, such as:
- Lithium
- Antimalarials
- Quinidine
- Indomethacin
Some external and internal factors exist that can increase the risk of developing psoriasis which includes:
- Cardiovascular disease
- Metabolic syndrome
- Trauma of the skin
- Hypertension
- Diabetes
- Infection
- Obesity
- Genetics
What is psoriatic arthritis?
Psoriatic arthritis is most common in people aged 30-50 years. This form of psoriasis causes joint inflammation with symptoms of arthritis. With this form of psoriasis, the patient develops progressive joint damage. Psoriatic arthritis affects around 15% of all individuals diagnosed with psoriasis.
While the cause is still unclear, scientists know it is an autoimmune condition. This can lead to their body instructing the immune system to target the wrong cells and produce chemicals that cause inflammation. This form of psoriasis can lead to intense pain and swelling in joints and the entheses. These areas may be warm to the touch and the skin may appear flushed. The regions often affected are the hands, fingers, feet, toes, knees, ankle and spine.
The symptoms of psoriatic arthritis include:
- Stiffness and reduced movement
- Fatigue
- Nail changes
- Swollen fingers & toes
- Lower back pain
- Red and swollen eyes
- Rashes
- Chest pain
What treatments are available for psoriasis?
The psoriasis treatment will vary depending on the type and severity of the conditions. The main options include medications, phototherapy, diet, exercise and emollients to keep the skin moisturized to help reduce the itching and irritation of plaques.
Medications often used to relieve the symptoms of mild psoriasis forms are:
- Coal tar
- Hydrocortisone cream
- Salicylic acid
Topical therapies are often the first line of treatment and are applied directly to the skin:
- Corticosteroids
- Synthetic Vitamin D
- Retinoids
- Pimecrolimus cream
- Tacrolimus ointment
Recent research has also shown that CBD and other cannabinoids applied topically may improve the symptoms of psoriasis. Different methods of application are available for medical cannabis.
How can medical cannabis help treat psoriasis?
Through both research and anecdotal results from patients, medical cannabis has shown to be an effective treatment option for many, both as a primary and secondary option.
Reducing Inflammation
A symptom of both psoriasis and psoriatic arthritis. An early 2009 study found that some cannabinoids in the cannabis plant can help regulate the immune system and reduce on-site inflammation. Another research study from 2016 suggested that some cannabinoids might benefit people with psoriasis by affecting the interaction between the immune and nervous systems. The use of medical cannabis to regulate inflammation has become more common as ongoing research studies utilize CBD as an effective anti-inflammatory.
Slowing cell growth
For those with psoriasis, the skin cells reproduce too quickly. In 2017, a study found that cannabinoids may slow the growth of skin cells and reduce their accumulation on the skin’s surface. While much more research needs to be done on the topic, cannabis has shown in preliminary studies to be effective at slowing the growth of tumours whose cells replicate rapidly.
Controlling pain
Cannabis, especially THC, can help reduce pain signalling and provide pain relief in some patients. A 2015 article in JAMA noted there is significant scientific evidence to indicate cannabinoids can help with pain. Apollo’s own published research study of over 700 chronic pain patients found both a large reduction in perceived pain and a reduction in the need for opioid use to manage said pain. For psoriasis and psoriatic arthritis patients, cannabis may help them manage their pain and discomfort.
Reducing itching
A 2017 review noted that cream containing palmitoylethanolamide (PEA), which has an incidence on cannabinoid type-1 receptors, appeared to reduce itching. More research is needed here, but positive results may be tied to the reduction in inflammation and cell growth.
Improving mental health
Psoriasis and psoriatic arthritis are chronic conditions that for now, have no known cure. With that said, it can have a negative impact on a person’s mental health. As we know, stress can be a trigger for psoriasis flare-ups as well as depression and inflammation. Medical cannabis has been shown to assist with anxiety, stress, and sleep issues in patients, and provides a great alternative to pharmaceutical options that are often more harmful to the body and include more unwanted side effects.
Licensed producers offer different types of medical cannabis products to best suit the needs of patients. Medical cannabis patients have access to products containing CBD, THC or a balanced of both depending on their needs. There are many different formats available which include cannabis oils, softgels, dissolvable powders, topical creams, dry flowers and much more. If you are interested in speaking to a healthcare professional about the use of CBD or medical cannabis, we offer free virtual/telephone appointments to all Canadians, 7 days a week.
CBD for psoriasis
A 2016 study showed that an endocannabinoid called anandamide was able to prevent the production of key inflammation signals that are known to initiate and perpetuate psoriasis in the skin and immune cells. Outcomes from a 2019 study investigating a topical CBD ointment applied to the skin lesions twice daily for two months indicated that the CBD ointment improved skin hydration and elasticity as well as quality-of-life measures that were assessed with the Psoriasis Area Severity Index.
A more recent study published at the end of 2020 examined a shampoo containing CBD that was effective at reducing the severity of scalp inflammation, itching and burning in patients with scalp psoriasis or seborrheic dermatitis. There is evidence that CBD can help improve sleep and reduce depression and anxiety.
Both an oral and topical treatment may be beneficial for patients looking to best manage their symptoms and improve their quality of life. The benefits of an oral treatment such as oil, softgel and edible, benefits last 8-12h. This could help to improve stress, inflammation, sleep and pain. In combination with a topical option, such as cream, oil, gel, or shampoo, the benefits last 8h but may improve itchiness, pain and inflammation on areas like hands, feet, knees and neck.
Can cannabis topicals help treat psoriasis?
Cannabis used topically may help with psoriasis and psoriatic arthritis to help relieve the symptoms such as itchiness, inflammation and pain. Different methods are available for patients to be used topically, alongside ingestible options. For medical use, patients can find topical creams, bath bombs, lotions, gels, oils, and lubricants infused with CBD that can be applied directly to the skin. Your health care provider, such as Apollo, can help you personalize your treatment to accommodate best your needs.
Summary
In conclusion, medical cannabis alongside the help of your health care provider may offer relief from the symptoms associated with psoriasis. Patients may find relief from pain, itchiness, inflammation, and anxiety, and improve their quality of life. Psoriasis is a chronic autoimmune illness, and you should always seek medical advice before starting a new treatment. With the right guidance, different options are available with medical cannabis to meet your needs. Contact our team of medical cannabis specialists today to learn more, book a free appointment, and gain a personalized treatment plan.
References:
https://www.medicalnewstoday.com/articles/52457
https://www.medicalnewstoday.com/articles/316757
https://www.medicalnewstoday.com/articles/320086
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/
https://pubmed.ncbi.nlm.nih.gov/27164964/
https://jamanetwork.com/journals/jama/fullarticle/2338256
https://www.psoriasis.org/advance/cbd-for-psoriasis-and-psa/